【Abstract】Objective To investigate the change of vascular endothelial growth factor (VEGF) expression in HepG2 cells under hypoxia. Methods HepG2 cells were cultured under hypoxia（hypoxia group） and normal condition (control group). VEGF expression of HepG2 cells was examined by immunohistochemical staining. The growth of HepG2 cells was examined by MTT colorimetry and cell count. VEGF level in the culture medium was measured by ELISA.Results After 48 h and 72 h of culture, the growth rate of HepG2 cells in hypoxia group was lower than that in control group (P＜0.05). The cell count in hypoxia group (2.51×104/μl and 2.69×104/μl, respectively) was much lower than that in control group(3.01×104/μl and 3.52×104/μl) after 48h and 72h of culture (P＜0.05). In hypoxia group, VEGF level in the culture medium after 24 h and 48 h was higher than that in control group (P＜0.05, P＜0.01). Conclusion Hypoxia may enhance the VEGF expression in HepG2 cells and this could be the reason of high expression of VEGF after transcatheterized hepatic arterial chemoembolization.
ObjectiveTo investigate the significance of apparent diffusion coefficient (ADC value) for pretrea-tment prediction of short-term treatment effect in patients with hepatocellular carcinoma (HCC) who underwent transca-theter arterial chemoembolization (TACE). MethodsA total of twelve HCC patients with twenty-three HCC lesions who underwent TACE in our hospital from May. 2014 to May. 2015 were enrolled prospectively, to explore the difference between pre-and post-TACE in diameter of tumor, ADC value of HCC lesions, ADC value of liver parenchyma, and analyze the predictive significance of ADC value of HCC lesions for TACE in treatment of HCC. ResultsThere were no statistical difference between pre-and post-TACE in diameter of HCC lesions and ADC value of liver parenchyma (P=0.635, P=0.473), but the ADC value of HCC lesions was higher after TACE than pre-TACE (P=0.003). After TACE, the area of necrosis in HCC lesions was≥50% in 17 lesions (73.9%, good effect group), and <50% in 6 lesions (26.1%, poor effect group). Compared with poor effect group, ADC values of HCC lesions in good effect group were both higher before and after TACE (P<0.050). Area under ROC curve (AUC value) of ADC value in HCC lesions before TACE for predicting the effect of TACE was 0.690 (95% CI:0.510-0.879), with the sensitivity and specificity of 82.3% (95% CI:65.5%-93.2%) and 53.8% (95% CI:25.1%-80.8%) respectively, and the demarcation point for good effect and poor effect was 1.24×103 mm2/s. ConclusionThis preliminary study demonstrates that the ADC value of HCC lesions before TACE may be a useful indicator to predict early response of TACE in treatment of HCC.
目的 应用联合微创介入方法治疗中晚期肝癌并探讨其疗效。方法 我院自1998年4月至2008年11月期间采用联合介入治疗的方法，即行经皮股动脉插管肝动脉化疗栓塞术，同期行B超引导下经皮穿刺瘤内乙醇注射(PEI)治疗中晚期肝癌175例。结果 左肝动脉行肝动脉化疗栓塞7例，右肝动脉行125例，单行化疗而未栓塞43例； 175例均行B超引导下PEI。随访6～28个月，平均19.3个月，死亡15例，其中8例死于肝功能衰竭，7例死于上消化道大出血伴肝癌广泛转移。29例存活6～12个月； 146例存活13～28个月，其中27例存活已超过26个月。结论 对于不能切除的中晚期肝癌采用联合介入治疗，因其具有操作简单、疗效可靠、经济、安全等优点，值得临床推广应用。
【Abstract】ObjectiveTo study the effect of preoperative gastric arterial chemoembolization on apoptosis of lymph node metastasis of gastric cancer. MethodsForty patients with gastric cancer and lymph node metastasis underwent curative resection, among which there were 20 patients who received the preoperative gastric arterial chemoembolization, and they constituted the treatment group. The rest of the patients were included in the control group. The expressions of p53, CD95 and bcl-2 were examined by immunohistochemistry and apoptosis in the lymph node metastasis was examined by in situ terminal transferasemediated dUTP nick end labeling （TUNEL）. ResultsThe expression intensity of p53 and CD95 in lymph node metastasis of treatment group increased more significantly than that of control group, whereas the expression intensity of bcl-2 decreased in treatment group. There was a significantly positive correlation between the expressions of p53 and CD95 and the apoptosis.ConclusionPreoperative gastric arterial chemoembolization may affect the expressions of p53, CD95 and bcl-2 and may induce the apoptosis of lymph node metastasis. It may be helpful to improve the effect of curative resection of gastric cancer.
Objective To evaluate the clinical efficacy and safety of transcatheter arterial chemoembolization (TACE) combined with thermotherapy for primary hepatic carcinoma (PHC), and to provide references for clinical practice and research. Methods The following databases as The Cochrane Library, PubMed, EMbase, CBM, CNKI, VIP and WanFang Data were searched electronically, and the other sources as supplying, such as tracing related references, were also retrieved. Besides, some unknown information was also obtained by communicating with other authors. All randomized controlled trials (RCTs) on TACE combined with thermotherapy versus TACE alone were collected. The literature was screened according to inclusive criteria, data were extracted and the quality of included studies was assessed, and then meta-analysis was conducted using RevMan 5.1 software. Results A total of 17 RCTs with 907 patients were included. Meta-analysis showed that compared with TACE alone, TACE combined with thermotherapy had a significant difference in 1-year survival rate (HR=2.40, 95%CI 1.65 to 3.48, Plt;0.000 01), 2-year survival rate (HR=3.28, 95%CI 1.87 to 5.76, Plt;0.000 1), total effective rate (RR=1.59, 95%CI 1.42 to 1.79, Plt;0.000 1) and improvement rate of life quality (RR=1.79, 95%CI 1.42 to 2.25, Plt;0.000 1). The incidences of myelosuppression and alimentary canal reactions were lower in TACE combined with thermotherapy group than those in TACE alone group, but statistically significance was only found in myelosuppression (RR=0.79, 95%CI 0.69 to 0.92, P=0.001). Conclusion Compared with TACE alone, TACE combined with thermotherapy can improve long-term survival rate and short-term curative effect, ameliorate the quality of life, and tend to reduce the incidence rate of side effects. But its long-term curative effect and more comprehensive safety still needs to be further verified by more large sample and high quality RCTs.
