Liver Cancer In China Research Articles

Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System in Diagnosing Hepatocellular Carcinoma: Diagnostic Performance and Interobserver Agreement.

To determine the diagnostic performance and inter-reader agreement of the contrast-enhanced ultrasound liver imaging reporting and data system (CEUS-LI-RADS) for diagnosing hepatocellular carcinoma (HCC) in high-risk patients. In this prospective study, CEUS-LI-RADS categories (LR-5 for predicting HCC) were assigned by six blinded readers and compared to the definitive HCC diagnosis in patients with liver cirrhosis per the 2017 China Liver Cancer Guidelines (CLCG). CEUS features were recorded in 96 patients with 96histology-proven lesions. The diagnostic performance of LR-5 was described by the sensitivity, specificity and accuracy. Multi-reader agreement was assessed by using intraclass correlation coefficients (ICC). In cirrhotic patients, the specificity of LR-5 (range: 92.7-100.0 %) was statistically higher than that of CLCG for each reader (range: 28.6-64.3 %). However, the sensitivity (range: 38.6-63.6 %) and accuracy (range: 53.4-70.7 %) were statistically lower in CEUS-LIRADS than in CLCG (sensitivity range: 88.6-100.0 %; accuracy range: 77.6-86.2 %). Only fair to moderate inter-reader agreement was achieved for the CEUS-LI-RADS category (ICC = 0.595) and washout appearance (ICC range: 0.338 to 0.555). Neither nodule-in-nodule nor mosaic architecture was observed more often in HCC (all P > 0.05), with poor inter-reader consistency for both (both ICC < 0.20). CEUS-LI-RADS category 5 has a high specificity but a low accuracy for identifying HCC in high-risk patients. Inter-reader agreement is not satisfactory concerning CEUS-LIRADS category and washout appearance. Moreover, the clinical value of ancillary features favoring HCC is quite limited.

Research progress on anti-hepatocellular carcinoma mechanism of active ingredients of traditional Chinese medicine

According to the latest data, the annual mortality rate of liver cancer in China ranks the second among malignant tumors, and it has become one of the most fatal cancers in urban and rural areas. This article starts with the active ingredients of traditional Chinese medicines for liver cancer to summarize the relevant literature at home and abroad, with the hope to provide theoretical references for the development of traditional Chinese medicines against liver cancer. The results show that the active ingredients of traditional Chinese medicines such as Chinese herbal extracts, flavonoids, polysaccharides, alkaloids, saponins, volatile oils, terpenes, quinones, phenols, bioenzymes, and protein components are the entry points, mainly by inhibiting the proliferation of cancer cells, blocking the cancer cell cycle, inhibiting the invasion and metastasis of cancer cells, regulating signal pathways, regulating vascular endothelial growth factor(VEGF) and reactive oxygen species(ROS), etc. to play the effects against liver cancer. It can be seen that the active ingredients of traditional Chinese medicine with coordinated intervention effects at multiple levels and multiple targets are expected to become ideal medicines for the treatment of liver cancer.

Combination therapy with lenvatinib and anti-PD-1 antibodies for unresectable or advanced hepatocellular carcinoma: A real-world study.

