Cases Of Primary Liver Carcinoma Research Articles

Changes of serum Golgi protein-73 before and after interventional therapy and operation in patients with primary liver carcinoma

Objective To investigate the changes of serum Golgi protein-73 (sGP73) in patients with primary liver carcinoma (PLC) before and after interventional therapy and operation.Methods Enzyme linked immunosorbent assay (ELISA) was used to detect the level of serum sGP73 in 33 cases of normal control subjects and 65 cases of PLC,and sGP73 levels in 24 cases of stage Ⅱ PLC pre-and post-interventional therapy,and 22 cases of stage Ⅰ PLC pre-and post-operation were compared.Results The sGP73 levels were elevated in all subgroups of patients with PLC [(212.19 ± 18.10) μg/L] compared to the controls [(52.60 ±3.74) μg/L,P ＜0.01].sGP73 was correlated with clinical stage,but not with sex and age.The sGP73 levels in stage Ⅲ [(228.79 ± 11.99) μg/L] were higher than those in stage Ⅱ [(216.21 ±8.10) μg/L,P＜0.01],those in stage Ⅱ were higher than those in stage Ⅰ [(192.03 ± 8.26) μg/L,P ＜0.01],and those in stage Ⅰ were higher than those in normal control subjects (P ＜0.01).The sGP73 levels were remarkably reduced in patients with PLC after interventional therapy or operation (P ＜ 0.01).Conclusion These results suggest that detection of sGP73 is helpful for evaluating treatment response and prognosis of PLC. Key words: Golgi protein-73 ; Primary liver carcinoma ; Interventional therapy

Serum Dickkopf-1 changes before and after operation and interventional therapy in patients with primary liver carcinoma

Objective To investigate the changes of serum Dickkopf-1 （DKK1） in patients with primary liver carcinoma （PLC） before and after operation and interventional therapy. Methods Enzyme linked immunosorbent assay （ELISA） was used to detect the serum DKK1 levels in 60 cases of PLC and 30 cases of normal control subjects. The serum DKK1 levels in 20 cases of stage I PLC pre- and post-opera- tion, and 18 cases of stage 11 PLC pre- and post-interventional therapy were compared. Results Serum DKK1 was correlated with clinical stage of patients with PLC, but not with sex and age. The serum DKK1 levels in patients with stage IU of PLC （ 11.54 ＋ 0. 80 ） μg/L were higher than in those with stage 11 （9.16＋0.73） μg/L, （P〈0.01）, those in stage II （9.16 ±0.73） Ixg/L higher than in stage I （6.24±1.12） μg/L, （P〈0.01）, and those The stage I （6.24 ±1.12） Ixg/L higher than in normal controls （3.14± 0. 84） μg/L. （ P 〈 0.05 ）. The serum DKK1 levels were remarkably reduced in patients with PLC after operation or interventional therapy （ P 〈 0.01 ）. Conclusion These results suggest that the level of DKK1 might play a significant role in the progression of PLC. Key words: Dickkopf-1 ; Carcinoma, hepatocellular; Interventional therapy; Operation

Clinical outcomes of ATP-tumor chemosensitivity assay directed chemotherapy in hepatocellular carcinoma

This study aims to investigate the clinical response of ATP tumor chemosensitivity assay (ATP-TCA) directed chemotherapy regimens delivered via hepatic artery infusion in 104 cases of primary liver carcinoma (PLC). Tumor tissue was obtained via laparotomy and cultivated in vitro. This tissue was put through the assay to determine chemosensitivity. A single drug regimen of either 5-FU, MMC and ADM and a combination drug regimen were used. The treatment assigned was dependent on the result of the ATP-TCA. In the control group, 30 cases of diagnosed PLC were given the conventional three-combination drug. The two groups were evaluated after three courses of chemotherapy. The results are as follows. The overall response rate of sensitivity test ranged from 36% to 44% in the single drug therapy groups and 81% in the combination drug group. The clinical overall response rate was 75% in the treatment group and 56% in control group. The treatment group had better results than the control group as survival period over six months was 80% and over one year 44%. In the control group, survival period over six months was 60% and 30% over one year. In short, ATP-TCA directed chemotherapy shows better results for terminal stages of PLC in that you can decrease the dose of drugs thereby reducing the side-effects with possible improvements in therapeutic effects.

Liver carcinoma in PiZ alpha-1-antitrypsin deficiency.

