Primary Hepatic Carcinoma Patients Research Articles

Impact of intraoperative allogenic and autologous transfusion on immune function and prognosis in patients with hepatocellular carcinoma.

The effect of intraoperative blood transfusion on the immune function and prognosis of hepatocellular carcinoma (HCC) has not been fully investigated. The aim of this study was to evaluate the effects of intraoperative autologous blood transfusion and allogeneic blood transfusion on immune function and prognosis in surgically treated HCC patients. One hundred fourteen primary hepatic carcinoma patients who would undergo selective operations were divided into two groups, 35 patients in the experimental group received intraoperative autologous blood transfusion and 79 patients in the control group received allogeneic blood transfusion. The amount of serum T lymphocyte subsets, natural killer (NK) cells and immunoglobulin before and after operation, as well as the recurrence-free survival (RFS) were compared. Results shown that, there was no significant difference in the level of immunocytes and immunoglobulin between the two groups before treatment (P > .05). At 1 day after surgery, there were significant differences in T lymphocyte, NK cells and immunoglobulin levels before and after transfusion. CD3+, CD4+, CD4+/CD8+, and NK cells in autologous transfusion group were significantly higher than those in allogeneic transfusion group (P < .05); the level of IgG, IgM, and IgA in allogeneic transfusion group were significantly lower than those before operation (P < .05), the level of IgG, IgM, and IgA in autologous transfusion group did not significantly fluctuate, and significantly higher than those of allogeneic transfusion group (P < .05). At 5 days after surgery, all indexes of autologous transfusion group recovered to the preoperative level, the levels of CD3+, CD4+, CD4+/CD8+, NK cells, IgG, IgM, and IgA were significantly higher than those of allogeneic transfusion group (P < .05). The follow-up results showed that the RFS of autologous transfusion group was significantly higher than that of allogeneic transfusion group (P < .05). In conclusion, compared with allogeneic blood transfusion, intraoperative autologous blood transfusion possessed less impact on immune function, it may even improve immune function and RFS in HCC patients after surgery. Therefore, HCC patients should be recommended to receive autologous blood transfusion instead of allogeneic blood transfusion when they need blood transfusion during the perioperative period.

Selective downregulation of distinct circRNAs in the tissues and plasma of patients with primary hepatic carcinoma.

Multiple studies have indicated that circular RNAs (circRNAs) are closely associated with malignant tumor development and metastasis. However, the significance of circRNAs in primary hepatic carcinoma (PHC), particularly in the plasma, remains largely undetermined. In the current study, circRNA expression profiles in three pairs of tumor and adjacent normal samples from patients with PHC, were examined using circRNA chip screening. A total of 80 circRNAs were upregulated, while 75 circRNAs were downregulated in PHC tissues, relative to para-tumor tissues (fold change, ≥1.5). A total of two upregulated circRNAs and three downregulated circRNAs were selected as candidates for further validation of their differential expression. This was performed using reverse transcription-quantitative PCR with 11 pairs of PHC tissues and para-tumor tissues. The results indicated that hsa_circ_0003056 exhibited reduced expression in PHC tissues. Moreover, hsa_circ_0003056 and hsa_circ_0067127 were quantified in the plasma samples of 35 PHC patients and 32 healthy donors. The results revealed that hsa_circ_0067127 was significantly downregulated in the patients' plasma. Finally, a competing endogenous RNA network was constructed, which consisted of one circRNA (hsa_circ_0003056 or has_circ_0067127), five miRNAs and miRNA-targeted genes (mRNAs). Kyoto Encyclopedia of Genes and Genomes pathway analysis indicated that differentially expressed (DE) genes were significantly enriched in the pathway associated with ‘regulation of the pluripotency of stem cells’ for hsa_circ_0003056, and ‘ubiquitin-mediated proteolysis’ and ‘prostate cancer’ for hsa_circ_0067127. Gene ontology analysis revealed that DE genes were primarily associated with the ‘modulation of kinase activity’ and ‘intracellular and transmembrane-ephrin receptor activity’ for hsa_circ_0003056, ‘artery morphogenesis activity’, ‘HOPS complex and transferase activity’ and in ‘transferring acyl groups’ for hsa_circ_0067127. This approach indicated that hsa_circ_0003056 in PHC tissue, and hsa_circ_0067127 in PHC plasma, are downregulated and may be implicated in the tumorigenesis of PHC.

The prognostic significance of serum gamma-glutamyltransferase levels and AST/ALT in primary hepatic carcinoma

BackgroundBlood counting and the liver function tests, as the routine examinations, can reflect the immune and nutritional status of the body, our aim is to assess the prognostic significance of serum gamma-glutamyltransferase (GGT) levels and AST/ALT in primary hepatic carcinoma.MethodsClinico-pathological data of 414 patients with primary hepatic carcinoma in the 1st Affiliated Hospital of Anhui Medical College between January 2007 to January 2014 was analyzed retrospectively in this study. Survival curves were described by Kaplan-Meier method and compared by Log-rank test, univariate and multivariate analysis were used to identify the prognostic factors.ResultsGGT was positively correlated with the tumor size(P = 0.000), tumor volume (P = 0.000), tumor volume percent (P = 0.004), TNM stage(P = 0.009), 1-year survival rate (P = 0.000), 3- years survival rate (P = 0.000) and 5-years survival rate(P = 0.000). The serum ALT/AST was significantly correlated with age (P = 0.047), tumor size(P = 0.002), tumor volume (P = 0.010), tumor volume percent (P = 0.005), TNM stage(P = 0.006), liver cirrhosis(P = 0.003), 3- years survival rate (P = 0.032) and 5-years survival rate(P = 0.000). The Kaplan-Meier curves showed that the patients with primary hepatic carcinoma had a longer time in the low GGT group and low AST/ALT group, showing a significant difference (P < 0.05). The univariate and multivariate analyses showed that TNM stage, differentiation grade, tumor volume, GGT and AST/ALT were independent factors for predicting overall survival rate of primary hepatic carcinoma patients.ConclusionsGGT and AST/ALT were independent factors for predicting overall survival rate of primary hepatic carcinoma patients.