e16610 Background: Combination therapy of anti-angiogenic therapy and anti-PD-1 antibody had shown promising anti-tumor effects for advanced hepatocellular carcinoma (HCC) in clinical trials. Here we report the effectiveness and safety of the combination therapy of lenvatinib and anti-PD-1 antibodies in a cohort of unresectable or advanced HCC pts. Methods: From Sep 2018 to Jan 2020, 77 consecutive pts received a combination treatment of lenvatinib and an anti-PD-1 antibody. Lenvatinib was given 8 mg/d regardless of patient body weight and anti-PD-1 antibody was used either q2wk (nivolumab or camrelizumab) or q3wk (pembrolizumab, sintilimab or toripalimab). pts who completed at least one efficacy and safety assessment were eligible for this study. Tumor response were evaluated with abdominal contrast-enhanced MRI/CT and/or chest CT every 2 mo (± 1 wk). Laboratory tests were monitored every 2-3 wk. Results: 59 pts were eligible for this study. Of them, 1 (1.7%) were BCLC stage A, 10 (16.9%) were BCLC stage B, 48 (81.4%) were BCLC stage C (including 20 pts in China Liver Cancer [CNLC] stage IIIa and 28 in CNLC stage IIIb). 43 (72.9%) pts were treated as first-line therapy. The table below shows efficacy results. R0 resection was performed in 6 (10.2%) pts due to tumor regression. By the data cut-off date, 13 pts died, and mOS was not mature. Overall, the combination treatment was well tolerated. 28 (47.5%) pts had at least one ≥ grade 3 treatment-emergent adverse event. 3 (5.1%) pts died from immune-related adverse events, 2 of them died from immune-related adverse events after hepatectomy. Conclusions: The combination of lenvatinib + anti-PD-1 antibody is effective and well-tolerated in pts with HCC as first-line or second-line treatment. It is also noted that initially unresectable HCC may be converted to resectable HCC following this combination treatment. [Table: see text]

Initially unresectable hepatocellular carcinoma treated by combination therapy of tyrosine kinase inhibitor and anti-PD-1 antibody followed by resection.

e16690 Background: Combination of tyrosine kinase inhibitor (TKI) and anti-PD-1 antibody showed a high tumor response for advanced hepatocellular carcinoma (HCC). We are aiming to study the effect of combination therapy followed by resection in pts with initially unresectable HCC. Methods: 60 consecutive pts with unresectable or advanced HCC were treated with combination therapy as first-line treatment, including 2 in BCLC-A (China Liver Cancer stage [CNLC]-Ib), and 13 in BCLC-B (CNLC-IIa and IIb), 26 in BCLC-C (vascular invasion, CNLC-IIIa) and 19 in BCLC-C (extrahepatic metastasis, CNLC-IIIb). Tumor response and resectability were evaluated by imaging every 2 months (± 1 week). The criteria of resectability included: (1) R0 resection can be achieved; (2) remnant liver volume ≥ 40%; (3) Child-Pugh score is 5; (4) no contra-indications for hepatectomy. Results: Conversion to resectable HCC was identified in 11 (18.3%) pts after combination therapy. Of them, 2 pts are still under treatment for immune-related adverse events, and 9 underwent hepatectomy as of January 2020. Of the 9 pts, the initial tumor was unresectable because of macro-vascular invasion (n = 6, 1 Vp3, 3 Vp4, 1 hepatic vein, 1 inferior vena cava), extrahepatic metastasis (n = 1, right adrenal gland), tumor nodules ≥ 4 (n = 1) and recurrent HCC within 2 months after first resection (n = 1). The TKIs used were lenvatinib (n = 6) and apatinib (n = 3); anti-PD-1 antibodies used were pembrolizumab (n = 4), sintilimab (n = 3), camrelizumab (n = 1) and nivolumab (n = 1). The median interval between start of combination therapy and resection was 99 days (range, 73–251). The median post-operative hospital stay was 14 days (range, 11–68). The prevalence of post-hepatectomy liver dysfunction (the criteria by ISGLS) is 5 (55.6%) pts, and the post-operative complications (by Clavien–Dindo classification) occurred in 4 (44.4%) pts, including grade I in 1, grade IIIa in 2, and grade V in 1 (died from immune-related adverse events). Tumor response (RECIST v1.1) evaluated before surgery were PR (n = 5), SD (n = 3), and PD (n = 1). Pathological CR (pCR) was found in 5 (55.6%) cases. After a median follow up of 72 days (range, 11–184), tumor recurrence were diagnosed in 1 patient, and mortality without tumor recurrence in 1 patient, the other 7 cases remained tumor-free. Conclusions: This is to date the largest cohort of pts underwent R0 resection after combination therapy for initially un-resectable HCC. The combination of a TKI and anti-PD-1 antibody is feasible as a conversion therapy.

