Cases Of Metastatic Liver Cancer Research Articles

Application of Laennec extrathecal blockade combined with indocyanine green fluorescence imaging in laparoscopic anatomic hepatectomy.

To investigate the safety and application value of combining Laennec extracapsular occlusion with ICG fluorescence imaging in laparoscopic anatomic hepatectomy. Complete laparoscopic dissection was performed outside the Laennec sheath, blocking Glisson's pedicle of the corresponding liver segment or lobe. An appropriate amount of indocyanine green (ICG) dye was intravenously injected, and the boundary line between the pre-cut liver segment and liver lobe was identified using fluorescence laparoscopy. Complete resection of the liver segment or lobe was performed based on anatomical markers. Clinical data, including operation time, intraoperative blood loss, postoperative hospital stay, and postoperative complications, were collected. A total of 14 cases were included in the study, including seven cases of primary liver cancer, three cases of metastatic liver cancer, three cases of intrahepatic bile duct calculi, and one case of hepatic hemangioma. All 14 patients underwent anatomic hepatectomy under fluorescent laparoscopy, with four cases involving the right liver, seven cases involving the left liver, two cases involving the right anterior lobe, and one case involving the right posterior lobe. Combining laparoscopic follow-up of the Laennec membrane with Glisson outer sheath block and intraoperative ICG fluorescence imaging provides real-time guidance for locating the resection boundaries during anatomic hepatectomy. This approach helps in controlling intraoperative bleeding, reducing operation time, and ensuring high safety. It holds significant value in clinical application.

The therapeutic outcomes of ultrasound-guided percutaneous radiofrequency therapy for subcardiac liver malignant tumor

Objective: To examine the safety and effectiveness of ultrasound-guided percutaneous radiofrequency ablation in the treatment of liver malignant tumor under subcardiac. Methods: The clinical data of 26 patients (31 tumors) with subcardiac liver malignant tumors who underwent ultrasound-guided percutaneous radiofrequency ablation from January 2017 to October 2019 at the Affiliated Tumor Hospital of Zhengzhou University were retrospectively analyzed. There were 21 males and 5 females. The age was 55 years old (range: 40 to 77 years old) .There were 14 cases of primary liver cancer and 12 cases of metastatic liver cancer. The maximum diameter of tumor was (2.3±1.0) cm (range: 1.0 to 4.2 cm) .According to the maximum diameter of the tumor, 1∶1 match was made between 27 non-subcardiac patients admitted at the same time and a total of 36 liver malignant tumors. subcardiac tumor is defined as tumor ≤1 cm from pericardium in sagittal or coronal imaging. The ablation effect and complications were recorded, and the one-time complete ablation rate, main technical efficiency and complications were evaluated. The preoperative baseline characteristics, ablation effect and complications of the two groups of patients were collected and counted. Single factor analysis and Logistic regression analysis were used to analyze the independent risk factors that affect the ablation effect of ultrasound-guided percutaneous radiofrequency ablation for liver malignant tumors under subcardiac. Results: The one-time complete ablation rate of tumor after radiofrequency ablation was 80.8% (21/26) in the subcardiac group and 92.6% (25/27) in the non-subcardiac group. There was no significant difference between the two groups (P>0.05) . No evidence of local tumor progression was found in the follow-up evaluation of the two groups one month after radiofrequency ablation, and the main technical effective rate was 100%.Ablation-related complications occurred in 2 patients in the subcardiac group. Multivariate analysis both showed that the distance between tumor margin and pericardium ≤5 mm was an independent risk factor affecting radiofrequency ablation (OR=0.020, 95%CI: 0.001 to 0.454, P=0.014) . Conclusions: Ultrasound-guided percutaneous radiofrequency ablation can safely and effectively treat liver malignant tumor under subcardiac. When there is a tumor near the patient's heart (the distance between the edge of the tumor and pericardium is ≤5 mm) , special attention should be paid to formulate a detailed and reasonable ablation plan to minimize tumor residue.

Diagnosis of liver tumors by multimodal ultrasound imaging.

