目的:通过数字减影血管造影(DSA)研究原发性肝癌(HCC)CT增强门静脉期强化特点及其原因。方法:本组HCC门静脉期强化共4例,行CT双期增强扫描及肝脏供血动脉DSA检查,分析供血动脉特点与门静脉期强化间的关系。结果:本组门静脉期均强化。完全性门静脉期强化1例,其供血动脉来源于膈下动脉及肝动脉分支1例;区域性门静脉期强化3例,其供血动脉来源于膈下动脉2例,来源于胃十二指肠动脉的网膜分支1例。供血动脉均走行较长。结论:HCC门静脉期强化供血动脉走行较长,部分管径纤细,导致肿瘤强化延迟。
Objective To determine whether Rb gene is involved in the genesis of primary hepatocellular carcinoma(HCC). MethodsForty paraffin specimens of primary HCCs with corresponding adjacent liver tissues and normal liver tissues were investigated for Rb protein expression by tissue chip and SP immunohistochemical technique. ResultsLoss of Rb protein expression occurred in 17 of 40 tumor samples, whereas in 4 of 40 adjacent liver tissue samples, only 1 of 40 normal liver tissue specimens showed negative Rb staining.Rb protein deletion in HCC was higher than that in adjacent tissues and normal liver tissues (P＜0.05).Rb protein deletion rate doesn’t correlated remarkably with tumor size or phathology grade of HCC （Pgt;0.05）. ConclusionRb protein deletion may play an important role in the tumorigenesis of HCC.Tissue chip is an effective highthroughput technique platform for the study of tumor molecular pathology.
目的 通过复制人肝癌细胞株HepG2裸鼠皮下移植瘤模型，观察绿茶提取物表没食子儿茶素没食子酸酯（EGCG）干预对HepG2移植瘤新生血管生成的影响。 方法 瘤体接种复制HepG2移植瘤模型，荷瘤裸鼠20只随机分组，实验组给予EGCG溶液每日20 mg/（kg·只），腹腔注射3周，对照组给予等量灭菌注射用水3周，末次用药24 h，后处死裸鼠，剥离移植瘤。常规病理切片观察移植瘤组织结构；逆转录-聚合酶链式反应和免疫组织化学法检测移植瘤缺氧诱导因子-1α（HIF-1α）、血管内皮生长因子（VEGF）mRNA及蛋白表达，并通过检测CD34表达计数瘤组织微血管密度（MVD）。 结果 组织病理学观察实验组移植瘤见大量坏死区，瘤体内血管数量明显少于对照组；实验组HIF-1α、VEGF mRNA及蛋白表达水平比对照组均明显下调（P＜0.05），实验组MVD比对照组明显下降（P＜0.05）。 结论 EGCG可抑制荷瘤裸鼠HepG2移植瘤新生血管生成。
目的探讨肝癌手术切除后的序贯综合治疗,以达到有效防治肿瘤复发的目的。方法从我科收治的肝癌患者中挑选3例手术治疗后进行序贯综合治疗并取得良好效果病例，对其临床资料进行分析，从中获取有关肝癌术后治疗的经验。结果3例肝癌患者在我科手术后接受了积极的预防复发措施，虽最终均出现复发，但对待复发的肿瘤均采取积极的应对措施，获得了长期生存。结论对于肝癌手术切除后的患者进行积极的序贯性综合治疗有较好的临床意义，鼓励对术后复发病例进行积极序贯综合治疗。
Objective To investigate the effect of the drug-resistance characteristic of neoplasm cell on the expression of Fas during the chemical medi-cure.Methods The adriamycin-resistance hepatic carcinoma cells (HepG2 cell lines) were estabilished by cell biology. Changes of expression of the HepG2 cell lines was determined by immunohistochemistry. Results When the HepG2 cell lines were not induced by adriamycin, the expression of Fas of them was weak and Fas mainly existed in cell membrane. When induced by adriamycin, the expression was enhanced and Fas mainly existed in cytochylema. Simultaneously, the death rate of the cell lines changed. The death rate of the drug-resistance cell lines in 0.1 μg/ml ADM was almost as same as that of non-drug-resistance cell lines without ADM (Ｐ＞0.05) and was significantly different from that of non-drug-resistance cell lines in 0.1 μg/ml ADM (Ｐ＜0.05). Conclusion Changes of the expression of Fas may be one of the drug-resistance mechanisms of carcinoma cell.
