Liver cancer is one of the world’s most prevalent malignancies, and is also the third leading cause of cancer death in China. Hepatitis and cirrhosis background is a major feature of liver cancer patients in China, which makes specific requirements that suits the national conditions in many aspects of prevention and control like screening diagnosis, treatment options, and prognosis follow-up. The Specifications for Diagnosis and Treatment of Primary Liver Cancer (2017 Edition), which is based on China’s practice, proposes liver cancer staging in line with China’s national conditions and forms a multi-disciplinary joint diagnosis and treatment model based on surgical treatment. Liver transplantation is included in liver cancer as one of the surgical treatments option. It also emphasizes the support of evidence-based medicine. The Specifications for Diagnosis and Treatment of Primary Liver Cancer (2017 Edition) may have laid a solid foundation for future diagnosis and treatment of liver cancer in China.
Objective To explore the changes and interrelationship of serum interleukin-12 (IL-12) and T lymphocyte subset in patients with primary hepatic carcinoma (PHC). Methods Serum IL-12 level was determined by ELISA in 36 patients with PHC. The peripheral blood T lymphocyte subset was assessed with flow cytometry. The distribution and changes of T lymphocyte subset in the tumor tissue were detected by immunohistochemistry analysis. Results The numbers of the CD＋4 T cell were reduced and of the CD＋8 T cell increased either in peripheral blood or tumor tissue, and showed the trend of the ratio (T4/T8) declined progressively with the aggravation of the state with PHC. IL-12 and T4/T8 had significant interrelationship.Conclusion IL-12 is an important antitumor factor of the patients with PHC. T lymphocyte subset plays a great role in the process of antitumor.
“Chinese Guideline for Diagnosis and Treatment of Primary Liver Cancer （version-2022）” （China Liver Cancer Staging, Abbreviation “CNLC 2022”） was updated recently and the “Barcelona Clinical Liver Cancer Strategy for Prognosis Prediction and Treatment Recommendation: The 2022 update” （Abbreviation “BCLC 2022”） was also updated in December 2021. The similarities and differences of the two guidelines were interpreted. For the BCLC stage B and C, which are equivalent to CNLC stage Ⅱa and Ⅱb and CNLC stage Ⅲa, respectively, the recommendation of surgical treatment and radiation therapy are disparate in the CNLC 2022 and BCLC 2022. For the systematic treatment of advanced liver cancer, Atezolizumab-Bevacizumab, Renvatinib and Sorafenib were both recommended as the first-line medication in the two guidelines. However, the CNLC 2022 is more flexible than BCLC 2022, which provides more treatment options for Chinese liver cancer patients. It is worth paying attention to two important new concepts proposed in the BCLC 2022: stage migration during treatment and untreatable progression. The BCLC stage B was divided into three subgroups according to tumor burden and liver function and different clinical pathways were recommended in the BCLC 2022.
【Abstract】ObjectiveTo investigate the expressions of aromatase (Arom) and survivin (Surv) in primary hepatocarcinoma(PHC), and explore their relationships with the clinicopathology of PHC. MethodsThe specimens from 47 patients with PHC were fixed in 10% formalin and routinely embedded in paraffin. The specimens were continuously sliced into 4 μmthick sections. ABC immunohistochemistry was performed to detect the expressions of Arom and Surv with polyclonal antibodies and scored them under highpower microscopy. Results The positive rates and the scores of Arom and Surv in cancer tissues were significantly higher than those of the paratumor tissues 〔Arom: 40.43% vs 21.28% (P＜0.05), 1.53±1.69 vs 0.79±1.41 (P＜0.05); Surv: 63.83% vs 31.91% (P＜0.01), 2.40±1.96 vs 1.45±1.80 (P＜0.05)〕. The score of Surv in tumors with the maximal diameter ＜5 cm (4.00±2.10) was significantly higher than that in tumors with the maximal diameter ≥5 cm (2.17±1.86)， P＜0.05. However, there was no relationship between the expressions of Arom and Surv in PHCs and other clinicopathologic features of the PHCs. The positive correlation was found between the score of Arom and that of Surv in PHCs （r=0.316，P＜0.05）. ConclusionThe expressions of Arom and Surv might be closely related to the carcinogenesis and development of PHC.
ObjectiveTo introduce the general situation about oval cells and the advance in research on relation between the hepatic oval cells and hepatocellular carcinoma (HCC). MethodRelevant literatures in recent years about oval cells in hepatocellular carcinoma were collected and analyzed. ResultsHepatic oval cells are progenies of the hepatic stem cells that are thought to reside in the terminal branches of the biliary tree, termed the canals of Hering.After severe liver injury resulting in hepatocyte and cholangiocyte necrosis/apoptosis, the dual-potential oval cells will proliferate and differentiate into hepatocytes or cholangiocytes to replace the respective lost cell types.Recent studies have found many new oval cell surface markers, and promoted the recognition of oval cells.The level of oval cells proliferation is positively correlated with the malignant and inflammatory level of chronic liver diseases.More importantly, oval cells is involved in the occurrence, development, recurrence, and metastasis of liver cancer, and closely related to the prognosis of HCC. ConclusionAn improved understanding of the biological behavior of hepatic oval cells may lead to the development of novel diagnosis, treatment regimens, and prevention for hepatocellular carcinoma.
Objective To explore the curative effect of surgical treatment for primary liver cancer with portal vein tumor thrombus（PVTT）. Methods The clinical data of 227 patients who were performed surgical treatment because of primary liver cancer with PVTT were analyzed retrospectively. Results Two hundreds and seventeen cases were performed surgical resection, 14 cases died from postoperative complications. The median survival time was 17.7 months, and the l-, 2-, 3-, and 5-year survival rates were 61.9%, 37.2%, 21.7%, and 4.0% respectively. There were 40 cases with PVTT ofⅠtype, the l-, 2-, 3-, and 5-year survival rates were 82.3% , 61.7%, 38.6%, and 6.6% respectively，which was obviously higher than those with PVTT of Ⅱ type （n=129, 61.1%, 34.3%, 20.8%, and 5.3%） and PVTT of Ⅲ type （n=48, 46.8%, 24.0%, 9.6%, and 0）, P＜0.05. There were 84 cases whose PVTT and tumor were resected together, the l-, 2-, 3-, and 5-year survival rates were 67.3%, 43.2%, 28.1%, and 7.9% respectively，which were obviously higher than those patients whose PVTT were removed from cross-section of liver （n= 85, 65.1%, 38.8%, 22.3%, and 3.4%） and patients whose PVTT were removed by cutting the portal vein （n=48, 46.8%, 24.0%, 9.6%, and 0）, P＜0.05. The l-, 2-, 3-, and 5-year survival rates of 76 cases who received postoperative therapy of TACE/TAI were 75.3%, 53.2%, 33.1%, and 5.7% respectively, which were obviously higher than those patients who were not received any postoperative therapy （n=141, 54.8%, 29.1%, 15.9%, and 3.2%）, P＜0.05. Conclusions Surgical treatment is an effective treatment for primary liver cancer with PVTT. Surgery should strive for resecting the tumor and PVTT together, and postoperative therapy of TACE/TAI may have a favorable effect on the long term survival rate.