To investigate the diagnostic value of multimodal ultrasound imaging composed of conventional ultrasonography (US), contrast-enhanced ultrasonography (CEUS), and shear wave elastography (SWE) for liver tumors.Between October 2017 and October 2019, US, CEUS, and SWE examinations of a total of 158 liver tumors in 136 patients at The First Affiliated Hospital of Nanchang University were performed. The histopathological or imaging diagnostic results were used as controls to evaluate the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of US, CEUS, SWE, and multimodal ultrasound imaging, which combines these 3 modes, in the differential diagnosis of benign and malignant liver tumors.Among the 158 tumors, there were 64 benign tumors, including 55 cases of hepatic hemangioma, 3 cases of focal nodular hyperplasia of the liver, 4 cases of hepatic cyst, and 2 cases of focal nonuniform distribution of fat in the liver. There were 94 malignant tumors, including 32 cases of hepatocellular carcinoma, 22 cases of intrahepatic cholangiocellular carcinoma, 29 cases of metastatic liver cancer, and 11 cases of dysplastic nodules in cirrhotic liver. In the diagnosis of benign and malignant liver tumors, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 82.56%, 68.06%, 75.96%, 75.53%, and 76.56% for US; 92.39%, 86.36%, 89.87%, 90.43%, and 89.06% for CEUS; 87.14%, 76.81%, 82.91%, 82.98%, and 82.81% for SWE; and 97.85%, 95.38%, 96.83%, 96.81%, and 96.88% for multimodal ultrasound imaging, respectively. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were all significantly higher for multimodal ultrasound imaging than those values for US, CEUS, and SWE (all P < .05). The areas under the receiver operating characteristic curve for US, CEUS, SWE, and multimodal ultrasound imaging in the diagnosis of benign and malignant liver tumors were 0.760, 0.897, 0.829, and 0.968, respectively.US, CEUS, and SWE all have diagnostic value in the diagnosis of benign and malignant liver tumors. Multimodal ultrasound imaging could significantly increase the accuracy of the diagnosis of benign and malignant liver tumors and has higher value for clinical application.

Treatment of liver tumors using radiofrequency ablation with a multi-electrode and multi-sited switching system: Efficacy analysis in 176 patients

Background: We retrospectively reviewed our 2-year experience in using a novel radiofrequency ablation (RFA) with a Multi-electrode and Multi-sited Switching System for the treatment of liver tumors. Methods: We performed a total of 178 RFAs with a Multi-electrode and Multi-sited Switching System on 176 patients from Dec. 2013 to Jan. 2015. There were a total of 304 tumors treated with an average diameter of 4.72 ± 1.7 cm (range, 2.2–10.4 cm); 134 male patients and 42 female patients with a mean age of 52.95 ± 11.87 (range, 22–83). There were 42 cases of new-onset primary liver cancer, 75 cases of recurrent primary liver cancer, 29 cases of metastatic liver cancer, and 30 cases of hemangioma. Ultrasonography or contrast-enhanced CT of the liver was performed 48 h after the surgery to determine whether the ablation was complete and whether complications occurred. Results: The complete ablation rate of Multi-electrode and Multi-sited Switching System was 98.68% (300/304), and the complete ablation rate with one procedure was 98.02% (298/304); the total ablation time was 2275 min, and the mean ablation time per procedure was 13.04 ± 5.39 min, a 56.24% reduction relative to that of single-sited RFA. No hospital deaths occurred in any of the enrolled 176 patients. The complication rate was 2.35%. Conclusion: Multi-electrode and Multi-sited RFA is a safe, effective method for treating liver tumors. It was here found to improve the complete ablation rate with one procedure in RFA treatment of liver tumors and to shorten the RFA time, which reduces surgical risks.