Genomic DNA methylation profiling indicates immune response following thermal ablation treatment for HBV-associated hepatocellular carcinoma.

Hepatitis B virus (HBV)-associated hepatocellular carcinoma (HCC) is the most common type of liver cancer in China. Thermal ablation is one of the main strategies for HCC treatment. However, few studies have investigated the properties of the immune response following thermal ablation thus far. In the present study, five subjects with HBV-associated HCC were recruited from The Beijing Youan Hospital. Peripheral blood mononuclear cells (PBMCs) were collected at three time points: Prior to thermal ablation (PR), 1–3 days post-ablation (P1) and 5–7 days post-ablation (P7). An Illumina 850K methylation microarray was employed to determine the DNA methylation profile of each sample. Data were analyzed using different methylation probes with the Bioconductor package in R. Following annotation of different methylation CG sites (CGs), the associated genes were subjected to an Ingenuity Pathway Analysis. A total of 3,000 significantly different CGs (adjusted P<0.05; |log(fold-change)|>0.5) were identified within the PR, P1 and P7 time points. Of these, 744 (24.8%) sites increased between the PR and P1 time points but gradually decreased at the P7 time point. The remaining 2,256 (75.2%) sites decreased between the PR and P1 time points gradually increased at the P7 time point. Following gene annotation of different CGs on the promoter, signaling pathways analysis demonstrated that ‘p70S6K signaling’, ‘CXCR4 signaling’, ‘dendritic cell maturation’, ‘production of nitric oxide and reactive oxygen species in macrophages’ pathways were activated at the P7 time point. The present study suggested that PBMC DNA methylation had changed soon after thermal ablation for subjects with HBV-associated HCC, and systemic immune responses were activated, particularly at the P7 time point.

Three Different Ways of Treating Primary Hepatocellular Carcinoma at an Early Stage: A Prospective Comparative Study.

Primary hepatocellular carcinoma (PHC) is one of the most common malignancies in clinical practice. According to the “Guidelines for Diagnosis and Treatment of Primary Liver Cancer in China,” PHC, at an early stage, can be treated by surgical resection and ablation. Surgical resection basically consists of two ways; one is open hepatectomy (OH), and the other is laparoscopic hepatectomy (LH), which is a newly developed technique associated with advantages of open surgery. Ablation, also known as percutaneous thermal ablation using radiofrequency ablation (RFA) and microwave ablation (MWA), is a minimally invasive curative treatment for hepatocellular carcinoma. This preliminary report was aimed at evaluating the postoperative outcome of the patients undergoing these three therapeutic methods, respectively. The study analyzed the data of 95 patients who underwent LH, OH, or ablation between June 2018 and June 2019 at First People's Hospital of Changzhou, Third Affiliated Hospital of Soochow University. There were 20 patients in the ablation group, 35 patients in the OH group, and 40 patients in the LH group. Among the three groups, the postoperative short-term outcome was the best in the ablation group, suggesting that it was a safe and cheap way to treat PHC at an early stage.

Guidelines for diagnosis and treatment of primary liver cancer in China (2019 edition)

Guidelines for diagnosis and treatment of primary liver cancer in China (2019 edition)

The strategy of cascade prevention and treatment during a full course of disease for hepatocellular carcinoma

The five-year overall survival rate with liver cancer currently ranks the second lowest among seventeen common malignant tumors in China. The occurrence and development of liver cancer is a process of progressive exacerbation. Nowadays, the clinical research is mainly aimed at the intermediate stage, that is, the exploration of the principle and method of diagnosis and treatment in the hospital. Notably, the research on the precancerous stage and the recovery stage after treatment of liver cancer are still seriously inadequate. We put forward a stepwise strategy to emphasize that only the full course of prevention and treatment study on liver cancer patients can significantly improve the overall efficacy of liver cancer in China.