One hundred sixty-four consecutive cases of primary liver carcinoma were evaluated for tumor type, (i.e., hepatocellular carcinoma [HCC], cholangiocarcinoma [CC], and combined hepatocholangiocarcinoma [CHCC]), and for signs of alpha-1-antitrypsin deficiency (AATD) in the surrounding liver tissue. Hepatocellular globular alpha-1-antitrypsin deposits, as detected by a monoclonal antibody to the mutant PiZ alpha-1-antitrypsin (AAT), were seen in 13 cases (7.9%). With regard to tumor type, 4 of 111 HCC cases (3.5%), but 4 of 37 CC cases (10.5%), and even 5 of 16 CHCC cases (30%) were positive for this antitrypsin variant. In all but 1 of 13 cases of alpha-1-antitrypsin deficiency, the carcinoma developed in noncirrhotic liver tissue of elderly people (mean age, 62.9 years). In three patients, a heterozygous state of ATT (PiMZ) could be revealed using isoelectric focusing or direct genetic analysis. We conclude from our findings that CHCC and CC especially might be associated with PiZ alpha-1-antitrypsin deficiency. Primary liver carcinoma might develop even in a heterozygote state of PiZ alpha-1-antitrypsin deficiency without concurrent liver disease. Furthermore, liver cirrhosis is not a precondition for these tumors.

Evaluation of partial hepatectomy for primary liver carcinoma

From 1964 to 1985, 120 cases of primary liver carcinoma had undergone hepatectomy in our hospital. Seven of these cases underwent hepatic lobectomy, 28 cases had palliative hepatic resection, and 85 cases had partial hepatectomy. We introduced different surgical modes and compared the mortality, survival rates, and complications between the hepatic lobectomy and partial hepatectomy groups. The mortality rates of these two groups were 14.3 and 3.5%, respectively, and the 1, 3, and 5 year survival rates were 83.3, 33.3, and 16.7 and 68.8, 48.1, and 20%, respectively. In the palliative hepatectomy group (28 cases), ten cases received combined radiotherapy postoperation. Most of these cases died during the first year postoperation. Primary liver cancer in Asia is commonly associated with hepatic cirrhosis. We suggest that partial hepatectomy is suitable for such patients. The results of the present series showed that the outcomes of the hepatic lobectomy and partial hepatectomy groups did not differ, but in partial hepatectomy, the operative mortality and complications were reduced, bleeding minimized, and operation time also shortened.

Immunohistochemical Characterization of 130 Cases of Primary Hepatic Carcinomas

Primary liver carcinoma (PLC) may express a certain number of markers. Here we communicate results of an analysis of five such markers (alpha-1-antitrypsin--AAT--, carcino-embryonic antigen --CEA--, alpha-fetoprotein --AFP--, and superficial --HBsAg-- and core --HBcAg-- antigens of hepatitis B virus) by means of PAP techniques in 130 cases of PLC, comparing the neoplastic tissue and the non-tumorous liver. Three variants of PLC are distinguished: hepatocarcinoma (HC) (108 cases); cholangiocarcinoma (CC) (19 cases); and three cases of hepatocholangiocarcinoma (HCC). AAT was positive in 29 HC, 2 HCC, and negative in all 19 CC. CEA appeared positive in 16 HC, 16 CC and only one HCC. AFP was positive in two HC, and negative in all CC and HCC. HBsAg displayed positivity in 15 HC and one HCC, being negative in all 19 CC. HBcAg was positive in 4 HC, and negative in all CC and HCC. HBsAg was also positive in two neoplastic emboli associated with HC. On the non-tumorous liver tissue the immunohistochemical results showed positivity for AAT and CEA, but not for AFP. Therefore the present results confirm that in the geographical area from which these tumors proceed, PLC is closely correlated with HBsAg positivity and with cirrhosis.