Abstract 3422: Alteration of aldo-keto reductase family 1, member B10 (AKR1B10) expression among tumor and background non-tumorous tissue of curatively resected hepatocellular carcinoma is associated with worse prognosis

Abstract Background and Objectives: When assessing hepatocellular carcinoma (HCC), it is quite important to examine prognostic factors in the background non tumorous liver tissue as well as HCC tissue itself. We tried to elucidate molecular prognostic predictors which have some relation with both tumor and background tissue for curatively resected HCC. Methods: Candidate genes were extracted from the background non tumorous liver samples via microarray analysis. Control samples, termed super normal (SN) liver, were obtained from 11 cases of metastatic liver cancer. Corresponding non tumorous liver tissue (CN) was surgically obtained from a typical HCC patient with chronic hepatitis C background for comparison. Expression profiling microarray demonstrated 4 genes as candidates for prognostic factors. Among them, Aldo-keto reductase family 1, member B10 (AKR1B10) was extracted to investigate in 158 consecutive curatively resected HCC cases by real-time quantitative reverse transcription polymerase chain reaction. The relation between AKR1B10 expression and clinicopathological factors were assessed and statistical analyses were performed with Kaplan-Meier method and compared using the log-rank test. Univariate and multivariate Cox proportional hazards models were used to determine the independent risk factors associated with the RFS and OS. Results: The expression level of AKR1B10 (expression score/GAPDH×1000) was significantly higher in HCC tissues (median: 9.22 [range: 0.0003-611.02], n = 158) than in CN (0.5461[0.0018-69.03], n = 158) tissues (P &amp;lt; 0.001). 158 HCC cases were subsequently divided into two groups based on AKR1B10 expression in tumor and CN in each case: one consisting of the T ≥ CN cases (n = 132) and the other of the T &amp;lt; CN (n = 26). T &amp;lt; CN cases demonstrated significant correlation with worse recurrence-free survival (P = 0.0074) and overall survival (P&amp;lt;0.0001). Furthermore, multivariate analysis identified AKR1B10 expression T&amp;lt;CN as an independent prognostic factor in overall survival (P = 0.0011). The alteration of AKR1B10 expression level in T and CN was significantly correlated between liver damage score (B or C / A) (P = 0.035) and infiltration to capsule (+ / -) (P = 0.0284) respectively. Conclusions: Our findings suggested that basically, AKR1B10 expression is much higher in T than in CN but once AKR1B10 expression inversion between tumor and CN occurs; its prognosis becomes significantly worse. This T&amp;lt;CN change may well expressed both CN ill status and T malignancy. This alteration might be one of the good and suggestive prognostic predictors for resected HCC. Citation Format: Shuji Nomoto, Fuminori Sonohara, Yoshikuni Inokawa, Mitsuro Kanda, Tsutomu Fujii, Hiroyuki Sugimoto, Masahiko Koike, Michitaka Fujiwara, Yasuhiro Kodera. Alteration of aldo-keto reductase family 1, member B10 (AKR1B10) expression among tumor and background non-tumorous tissue of curatively resected hepatocellular carcinoma is associated with worse prognosis. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 3422. doi:10.1158/1538-7445.AM2015-3422

High expression of Janus kinase 2 in background normal liver tissue of resected hepatocellular carcinoma is associated with worse prognosis.

When assessing hepatocellular carcinoma (HCC), it is important to examine prognostic factors in the background normal liver tissue and consider malignant aspects of the primary lesion. Candidate genes were extracted from the background normal liver samples via multiarray analysis. Control samples, termed supernormal (SN) liver, were obtained from 11 cases of metastatic liver cancer. Corresponding normal (CN) liver tissue was surgically obtained from a typical HCC patient with chronic hepatitis C background for comparison. Expression profile and methylation array demonstrated that Janus kinase 2 (JAK2) gene expression was increased by 2.378‑fold in the CN tissue. Methylation array reported a lower value for CN (0.125) than SN tissues (0.748). We then investigated JAK2 expression by real-time quantitative reverse transcription-polymerase chain reaction in 100 consecutive resected HCC cases. The average expression level of JAK2 (normalized to GAPDH) was significantly lower in CN (9.24±6.43, n=100) than in SN (35.21 ± 21.38, n=11) tissues (P<0.001). As such a result was contrary to our expectation, the case used for array analysis seemed to be a rare incidence. One hundred HCC cases were subsequently divided into two groups based on JAK2 expression in the adjacent normal tissue: one consisting of the upper 70% of cases (n=70) and the other of the remaining 30% (n=30). Higher JAK2 expression in the adjacent tissue demonstrated significant correlation with worse survival (P=0.022). Furthermore, multivariate analysis identified higher JAK2 expression in the background normal liver tissue of HCC as an independent prognostic factor (P=0.032). Our findings suggest that higher JAK2 expression in the background normal liver tissue of HCC may be a good prognostic biomarker for resected HCC.

