Objective To explore the expression and function of NDRG2 gene in human primary hepatocellular carcinoma and normal hepatic tissues. Methods The immunohistochemical ABC method， Western blot， and Real-time PCR were used to investigate the expression and content of NDRG2 in human hepatocellular carcinoma and hepatic normal biopsies. Results The NDRG2 protein located in cytoplasm. The positive rate was 16.67%（5/30） and 100%（30/30） in hepatocellular carcinoma and normal hepatic tissues, respectively. The relative content of NDRG2 protein in hepatocellular carcinoma and normal hepatic tissues were 0.029 0±0.005 9 and 0.109 2±0.002 8. There were significant differences between human hepatocellular carcinoma and hepatic normal biopsies both in staining positive rates and relative content（P＜0.05）. The Western blot also agreed with the result，the expression level of NDRG2 protein in hepatocellular carcinoma and normal hepatic tissues was 1.13±0.15 and 1.57±0.18， respectively, there was significant difference（P＜0.05）. Also, compared with normal hepatic tissues, the expression level of NDRG2 mRNA in carcinoma tissues was reduced significantly (0.89±0.15 vs. 1.48±0.17, P＜0.05). However, there were no significant differences in NDRG2mRNA expression between Edmondson-Steiner grades. Conclusions There possibly have difference in NDRG2 expression between human primary hepatocellular carcinoma and normal hepatic tissue. NDRG2 gene may take part in the pathogenesis of human primary hepatocellular carcinoma. Futher study will be needed to study its mechanism and function.
Primary hepatocellular carcinoma is a common cancer. Many patients are found with intermediate-advanced stage, rapid development, poor treatment and high mortality. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) can discover the early lesions and therefore plays an important role in diagnosis, treatment and prognosis of patients with hepatocellular carcinoma. It especially has obvious advantages in detecting metastasis and monitoring recurrence. However, 18F-FDG PET/CT imaging has poor quality and low diagnosis rate. Understanding the advantages and limitations of 18F-FDG PET/CT can provide better basis for clinical diagnosis and treatment for hepatocellular carcinoma patients. This article briefly introduces the research and application of 18F-FDG PET/CT in the diagnosis and treatment of hepatocellular carcinoma.
Objective To explore the opportunity of surgery after transarterial chemoembolization therapy for patient with primary hepatocellular carcinoma in Barcelona Clinic Liver Cancer (BCLC) B stage. Methods Multi- disciplinary team (MDT) carried out for a BCLC B stage patient in October 2017 in the Second Affiliated Hospital of Chongqing Medical University. The patient diagnosed with massive primary hepatocellular carcinoma in right lobe of the liver accompanied by para-tumor satellite nodules and metastatic nodules in quadrate lobe (BCLC B stage) in 2 months ago and received twice TACE therapies in the first 2 months. The MDT group developed anterior approach in right hepatectomy and tumor enucleation in the left medial segment. Results The experts group of MDT agreed on the patient undergone twice TACE therapies, whose tumor in right lobe had shrinked and left lobe enlarged, and the patient acquired the opportunity for surgery. By elaborately devised perioperative care and surgery risk control, the patient undergone operation successfully and recovered without any operative complications. Conclusions A proportion of BCLC B stage patients with hepatocellular carcinoma can acquire the opportunity of a second stage operation for removal of the tumor. We should manage this portion of patients well and strive for the best therapeutic effect.
ObjectiveThe present study was to investigate the value of multi-disciplinary team (MDT) model in patient with primary giant liver cancer.MethodsThe MDT model was carried out for a BCLC B stage patient who admitted in the Second Affiliated Hospital of Chongqing Medical University in July 2018. The associated references were reviewed and the treatment methods were discussed about primary giant liver cancer.ResultsAn elder man who was diagnosed as primary hepatocellular carcinoma (minor cancer) in right lobe of the liver in three years ago and took Chinese medicine orally. When the patient subsequent visited this time, the liver cancer increased about 10 cm. After discussed by MDT, the treatment method was draw up to transarterial chemoembolization (TACE) plus surgery. After received twice TACE therapies in the later 14 weeks, the tumor in right lobe had significantly shrinked and left lobe enlarged. The patient underwent laparoscopic right liver hepatectomy after the second MDT discussion in 5 months later. The patient underwent operation successfully. The operation lasted for 270 minutes, and the intraoperative blood loss was about 500 mL. The suspended red blood cells (400 mL) was infused. The patient underwent transient liver failure and recovered through hepatoprotective and symptomatic supportive treatment, and discharged on 12 days after operation. A retrospective examination of abdominal CT at 4 months postoperatively revealed a significant hyperplasia of the left lobe of the liver, and there was no sign of recurrent tumor. The patient was continue to followed up.ConclusionsThepatient with primary giant hepatocellular carcinoma who cannot underwent surgery at the first time can received TACE, and a few patients could be underwent radical operation later. MDT should be applied flexibly in the treatment of patients with huge hepatocellular carcinoma from beginning to end, so the best treatment plan should be carried out for patients.
ObjectiveTo compare the efficacy and safety of three different modes of blood flow blocking in hepatectomy for primary hepatocellular carcinoma.MethodsThe clinical data of 152 patients with primary hepatocellular carcinoma who underwent hepatectomy and postoperative pathology examination in our department in recent 3 years (2017–2020) were retrospectively analyzed. According to the modes of intraoperative hepatic blood flow occlusion, the patients were divided into three groups: intermittent Pringle method (IPM) group (41 cases), IPM was applied only; hemihepatic group (35 cases), hemihepatic blood flow blocking method was used only; and combined group (76 cases), combined hemihepatic blood flow blocking method and IPM. SPSS software was used to compare the differences of the three groups’ general data, intraoperative blood loss and postoperative liver function indexes. The changes of transaminase levels in the three groups were observed dynamically.ResultsBaseline data of the three groups were not statistically significant (P>0.05). There were no statistically significant differences in operative time, the number of resected liver segments, blood transfusion rate, incidence of complications, and postoperative length of stay among the three groups (all P>0.05). The intraoperative blood loss of the combined group and the IPM group were significantly less than that of the hemihepatic group (P<0.05). There was no difference in blood loss between the combined group and the IPM group (P>0.05). However, the blocking times in the combined group were significantly less than those in the IPM group (P<0.05). The transaminases in the three groups were close to the preoperative level on the fifth day after operation. Conclusions In hepatectomy of primary hepatocellular carcinoma, the three blocking modes are safe and effective. The combined application of hemihepatic blood flow blocking method and intermittent Pringle method can significantly reduce intraoperative blood loss, reduce the number of blocking, and do not aggravate the liver function injury.