Immunohistochemical Characterization of 130 Cases of Primary Hepatic Carcinomas

Primary liver carcinoma (PLC) may express a certain number of markers. Here we communicate results of an analysis of five such markers (alpha-1-antitrypsin-AAT-, carcinoembryonic antigen -CEA-, alpha- fetoprotein -AFP-, and superficial -HBsAg- and core -HBcAg- antigens of hepatitis B virus) by means of PAP techniques in 130 cases of PLC, comparing the neoplastic tissue and the non-tumorous liver. Three variants of PLC are distinguished: hepatocarcinoma (HC) (108 cases); cholanglocarcinoma (CC), (19 cases); and three cases of hepatocbolangiocarcinoma (HCC). AAT was positive in 29 HC, 2 HCCI and negative in all 19 CC. CEA appeared positive in 16 HC, 16 CC and only one HCC. AFP was positive in two HC, and negative in all CC and HCC. HBsAg displayed positivity in 15 HC and one HCC, being negative in all 19 CC. HBcAg was positive in 4 HC, and negative in all CC and HCC. HBsAg was also positive in two neoplastic emboli associated with HC. On the non-tumorous liver tissue the immunobistocbemical results showed positivity for AAT and CEA, but not; for AFP. Therefore the present results confirm that in the geographical area from which these tumors proceed, PLC is closely correlated with HBsAg positivity and with cirrhosis.

Chromatographic characterisation of neurotensin-like immunoreactivity in plasma and tissue extracts from hepatoma patients

To determine the nature of the neurotensin-like immunoreactivity produced by some cases of primary liver carcinoma, plasma and tumour neurotensin-like immunoreactivities were characterised in patients with neurotensin-producing hepatoma by chromatographic analysis in conjunction with radioimmunoassay with C- and N-terminally directed antisera. Gel filtration revealed that the majority of neurotensin-like immunoreactivity extracted from the tumour was co-eluted with synthetic neurotensin, whereas a substantial amount of the plasma immunoreactive neurotensin emerged at the void volume. Tumour neurotensin-like immunoreactivity showed a degree of heterogeneity on gel filtration and high pressure liquid chromatography that contrasted with neurotensin-like immunoreactivity extracted from ileal mucosa, suggesting a different post-translational processing of neurotensin within tumour tissue. The ratio of neurotensin 1–8 to neurotensin 1–13 in the patients' plasma suggested that neurotensin was metabolised in a manner similar to that in healthy subjects. The clinical and biological significance of the ectopic production of neurotensin in some hepatomas remains unclear.

The clinico-pathological analysis of 30 cases of primary liver carcinoma (PLC)

The clinico-pathological analysis of 30 cases of primary liver carcinoma (PLC)

Primary Liver Carcinoma and Liver Cirrhosis in Atomic Bomb Survivors, Hiroshima and Nagasaki, 1961-75, With Special Reference to Hepatitis B Surface Antigen

During 1961-75, 128 cases of primary liver carcinoma (PLC) in the Radiation Effects Research Foundation life-span study extended sample and 301 cases of liver cirrhosis in the pathology study sample were observed. The presence of hepatitis B surface antigen (HBsAg) was assessed in all of the cases with the use of orcein and aldehyde fuchsin stains and was confirmed by the immunofluorescence technique. The incidence of PLC was two times higher in Nagasaki than in Hiroshima, which was statistically significant, but little difference was noted in the prevalence of cirrhosis in the two cities. Findings that might possibly explain the higher PLC incidence in Nagasaki were 1) the 2.3 times higher presence in Nagasaki than in Hiroshima of HBsAg in the livers of subjects without liver disease and 2) the two times higher prevalence in Nagasaki than in Hiroshima of cirrhosis with PLC. We believe that the higher incidence of PLC in Nagasaki is attributable to hepatitis B virus infection, although other factors (e.g., immunologic competence affected by radiation) cannot be excluded. In both cities, a suggestive relationship of radiation dose to cirrhosis prevalence, but not to PCL prevalence, was noted. To clarify possible radiation effects on cirrhosis prevalence, further follow-up of the populations of these two cities is necessary.

The significance of 5'-nucleotide phosphodiesterase isozymes in the diagnosis of liver carcinoma.

The results of determination of the serum 5'-NPDase isozymes in 95 cases of primary liver carcinoma and other kinds of disease are presented. The 5'-NPDase-V was positive in 83.2% of primary liver cancer cases. This test might be a useful supplement to AFP determination, especially in AFP-negative liver cancer patients. In most patients who had undergone successful liver resection for primary carcinoma, the test became negative. A positive 5'NPDase-V test in patients with cancer elsewhere in the body may suggest liver metastasis. In addition, this test may be of some help in the differentiation of primary liver cancer from other kinds of liver disease. The problem of "false-positive" results of this test is discussed.