Abstract 2870: ZGPAT gene expression in non-tumor hepatocellular carcinoma tissue is a likely biomarker for survival risk

Abstract [Background &amp; Aim] Hepatocellular carcinoma (HCC) often recurs after surgery and multicentric occurrence is more common than intrahepatic metastasis. We therefore examined factors in non-tumor liver tissue in HCC. [Material &amp; Methods] Control samples, termed super normal liver tissues (SN), were taken from 11 cases of metastatic liver cancer. One of corresponding samples of normal tissues (CN) was selected for comparison from a typical specimen with chronic hepatitis C and HCC. We performed expression profiling and methylation arrays on these samples, identified genes that differed between SN and CN. We analyzed the identified genes using quantitative real-time reverse-transcriptase polymerase chain reaction on SN from 11 cases of metastatic liver cancer and CN from 109 cases of HCC. [Results] We found the zinc finger, CCCH-type with G patch domain (ZGPAT) gene to have expression decreased 4.198-fold in CN, and higher methylation status in CN (0.718), than in SN (0.360). The average expression value of the ZGPAT gene (ZGPAT value ×103 / GAPDH) decreased in CN (9.94 ± 10.68) relative to SN (28.55 ± 22.05). Compared with other patients, those with strongly reduced ZGPAT expression (&amp;lt; 1.5) in their non-tumor liver samples had significantly shorter overall survival (P = 0.024), but not recurrence-free survival (P = 0.515). [Discussion &amp; Conclusion] Our results indicate that expression of the ZGPAT gene in non-tumor liver tissue is a good biomarker for the risk of HCC development. ZGPAT gene is reportedly a transcription repressor that negatively regulates expression of epidermal growth factor receptor, which in turn, mediates cell proliferation, survival, migration. In treating HCC, detection of both prognostic factors from non-tumor liver tissue and malignant factors of the primary cancer lesion is important. Citation Format: Mitsuhiro Hishida, Shuji Nomoto, Yoshikuni Inokawa, Nao Takano, Mitsuro Kanda, Naoki Iwata, Chie Tanaka, Daisuke Kobayashi, Yoko Nishikawa, Suguru Yamada, Goro Nakayama, Tsutomu Fujii, Hiroyuki Sugimoto, Masahiko Koike, Michitaka Fujiwara, Yasuhiro Kodera. ZGPAT gene expression in non-tumor hepatocellular carcinoma tissue is a likely biomarker for survival risk. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 2870. doi:10.1158/1538-7445.AM2014-2870

Abstract 3822: Correlation between worse prognosis and lower expression of the TPPP gene in patients with hepatocellular carcinoma, detected by multiarray analysis

Abstract Background. Hepatocellular carcinoma (HCC) patients who undergo liver resection often suffer multicentric occurrence after surgery. Therefore, understanding carcinogenesis in background liver is important. Methods. Control liver samples (super normal [SN]), were taken from 11 cases of metastatic liver cancer. We selected corresponding normal tissue from typical cases of HCC with chronic hepatitis C (corresponding normal [CN]) for comparison. Expression profiling and methylation arrays were performed to compare SN and CN. Array data showed that the tubulin polymerization promoting protein (TPPP) gene showed differences in both array analyses. The relationship between clinicopathological factors of 179 HCC patients and TPPP expression was investigated. Results. The expression array showed that the TPPP gene was decreased by 2.236-fold (log2 ratio) in CN compared with SN. The methylation array showed a higher value of methylation for CN (0.730) than SN (0.384). We studied TPPP gene expression by real-time reverse transcription PCR. When compared expression level of TPPP (TPPP value ×103/GAPDH), among SN (n=11), normal liver tissue of HCC patients (n=179), and tumor tissue of HCC (n=179), there were significant differences (median: 116, 4.60, and 2.63, respectively). The group with lower TPPP expression in tumors compared with normal tissue showed a worse prognosis of overall survival than that in the increased expression group (P=0.0317). Strongly reduced TPPP expression in tumor tissue compared with normal tissue (ratio &amp;lt;0.3, n=57) was detected as an independent prognostic factor by multivariate analysis (P=0.0310). Conclusions. Expression of the TPPP gene in tumor and non-cancerous liver tissue in HCC patients is significantly lower compared with SN. HCC patients with this low TPPP expression show a poor prognosis. This indicates that this gene is a new candidate of tumor suppressor genes in HCC. Low TPPP expression in liver tissue might be a predictor of HCC. Citation Format: Yoshikuni Inokawa, Shuji Nomoto, Mitsuhiro Hishida, Nao Takano, Mitsuro Kanda, Michitaka Fujiwara, Masahiko Koike, Hiroyuki Sugimoto, Tsutomu Fujii, Goro Nakayama, Suguru Yamada, Chie Tanaka, Daisuke Kobayashi, Naoki Iwata, Yasuhiro Kodera. Correlation between worse prognosis and lower expression of the TPPP gene in patients with hepatocellular carcinoma, detected by multiarray analysis. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 3822. doi:10.1158/1538-7445.AM2014-3822