Objective To investigate the growth of tumors and the natural life length of the rats after the adriamycinethylcellulose microspheres(ADM-EC mc) were injected in the rats bearing transplantable liver cancer through their hepatic arteries.Methods ADM-EC mc were infused into the proper hepatic arteries of the Wistar rats (W256). All of the rats were divided randomly into five groups, group 1: control, group 2: normal saline, group 3: conventional ADM, group 4: placebo ethylcellulose microspheres, and group 5: ADM-EC mc. Results As compared with other four groups, the ADM-EC mc (group 5) showed the best inhibition of the growth of tumors and the longest mean life length of the rats. Conclusion Hepatic arterial infusion of ADM-EC mc can inhibit the growth of the tumor, aggravate the necrosis, and improve the effects of the chemotherapy of liver cancer.
Objective To evaluate the efficacy and safety of transcatheter arterial chemoembolization (TACE) combined with transurethral resection of bladder tumor (TURBT) for muscle-invasive bladder cancer (MIBC). Methods China National Knowledge Infrastructure, Chongqing VIP, Wanfang, SinoMed, PubMed, Web of Science, and Cochrane Library were searched from the establishment of databases until December 2023. All randomized controlled trials of TACE combined with TURBT for MIBC were collected and subjected to meta-analysis using RevMan 5.4 software. Results A total of 7 studies were included, involving 490 patients, with 246 in the TACE+TURBT group and 244 in the TURBT group. The meta-analysis results showed that compared with TURBT, TACE+TURBT had certain advantages in reducing recurrence rate [relative risk (RR)=0.49, 95% confidence interval (CI) (0.35, 0.68)], improving survival rate [RR=1.16, 95%CI (1.07, 1.27)], shortening surgical time [standardized mean difference (SMD)=−4.97, 95%CI (−7.54, −2.40)], reducing intraoperative bleeding [SMD=−4.19, 95%CI (−5.78, −2.60)], and improving quality of life [SMD=4.51, 95%CI (2.15, 6.86)]. The adverse reactions of the two groups were similar. Conclusions Existing evidence suggests that TACE may reduce intraoperative bleeding and shorten surgical time to help achieve maximum TURBT. TACE combined with TURBT may be superior to simple TURBT in terms of tumor recurrence rate and survival rate. TACE combined with TURBT can benefit MIBC patients in bladder-preserving treatment plans.
【摘要】 目的 探讨中晚期宫颈癌术前动脉灌注化疗栓塞的临床价值。 方法 选择2005年6月-2009年12月35例经阴道镜活检确诊为宫颈癌临床分期Ⅱa~Ⅲb期宫颈癌患者，术前行1次子宫动脉化疗栓塞，化疗药物为博莱霉素（BLM）+顺铂（DDP）+环磷酰胺（CTX），栓塞剂为超液化碘油加明胶海绵颗粒。介入治疗后14~20 d行子宫全切加淋巴结清扫术。观察动脉灌注化疗栓塞前后肿块的大小变化、术中肿块粘连状况及出血量的多少。 结果 经介入治疗后肿块缩小32例：完全缓解（CR）3例、部分缓解（PR）29例，肿块无变化（NC）2例，进展（PD）1例，治疗有效率为91.4%。31例选择了手术治疗，手术率为88.6%。术中肿块粘连状况：无粘连24例，轻度粘连6例，中度粘连1例。术中出血量：≤100 mL 7例，100~200 mL 18例，200~400 mL 6例。 结论 中晚期宫颈癌术前动脉灌注化疗栓塞能有效地提高肿瘤切除率，降低手术风险。【Abstract】 Objective To evaluate the clinical value of preoperative transarterial chemoembolization for advanced cervical cancer. Methods A total of 35 patients with pathologically proved cervical cancer (from stage Ⅱa to Ⅲb) from June 2005 to December 2009 received preoperative transarterial chemoembolization once. Bleomycin, cisplantin and cytoxan were infused via bilateral uterine arteries, followed by arterial emboliezation with super-liquefaction iodipin and gel foam particles as embolic agent. Radical surgery was performed on the patients after 14-20 days. Volume change of mass, accretion state and haemorrhagia amount during the operation were analyzed. Results The masses deflated in 32 cases: complete response (CR) in 3, and partial response (PR) in 29. No change (NC) was seen in 3 cases. The effective rate was 91.4%. In 31 cases who underwent the operation, the operability was 88.6%, in whom non-accretionin was in 24, light accretion was in 6 and medium accretion was in 1. Haemorrhagia amount was less than 100 mL in 11 cases, 100-200 mL in 21cases, and 200-1 400 mL in 3 cases. Conclusion Preoperative chemoembolization can elevate exairesis rate and depress the operative risk effectively.