A bibliometric analysis on cohort study of liver cancer in China

Objective: To retrospectively analyze the application trend of cohort study in the field of liver cancer in past 27 years and to look forward to the future development trend. Methods: Chinese and English papers reporting the cohort studies of liver cancer conducted in the mainland of China since 1991 were included. The literature management software was used to analyze the publication time, institution, type and objective of the studies and the follow-up performance. Statistical analysis was carried out by using SPSS 21.0. Results: The number and quality of the papers reporting liver cancer-related cohort studies increased significantly in past 27 years and a core English journal group of this field has formed. The average annual growth rates of Chinese and English papers published were 20.4% and 35.2% respectively. About 52.3% of the Chinese papers and 73.5% of the English papers were published in past five years and the quality of these papers was high. The Chinese papers published on Chinese core journals accounted for 49.2%, and the English papers published on SCI periodicals (IF>3) accounted for 47.3%. For the study objective, those published on the domestic journals mainly focused on the pathogenesis of hepatoma (41.5%), studies with large sample size was the common form. The SCI studies mainly focused on the prognosis of liver cancer (40.7%). High-quality SCI papers are more interested in the studies of prognosis, and survival analysis was the common form. Conclusions: The application of cohort study in the field of liver cancer gradually increased in China. Large-scale study and prognosis analysis were conducted commonly. However, it is necessary to further improve the researchers' understanding of cohort study, improve the follow-up quality, and increase the application of scientific evaluation methods, such as survival analysis, for the better solving of clinical problems.

Identification of miR-4644 as a suitable endogenous normalizer for circulating miRNA quantification in hepatocellular carcinoma.

Background: Circulating microRNAs (miRNAs) have proved to be promising biomarkers for early diagnosis and therapeutic monitoring in cancers. Particularly for hepatocellular carcinoma (HCC), detection of circulating miRNA biomarkers as a new diagnostic approach has been written into the latest Guidelines for Diagnosis and Treatment of Primary Liver Cancer in China (2019 edition). However, no general consensus on an ideal endogenous normalizer for circulating miRNAs quantification has been reached, so it will affect the accuracy of quantitative results. In this study, we aim to identify a stable endogenous normalizer for analyzing circulating miRNAs.Methods: Candidate miRNAs were selected by screening dataset GSE104310, as well as data statistics and analysis. Five commonly reference genes were chosen for further comparison and verification. Then, the expression levels of these genes in serum were analyzed by quantitative reverse transcription PCR (RT-qPCR) among four groups, including patients diagnosed with HCC, chronic hepatitis B (CHB), liver cirrhosis, and healthy subjects. Furthermore, the stability of target genes was evaluated using geNorm, NormFinder, comparative ΔCq programs, and validated by database. We also explored the availability of the miRNA combination, and compared the performance difference between combination and individuals, as well as the selectivity of miRNA references in the combinations.Results: 11 candidate miRNAs were obtained, and miR-4644 stood out among these miRNAs, and proved to be much more stable than other endogenous miRNAs. Further study showed that miR-4644 exhibited higher stability and expression abundance than other commonly miRNA reference controls. Finally, we discovered the combination of miR-4644 and miR-16 revealed high performance in stability when compared to miRNA individuals. Furthermore, the combination consisted of references with closer nature could give rise to amplification effects in stability.Conclusions: Our findings demonstrated that miR-4644 is an ideal endogenous normalizer for circulating microRNA quantification in hepatocellular carcinoma. Besides, combining miR-4644 with miR-16 into a whole as a reference control would greatly improve the accuracy of quantification.