Abstract 3816: Correlation between worse prognosis and higher expression of the JAK2 gene in corresponding non-neoplastic tissue in patients with hepatocellular carcinoma, extracted by multiarray analysis

Abstract [Background &amp; Aim] Hepatocellular carcinoma (HCC) often recurs in the liver after surgery removing the primary lesion. Multi-centric occurrence (MO) is more common than intrahepatic metastases (IM). Then, it is insufficient to predict the prognosis by considering factors only in resected primary tumor. Factors in the background liver will also play important roles in prognosis. [Material &amp; Methods] Our control samples, termed super normal (SN) liver, were taken from normal tissues of 11 cases of metastatic liver cancer. We selected a corresponding non-neoplastic (CN) tissue of a typical HCC case with chronic hepatitis C as a sample to compare. Then, expression profiling and methylation arrays were performed for comparing the SN and the CN. We identified genes showing differences in gene expression and the rate of methylation. Prognosis was predicted for 100 cases of HCC based on gene expression. [Results] The expression profiling showed that expression of Janus kinase 2 (JAK2) gene was increased 2.378 in CN, and methylation array analysis showed a lower value for CN (0.13) than SN (0.75). We then studied JAK2 gene expression by quantitative real time RT-PCR. Unfortunately, the average expression value of JAK2 (JAK2 x103/GAPDH) had decreased in matching normal tissue (9.24±7.46) relative to SN (35.21±21.38). Only one case was expressed higher than SN average in CN. We divided the cases into two groups. Group A showed higher 70% of JAK2 expression cases (70 cases) and group B showed lower 30% of expression cases (30 cases). Then, the group A had a significant correlations with worth prognosis (p=0.017) by univariate analysis and showed independent worth prognostic factor (p = 0.032) by multivariate analysis. [Discussion &amp; Conclusion] It has been reported that JAK2 has an important role in reproduction of normal hepatocyte, and maintenance of liver functions in the super normal liver. While, in HCC tissues, STAT3-JAK2 pathway was reported as an oncogenic factor in proliferation and progression. In this study, the expression of the JAK2 gene in the background liver in HCC cases also had an important meaning and likely to be a good biomarker. When assessing cases of HCC, as well as considering malignant factor of the primary cancer lesion, it is important to extract prognostic factors from background liver tissue. Citation Format: Shuji Nomoto, Mitsuhiro Hishida, Yoshikuni Inokawa, Nao Takano, Mitsuro Kanda, Yasuhiro Kodera. Correlation between worse prognosis and higher expression of the JAK2 gene in corresponding non-neoplastic tissue in patients with hepatocellular carcinoma, extracted by multiarray analysis. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 3816. doi:10.1158/1538-7445.AM2014-3816

Long-term outcomes after hepatic resection combined with radiofrequency ablation for initially unresectable multiple and bilobar liver malignancies