随着对肝脏解剖认识的深入，CT、MRI等影像学技术的发展、新的断肝器械的应用以及外科技术的进步，肝切除的并发症和死亡率都明显下降; 随着腹腔镜技术在肝脏外科的应用，肝切除技术又有了新的发展空间，现仅就肝切除技术现状作简要回顾。
Four hundred and eighty two paients suffering from intrahepatic bile duct stone undergoing lobectomy and segmental resection (from 1975 to 1994,9) has reported. 63% of the patient in this group underwent 1-5 operations, including different types of biliary-intestinal anastomosis (21.6%). 482 cases underwent different types of hepatectomy, including left lateral-lobetomy 321 cases (66.6%),left hemihepatectomy 80 cases(16.6%), right hemihepatectomy 19 cases (3.9%), and multiple segmental resections 39 cases (8.1%, including Ⅴ+Ⅷ 11 cases, Ⅵ+Ⅶ 28 cases). Other type hepatectomy combined with guadrate lobectomy 20 cases (4.1%). Postoperative complication rate was 10.2%, including diliary fistula. hemobilia and subdiaphragmatic and resectional surface infectioin, 85% of the patients were followed up with an excellent result of 88%. The authors emphsize that hepatic lobectomy nad segmental resection is the core of treatment and selection of operative methods depends on clinical-patholigic types of the disease.
Objective To study the interaction and mechanism of prostaglandin I2 (PGI2) receptor/thromboxane A2 (TxA2) receptor (IP/TP) and cyclooxygenase-2 (COX-2) in ischemia reperfusion injury after liver transplantation of rat. Methods Rats were randomly divided into three groups: control group （n=16), orthotropic liver transplantation group （n=32) and nimesulide intervention group （n=32). The samples were obtained at 3 h, 6 h, 12 h and 24 h after operation. The expressions of COX-2, IP and TP mRNA were detected by RT-PCR. Immunohistochemistry was used to detect the localization and expression of COX-2. Hematoxylin Eosin staining was used to classify the injury extent of liver. Serum ALT and AST levels were detected to evaluate the changes of liver enzyme. Results COX-2 protein expression detected by immunohistochemistry in orthotropic liver transplantation group mainly distributed in the district of liver sinusoidal endothelial cells, liver cells and macrophage cells, which was significantly higher than control group and nimesulide intervention group. Expressions of IP mRNA, TP mRNA and COX-2 mRNA in the orthotropic liver transplantation group were significantly increased than those in control group (P＜0.05), and the ratio of IP/TP increased (P＜0.05). Expressions of IP mRNA and TP mRNA in nimesulide intervention group were significantly lower than that in the orthotropic liver transplantation group at 6 h and 12 h after operation (P＜0.05), and the ratio of IP/TP decreased at 3 h, 6 h and 24 h after operation (P＜0.05). The expression of COX-2 mRNA in nimesulide intervention group was significantly lower than that in the orthotropic liver transplantation group at 6 h, 12 h and 24 h after operation. In orthotropic liver transplantation group liver injury was obvious by HE staining, and more severve than that in nimesulide intervention group. Serum AST (each time) and ALT (3 h, 6 h and 12 h) levels in the orthotropic liver transplantation group were significantly higher than that in control group and nimesulide intervention group (P＜0.05) and peaked at 6 h after operation. Conclusion The balance of IP/TP takes part in and plays an important role in the ischemia reperfusion injury of liver transplantation. Changing imbalance of IP/TP may reduce liver transplantation ischemia reperfusion injury by inhibiting COX-2 expression.