Progress in immunotherapy for hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is one of the malignant tumors with the highest morbidity and mortality in the world. The morbidity and mortality of HCC are increasing every year. Liver cancer is a serious threat to public health in China and the death rate of patients with liver cancer in China is the highest in the world. Beyond surgery, chemotherapy and radiotherapy, immunotherapy is an emerging treatment for cancer, which could control and kill tumor cells by relieving the inhibitory status of immune cells in the tumor microenvironment and activating the immune function of the body. Immune checkpoint inhibitors, adoptive immunotherapy and tumor vaccine are the major treatments of immunotherapy. Compared with traditional therapy methods, immunotherapy could enhance immune function, delay tumor progression, prolong the survival time of patients, and becomes a hotspot in the basic and clinical cancer research. This article reviews the research progress of immunotherapy for liver cancer.

Make great efforts to improve the levels of refined diagnosis and individualized treatment for microvascular invasion of liver cancer in China

Recurrence after surgical resection is a bottleneck that severely restricts the long-term efficacy of patients with liver cancer, mainly referring to hepatocellular carcinoma and intrahepatic cholangiocarcinoma. As the most representative pathobiological feature of liver cancer, microvascular invasion (MVI) should be taken as an important focus to break through the bottleneck of postoperative recurrence. The new pathological diagnostic criteria and classification scheme of MVI has been written into the current Guidelines for Diagnosis and Treatment of Primary Liver Cancer of China. It is not only an important pathological indication for the clinical implementation of anti-recurrence therapy after operation, but also an key pathological basis for the clinical formulation of postoperative anti-recurrent therapy. Therefore, we intend to investigate how to make better use of it. From now on, multidisciplinary research should be strengthened in order to make real progress in the occurrence mechanism, migration pathway, distribution pattern, accurate identification and effective treatment of MVI in order to further improve the long-term efficacy of patients with liver cancer. Key words: Liver neoplasms; Microvascular invasion; Diagnosis; Pathology; Clinic

Liver cancer epidemiology in China, 2015

Objective: Using updated population-based cancer registration (PBCR) data, we estimated nation-wide liver cancer statistics overall, by sex and by areas in China. Methods: Qualified PBCR data of liver cancer in 2015 which met the data quality criteria were stratified by geographical locations, sex, and age groups. Age-specific incidence and mortality rates by sex and area were calculated. The burden of liver cancer was evaluated by multiplying these rates by the year of 2015 population. Chinese standard population in 2000 and World Segi's population were used for the calculation of age-standardized rates (ASR) of incidence and mortality. Results: Qualified 368 cancer registries covered a total of 309 553 499 populations in China, accounting for 22.52% of the national population. It is estimated that there were 370 000 new cases (274 000 males and 96 000 females) of liver cancer in China. The age-standardized incidence rates by Chinese standard population (ASR China) and World Segi's population (ASR World) were 17.64 per 100 000 and 17.35 per 100 000, respectively. Rural areas showed higher incidence (ASR China: 20.07 per 100 000, ASR World: 19.67 per 100 000) than urban areas (ASR China: 15.90 per 100 000, ASR world: 15.67 per 100 000). Subgroup analysis showed that western areas of China had highest incidence rate of liver cancer, with the ASR China of 20.65 per 100 000 and 20.22 per 100 000 for ASR world, respectively. For new cases of liver cancer deaths, there were 326 000 new deaths (242 000 males and 84 000 females) in China, with age-standardized mortality rate by Chinese standard population and World Segi's population of 15.33 per 100 000 and 15.09 per 100 000, respectively. Rural areas showed higher mortality (ASR China: 17.17 per 100 000, ASR world: 16.86 per 100 000) than urban areas (ASR China: 14.00 per 100 000, ASR World: 13.81 per 100 000). Conclusions: There is still a heavy burden of liver cancer in China. Rural residents have higher incidence and mortality of liver cancer compared with urban counterparts. It is likely that many factors such as hepatitis virus infection, and aflatoxin exposure play a dominating role. Prevention and control strategies should be enhanced in the future.