Clinical aspects of carcinoma of the liver (author's transl)

The incidence of epi-cirrhotic liver carcinoma is apparently on the increase. Between 1969 and 1973 there were 84 cases of primary liver carcinoma and 467 of cirrhosis among 10211 autopsies. In 74 (16%) the carcinoma had developed in a cirrhotic liver. Clincally the diagnosis of carcinoma had been made in only 14 cases. The mean survival time after the diagnosis was seven weeks, after onset of the terminal symptoms 13 weeks. Typical clinical features were decompensated, hypertrophic, often coarsely granular, liver cirrhosis. The best diagnostic method was apparently laproscopy and determination of alpha 1-fetoprotein and cholestatic enzymes.

Primary liver carcinoma.

From 1948 through 1970, 164 histologically diagnosed cases of primary liver carcinoma were managed at Charity Hospital in New Orleans. The disease was five times more common in males, and most frequently occurred in the 6th and 7th decades of life. Weight loss, upper abdominal pain, anorexia, and jaundice made up the most significant symptom complex. Hepatomegaly was the most common physical finding. Approximately 85% of the cases were hepatocellular carcinoma. Extra-hepatic metastases were present in 55% of the 120 cases which came to autopsy. Lung, regional nodes, adrenals, and bone were the favored sites. Tumor was limited to one lobe in 32% of cases. Cirrhosis of the liver was diagnosed in 56%. Six patients underwent hepatic resection; 1 lived over 3 years, and 1 is alive 3 1/2 years after operation. Twelve patients received chemotherapy; 1 was alive at 2 1/2 years. Forty-nine patients had an intra-abdominal operative procedure. Over-all survival data for operated vs. non-operated cases did not vary significantly. Twenty-seven patients had percutaneous liver biopsy; the death of 3 was directly attributable to intra-abdominal hemorrhage after this procedure. Cancer 33:1624–1629, 1974.

The histogenesis of primary hepatic carcinoma.

The existence of hepatocellular and cholangiocellular carcinomata, arising from liver cells and bile duct epithelium respectively, has long been recognized, although the proportions of each type have varied in different series. Gustafson (1937) reported 39 liver cell and 11 bile duct tumours amongst 62 cases of primary liver carcinoma based on 24,400 necropsies, and Wilbur, Wood, and Willett (1944) described 45 hepatomas and four cholangiomas. This predominance of liver cell tumours is also stressed by Counseller and Mclndoe (1926), Loesch (1939), and Hoyne and Kernohan (1947). On the other hand, Fried (1924) described four cholangiomas and one hepatoma, while Karsner (1911) and Cunningham (1943) reported a preponderance of cholangiomas. The existence of a combined tumour, consisting of hepatocellular and cholangiocellular elements, has been postulated comparatively recently. Milne (1909) and Beattie and Donaldson (1912) only recognized two types, while Pirie (1921) reported five tumours of doubtful or mixed amongst 36 cases of primary hepatic carcinoma. Gustafson (1937) described two cases of intermediate or dual origin in his series and this combined carcinoma has also been described by Warvi (1944). Allen and Lisa (1949), reporting five cases of combined liver cell and bile duct tumours amongst 35 cases of primary hepatic carcinoma, described three possible combinations, namely, separate hepatoand cholangiocellular tumours in the same liver, separate tumours which intermingle, and individual masses which display both features so intimately associated that they can only be interpreted as arising from the same site. Three of their cases fell within the last group, while Campbell (1949) described four examples of mixed tumour amongst 22 cases of spontaneous hepatocellular and cholangiocellular carcinoma in ducks. The occurrence of three apparently mixed hepatoand cholangiocellular tumours in an un-

Primary carcinoma of the liver; a clinicopathologic study of one hundred eight cases.

Primary carcinoma of the liver continues to be a challenging disease, for it is of uncommon occurrence, and it presents a major diagnostic and therapeutic problem. Attention was recently refocused on this disease when it was noted that it had markedly increased in autopsies performed at this hospital during the past decade; the reasons for this increase were analyzed in a previous article from this laboratory, and they will be briefly referred to later. The present study reviews the clinical, pathological, and laboratory features of autopsied cases of primary liver carcinoma at this hospital and contrasts the findings in this series with those of other reports. No attempt has been made to record all previous reports of liver carcinoma, but rather to use the articles dealing either with large numbers of cases, or those dealing with pertinent features of the disease. Early History Among the excellent summaries of the historical