BackgroundHepatic resection (HRE) combined with radiofrequency ablation (RFA) offers a surgical option to a group of patients with multiple and bilobar liver malignancies who are traditionally unresectable for inadequate functional hepatic reserve. The aims of the present study were to assess the perioperative outcomes, recurrence, and long-term survival rates for patients treated with HRE plus RFA in the management of primary hepatocellular carcinoma (HCC) and metastatic liver cancer (MLC). MethodsData from all consecutive patients with primary and secondary hepatic malignancies who were treated with HRE combined with RFA between 2007 and 2013 were prospectively collected and retrospectively reviewed. ResultsA total of 112 patients, with 368 hepatic tumors underwent HRE combined with ultrasound-guided RFA, were included in the present study. There were 40 cases of HCC with 117 tumors and 72 cases of MLC with 251 metastases. Most cases of liver metastases originated from the gastrointestinal tract (44, 61.1%). Other uncommon lesions included breast cancer (5, 6.9%), pancreatic cancer (3, 4.2%), lung cancer (4, 5.6%), cholangiocarcinoma (4, 5.6%), and so on. The ablation success rates were 93.3% for HCC and 96.7% for MLC. The 1-, 2-, 3-, 4-, and 5-y overall recurrence rates were 52.5%, 59.5%, 72.3%, 75%, and 80% for the HCC group and 44.4%, 52.7%, 56.1%, 69.4%, and 77.8% for the MLC group, respectively. The 1-, 2-, 3-, 4-, and 5-y overall survival rates for the HCC patients were 67.5%, 50%, 32.5%, 22.5%, and 12.5% and for the MLC patients were 66.5%, 55.5%, 50%, 30.5%, and 19.4%, respectively. The corresponding recurrence-free survival rates for the HCC patients were 52.5%, 35%, 22.5%, 15%, and 10% and for the MLC patients were 58.3%, 41.6%, 23.6%, 16.9%, and 12.5%, respectively. ConclusionsHRE combined with RFA provides an effective treatment approach for patients with primary and secondary liver malignancies who are initially unsuitable for radical resection, with high local tumor control rates and promising survival data.

Abstract 3539: A study of THOP1, a predictive factor of prognosis in HCC, by multi-array analysis of background liver.

Abstract Background &amp; Aim Hepatocellular carcinoma (HCC) often recurs in the liver after surgery removing the primary lesion. Multi-centric occurrence is more common than intrahepatic metastases.We have previously reported it by showing genotype of recurrent HCC, either by detecting the alteration of mitochondrial mutations (NomotoS et al. Clin Cancer Res. 2002 8:481-7), or by examining patterns of promoter hypermethylation in several tumor suppressor genes (Nomoto S. et al. Br J Cancer. 2007 97:1260-5) in tumor cell. Therefore, it is insufficient to predict prognosis by only considering factors in resected primary tumor. Factors in the background liver will also play important roles in prognosis. Material &amp; Methods Our control samples, termed super normal (SN) liver, were taken from normal tissues of 11 cases of metastatic liver cancer that underwent liver resection at our department. We selected a corresponding normal tissue of a typical case in which HCC was generated from chronic hepatitis C (CN) as a sample to compare. DNA and RNA were extracted from the cases. To eliminate the personal background, the DNA and RNA of 11 SN cases were mixed. Then, expression profiling and methylation arrays were performed to compare the SN and the CN. We identified genes showing differences in both expression and the rate of methylation. Prognosis was predicted for 48 cases of HCC based on gene expression. Results &amp; Discussion The expression profiling showed that expression of the THOP1 gene was decreased -4.119 in CN, and methylation array analysis showed a higher value for CN (0.86) than SN (0.48). We then studied THOP1 gene expression by quantitative real time RT (Reverse Transcription)-PCR. The average expression value of THP1 (THOP1 x103/GAPDH) had decreased in matching normal tissue (22.17) relative to SN (78.14). We divided the 48 cases into two groups, where Group A showed higher THOP1 expression than the average value (16 cases) and group B showed lower expression than average (32 cases). Group A correlated significantly with a highly differentiated histological type (p=0.0228) and a tendency to associate with a lack of vascular invasion (p=0.057). In addition, Group A showed significant correlations with prolonged survival (p = 0.0045) and recurrence-free survival (p = 0.001). This suggests that the expression of the THOP1 gene in the background liver of HCC cases is likely to be a good biomarker to predict survival and recurrence of HCC. Conclusion When assessing cases of HCC, as well as considering malignant factors of the primary cancer lesion, it is important to extract prognostic factors from the background liver tissue. Citation Format: Shuji Nomoto, Mitsuhiro Hishida, Yoshikuni Inokawa, Mitsuro Kanda, Hiroyuki Sugimoto, Tsutomu Fujii, Yasuhiro Kodera. A study of THOP1, a predictive factor of prognosis in HCC, by multi-array analysis of background liver. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 3539. doi:10.1158/1538-7445.AM2013-3539