Long-Term Trends of Liver Cancer Incidence and Mortality in China 1990-2017: A Joinpoint and Age-Period-Cohort Analysis.

Liver cancer (LC) is one of the most common causes of cancer-related deaths: this study aims to present the long-term trends and age–period–cohort effects of the incidence of and mortality from LC in China during 1990–2017. Incidence and mortality data were obtained from the Global Burden of Disease Study 2017. We determined trends in the age-standardized incidence rate (ASIR) and mortality rate (ASMR) using Joinpoint regression. An age–period–cohort (APC) analysis was performed to describe the long-term trends with intrinsic estimator methods. The ASMR decreased markedly before 2013 and increased thereafter, with overall average annual percent change (AAPC) values of −0.5% (95% confidence interval (CI): −0.6%, −0.3%) for men and −1.3% (−1.6%, −1.0%) for women during 1990–2017. The ASIR significantly increased by 0.2% (0.1%, 0.3%) in men and decreased by 1.1% (−1.2%, −1.0%) in women from 1990 to 2017. The risks of LC incidence and mortality increased with age in both genders. The period effect risk ratios (RRs) of incidence and mortality displayed similar monotonic increasing trends in men and remained stable in women. The cohort effect showed an overall downward trend and almost overlapping incidence and mortality in both genders, and later birth cohorts experienced lower RRs than previous birth cohorts. Older age, recent period, and birth before 1923 were associated with a higher risk of liver cancer incidence and mortality. The net age and period effects showed an increasing trend, while the cohort effects presented a decreasing trend in incidence and mortality risk. As China’s population aging worsens and with the popularization of unhealthy lifestyles, the burden caused by liver cancer will remain a huge challenge in China’s future.

Detection and Genomic Characterization of a Morganella morganii Isolate From China That Produces NDM-5.

The increasing prevalence and transmission of the carbapenem resistance gene blaNDM–5 has led to a severe threat to public health. So far, blaNDM–5 has been widely detected in various species of Enterobacterales and different hosts across various cities. However, there is no report on the blaNDM–5– harboring Morganella morganii. In January 2016, the first NDM-5-producing Morganella morganii L241 was found in a stool sample of a patient diagnosed as recurrence of liver cancer in China. Identification of the species was performed using 16S rRNA gene sequencing. Carbapenemase genes were identified through both PCR and sequencing. To investigate the characteristics and complete genome sequence of the blaNDM–5-harboring clinical isolate, antimicrobial susceptibility testing, S1 nuclease pulsed field gel electrophoresis, Southern blotting, transconjugation experiment, complete genome sequencing, and comparative genomic analysis were performed. M. morganii L241 was found to be resistant to broad-spectrum cephalosporins and carbapenems. The complete genome of L241 is made up from both a 3,850,444 bp circular chromosome and a 46,161 bp self-transmissible IncX3 plasmid encoding blaNDM–5, which shared a conserved genetic context of blaNDM–5 (ΔIS3000-ΔISAba125-IS5-blaNDM–5-ble-trpF-dsbC-IS26). BLASTn analysis showed that IncX3 plasmids harboring blaNDM genes have been found in 15 species among Enterobacterales from 13 different countries around the world thus far. In addition, comparative genomic analysis showed that M. morganii L241 exhibits a close relationship to M. morganii subsp. morganii KT with 107 SNPs. Our research demonstrated that IncX3 is a key element in the worldwide dissemination of blaNDM-5 among various species. Further research will be necessary to control and prevent the spread of such plasmids.