Percutaneous microwave coagulation therapy for patients with primary and metastatic hepatic tumors

Objective: To evaluate the efficacy and safety of percutaneous microwave coagulation therapy (PMCT) for patients with primary and metastatic hepatic tumors.Methods: The enrolled 100 patients with 186 tumor nodules who underwent PMCT included 79 cases of primary or recurrent liver cancers and 21 cases of metastatic liver cancer. The tumors were divided into two groups according to the tumor size in diameter: group A, 0.5 cm−<3 cm; group B, ≥3 cm−<5 cm. Under local and/or epidural anesthesia, a single percutaneous microwave antenna (or two antennas array applicator) was inserted directly into the tumor in the liver for thermo-coagulation with the aid of ultrasound guidance.Results: Among the 186 lesions in 100 patients with primary and metastatic liver cancers, in group A, 123 (66%) were coagulated once. A Follow-up of 6–12 months demonstrated that 112 lesions (91%) showed no local recurrence by CT or MRI; In group B, of the 63 lesions (33.87%) coagulated twice, 31 (49%) showed no local recurrence by CT or MRI during a follow-up of 6 months. There were no serious clinical side effects or complications in all the PMCT patients.Conclusion: PMCT gives satisfactory curative effect on tumors with <3 cm in size. It is partly effective on lesions ≥3 cm−<5 cm in size. It is a minimally invasive and effective therapy, can be used safely in the field of percutaneous hepatis surgery, and carried out even in patients with poor liver function.

Comparison of Prostanoids and Their Precursor Fatty Acids in Human Hepatocellular Carcinoma and Noncancerous Reference Tissues

Eicosanoid production and the compositions of precursor fatty acids were determined in human cancerous and reference liver tissues. Seventeen hepatectomized cases (12 cases of hepatocellular carcinoma (HCC) and 5 cases of metastatic liver cancer) were evaluated. The cancerous tissues and the noncancerous reference tissues were separated, lipids were extracted, and the fatty acids were determined as methyl esters by gas chromatography. Prostanoids (6-keto PGF 1α and TXB 2) were measured by radioimmunoassay. In HCC, the levels of α-linolenic acid (ω-3) (0.41 ± 0.38 × 100 μg/g) and dochosahexaenoic acid (10.41 ± 4.96 × 100 μg/g) in liver cancer tissue were significantly less than those in the reference tissues. In HCC, the levels of TXB 2 reference (1.86 ± 2.77 pg/mg wet weight) and 6-keto PGF 1α were 10-fold higher than those in reference tissues. We speculate that in HCC higher prostanoid levels in the liver are related in part to tumor metabolism.

ULTRASONIC STUDY ON METASTATIC LIVER CANCER

An 8-year experience with 36 cases of metastatic liver cancer with tumor diameter of less than 3 cm is reviewed for ultrasonographic features.Majority of metastatic liver cancers less than 3 cm in diameter showed round shape and thin marginal hypoechoic zone. Internal echo patterns of them were very diverse and they showed hyperechoic, isoechoic, hypoechoic and complex pattern. But complex pattern was recognized in the tumors larger than 2 cm. Majority of tumors larger than 2 cm showed heterogeneous whole arrangement of internal echo.Colorectal cancer had a tendency to show hyperechoic pattern. All cases of pancreas cancer revealed hypoechoic or isoechoic pattern. But gastric cancer didn't show the characteristic pattern in ultrasound.Another comparative study between ultrasonographic and histopathologic features was performed in 2 cases of metastatic liver cancer from the colon.Marginal hypoechoic zone seemed to be caused by compression of parenchyma surrounding the tumor and viable cancer cells in outer layer of the tumor. Hyperechoic internal echo might be caused by a mixture of degeneration, necrosis, bleeding and fibrosis in the tumor.