Cinobufacini injection for moderate and advanced primary liver cancer: A systematic review and meta-analysis

Cinobufacini, a compound extracted from bufo toad, is a traditional Chinese medicine (TCM) that has been shown to have efficacy in cancer treatment. The cinobufacini injection is widely used in patients with moderate and advanced liver cancer in China. In the present study, we aimed to determine the effects of cinobufacini injection for this specific category of patients. A search for randomized control trials (RCTs) using cinobufacini was conducted in the PubMed, EMBASE, CENTRAL, and the other four major Chinese databases. The systematic review was performed according to the recommendations of the Cochrane collaboration, and the RevMan 5.3. software was used for statistical analysis. A random-effects model was used to perform the data. Risk ratios (RR) with corresponding 95% confidence interval were calculated according to Cochrane handbook. A total of 11 RCTs consisting of 728 patients were included. All of the trials demonstrated significantly improved total response rates, total response rates of Karnofsky Performance Score (KPS), 1- to 2-year survival rates, and quality of life in the intervention groups injected with cinobufacini. There was no statistically significant difference between the groups (cinobufacini versus no cinobufacini; cinobufacini plus transcatheter arterial chemoembolization (TACE) versus TACE only) in terms of the 6-month survival rate, clinical benefit rate and clinical benefit rate of KPS. This systematic review demonstrated the beneficial effects of cinobufacini injection in terms of total response rate and the 1- to 2-year survival rate in patients with moderate and advanced liver cancer. The efficacy for the cinobufacini injection group might be better than that of the control group for treatment of moderate and advanced liver cancer. Given that the majority of the trials were of low quality, more high-quality prospective RCTs with strict design in accordance with CONSORT for TCM are needed.

Disease burden of liver cancer in China from 1997 to 2016: an observational study based on the Global Burden of Diseases

ObjectiveTo evaluate the trends in disease burden and the epidemiological features of liver cancer in China while identifying potential strategies to lower the disease burden.DesignObservational study based on the Global...

Strategies of primary prevention of liver cancer in China: expert consensus (2018)

Liver cancer is one of the most common cancers in China. The major risk factors are chronic infections of hepatitis B virus (HBV), hepatitis C virus (HCV), high exposure to aflatoxins. In addition, exposure to cyanotoxins and some preventable health behaviors are also recognized to contribute to liver cancer development. To relieve the disease burden, primary prevention of etiological interventions is an important strategy. Based on the liver cancer epidemiology in China and the effective evidences and results from the etiological interventions conduced in Chinese population domestically, the following strategies are recommended in the "Strategies of primary prevention of liver cancer: Expert Consensus (2018)" to promote the effective prevention of liver cancer in general population. Immunization with HBV vaccines, including the immune programs to neonates, infants and children born to mothers with different status of HBV infection. Antiviral therapies to the patients with chronic hepatitis B or hepatitis C. Avoiding or reducing the exposure to aflatoxins as well as the cyanotoxins. Changing harmful life style, including quitting smoking and limiting alcohol consumption etc.

Advances in Research on Immunological Checkpoint Inhibitors in Immunotherapy of Liver Cancer

The current treatments of liver cancer in China are mainly comprehensive treatment and systematic treatment, with poor therapeutic effect and high recurrence rate and metastasis rate. The existence of immunosuppressive microenvironment is an important reason for liver tumor cells to escape from the host immune system, and also an important basis for the occurrence and development of liver cancer. With the recent transformation of the target of tumor therapy from tumor cells to tumor cell immune microenvironment, immunotherapy has emerged quietly. It is a new strategy for the treatment of hepatocellular carcinoma to improve the immune attack on tumor cells by changing the immunosuppressive environment of hepatocellular carcinoma cells. Immune checkpoint is the main mechanism by which liver cancer cells escape the host immune system. PD-1/PDL-1 and CTLA-4 are targeted immunocheckpoint inhibitors, which have shown good therapeutic effects and application prospects in the clinical treatment of HCC. This article reviews the latest advances in immunocheckpoint inhibitors in the immunotherapy of hepatocellular carcinoma.

PCN75 - Disability Adjusted Life Years for Liver Cancer in China: Trend Analysis from 1990-2016 and Future Prediction

PCN75 - Disability Adjusted Life Years for Liver Cancer in China: Trend Analysis from 1990-2016 and Future Prediction