ULTRASONOGRAPHIC FINDINGS OF METASTATIC LIVER CANCER

210 cases of metastatic liver cancer for recent 5 years were subjected to ultrasonographic review. When compared to ultrasonographic fundings obtained from primary liver cancers, the findings from metastatic liver cancers were characterized by more frequent occurrence (79%) with smooth boundary, and also more frequent occurrence of thickened marginal low echo band if the band was involed. Sixty nine percent of the metastatic subjects revealed high internal echo level, or the two percent did an enhanced posterior echo of the tumor, which was lesser than that for primary cancer. The outside shadow was noted in as low as 8% of the subjects, while that figure was 29% in primary liver cancer cases. The above findings were observed with higher rate especially in tumors with sizes of more than 2cm to less than 5cm in diameter. An understanding of characteristics of ultrasonographic images, accordingly, appears to lead to improvement in correctly diagnosing of metastatic liver cancer.

第17回日本総合健診医学会学術大会講演抄録集 総合健診でみいだした肝癌と転移性肝癌の9例

第17回日本総合健診医学会学術大会講演抄録集 総合健診でみいだした肝癌と転移性肝癌の9例

Immunological analysis and characterization of lymphocyte subsets in specimens of human hepatocellular carcinomas and metastatic liver cancers.

The distribution and number of CD2 (Coulter T11)+ cells, CD16 (Leu 11b)+ cells, Leu 7+ cells, CD8 (OKT 8)+ cells, CD11 (Leu 15)+ cells, CD4 (Leu 3a + 3b)+ cells and Leu 10+ or Leu 14+ cells in the liver of patients with hepatocellular carcinoma (HCC) and metastatic liver cancer (MLC) were investigated using monoclonal antibodies and immunohistological methods. In the majority of those with HCC and MLC, CD8 (OKT 8)+, Leu 7+ and CD16 (Leu 11b)+ cells were present both in the tumor and non-tumor tissues. The CD8 (OKT 8)+ cells were more numerous than Leu 7+ and CD16 (Leu 11b)+ cells. No significant difference was observed in the distribution and number of Leu 7+ and CD16 (Leu 11b)+ cells, in any area, in both groups. The number of CD8 (OKT 8)+ cells predominated in the non-tumor area, in both groups. CD11 (Leu 15)+ cells and CD8 (OKT 8)+ cells were present in the ratio of 1:3 or 1:4. The number of CD4 (Leu 3a + 3b)+ cells was less than that of CD8 (OKT 8)+ cells in both groups, especially in the tumor area. A few Leu 10+ or Leu 14+ cells were present in all areas, in both groups. In most cases of MLC, the CD8 (OKT 8)+ cells were absent in the tumor area. There was no correlation between the distribution and number of these cells and anti-tumor chemotherapy or non-specific immunotherapy.

A STUDY OF THE PROGNOSIS OF METASTATIC LIVER CANCER

Of 83 cases of metastatic liver cancer treated by the authors, 39 with the primary lesion in the stomach and 33 in the large intestine were compared with regard to prognosis. The prognosis of hepatectomized patients was also evaluated. The group with metastatic liver cancer originating in the large intestine showed significantly better results than those of the group with the primary focus in the stomach. Examination of differentiating adenocarcinoma exhibiting a high frequency of liver metastasis revealed differences in properties, such as the stage of primary lesion and metastatic liver lesion, between the stomach and large intestine. The prognosis of the hepatectomized patients with liver metastasis was better than that of the non-hepatectomized patients. Of 14 hepatectomy cases, the large intestine (11) was the most frequent site of primary lesion, and these 11 cases showed satisfactory prognosis. Liver metastasis of colorectal cancer was the best indication for hepatectomy. Partial resection was thought to be a sufficient procedure for hepatectomy, since no prognostic difference was observed between segmental and partial resection.