Primary hepatic carcinoma patients with pancreatic metastasis combined with mucinous cystadenoma: a case report

患者男性，70岁，因右上腹痛半年余，发现肝占位1周入院。患者半年前无明显诱因出现右上腹痛，呈持续性闷痛，1周前腹痛加重。经腹部CT、MRI等检查，考虑为原发性肝癌、胰腺囊腺瘤。剖腹探查术中见结节性肝硬化，肝Ⅵ段7.0 cm × 4.0 cm肿块，质硬，边界欠清，可见包膜。胰头颈部见多个囊状肿物，边界不清。行肝Ⅵ段切除、Ⅴ段部分切除、胆囊切除术。术中结合病理综合考虑为晚期肝癌并远处转移。行姑息性手术治疗。术后病理结果：胰腺黏液性囊腺瘤；肝细胞性肝癌，低分化等。术后患者恢复良好。

Effects of fast track surgery nursing on fatigue and quality of life among hepatocellular carcinoma patients

Objective To explore the effects of fast track surgery (FTS) nursing on fatigue and quality of life among hepatocellular carcinoma patients. Methods From June 2017 to June 2018, we selected 80 primary hepatic carcinoma patients with hepatocellular carcinoma resection of hepatobiliary surgery at Peking Union Medical College Cancer Hospital as subjects by convenience sampling. All of the patients were divided into control group and observation group with the method of random number table, 40 cases in each group. Observation group carried out FTS, while control group adopted routine nursing. The intervention effects were compared with the Cancer Fatigue Scale (CFS) and the Quality of Life Questionnaire Core 30 (QLQ-C30) . Results Before intervention, there was no statistical difference in the score of CFS between two groups (P>0.05) . After intervention, the total score and dimension scores of CRF of observation group were lower than those of control group with statistical differences (P 0.05) . After intervention, the total score of QLQ-C30 of observation group was higher than that of control group with a statistical difference (P<0.01) . Conclusions FTS can effectively improve the postoperative fatigue of hepatocellular carcinoma patients and quality of life of patients which is worthy of clinical popularization and application. Key words: Carcinoma, hepatocellular; Quality of life; Fast track surgery; Fatigue

Curative effect of endostar combined with oxaliplatin in the treatment of primary hepatic carcinoma and its influence on immune cells.

Curative effect and adverse reactions of oxaliplatin combined with endostar in the interventional treatment of primary hepatic carcinoma (PHC) were investigated. A total of 101 PHC patients from October 2012 to December 2014 in The First Affiliated Hospital of Xi'an Jiaotong University were retrospectively collected. Fifty patients in combined therapy group were treated with oxaliplatin combined with endostar, while the remaining 51 patients in oxaliplatin group were treated with oxaliplatin alone. The treatment lasted for a total of 4 cycles (20 days as 1 cycle). The ratios of cluster of differentiation 3 (CD3)+, CD4+ and CD8+ were detected via enzyme-linked immunosorbent assay (ELISA). The objective response rate in combined therapy group was 92.00%, which was significantly higher than that in oxaliplatin group (74.51%). The main adverse reactions showed no statistical difference between the two groups (P>0.05). The median progression-free survival (PFS) was 8.6 months in combined therapy group and 6.3 months in oxaliplatin group, while the median overall survival (OS) was 12.9 months in combined therapy group and 10.6 months in oxaliplatin group. After treatment, CD4+ and CD3+ levels in the peripheral blood in both groups were obviously lower than those before treatment, but the CD8+ level was obviously higher than that before treatment. At the same time, changes in the ratio of T lymphocyte subsets in combined therapy group were superior to those in oxaliplatin group, displaying statistically significant differences (P<0.05). Oxaliplatin combined with endostar has a good curative effect in the treatment of PHC with mild adverse reactions, which can prolong the survival time of patients, improve the levels of T lymphocyte subsets and increase the immunity of patients, so it is worthy of promotion and application in clinic.

Short-term effect of metronomic chemotherapy of low-dose Tegafur on patients with primary hepatic carcinoma after radiofrequency ablation.

To investigate the therapeutic effect of metronomic chemotherapy with low-dose Tegafur on patients with primary hepatic carcinoma (PHC) after radiofrequency ablation (RFA). PHC patients who underwent RFA were assigned to RFA + Tegafur group and RFA group, respectively. Patients in RFA + Tegafur group received metronomic chemotherapy with low-dose Tegafur after RFA. PHC patients in RFA group only received radiofrequency ablation. Therapeutic efficacy of the two groups was prospectively analyzed within 18 months after RFA. Disease control rate (DCR) and progression-free survival (PFS) in both groups were evaluated. Follow-up data showed that DCR in RFA + Tegafur group and RFA group at 9 months after RFA was 93.3% and 73.4%, respectively (p=0.038). Within the 18-month follow-up, median PFS in RFA + Tegafur group and RFA group was 16.25 months and 12.25 months, respectively (p<0.001). One-year PFS in RFA group was 53.3%, which was remarkably lower than that of RFA + Tegafur group (83.3%, p=0.012). Moreover, the prevalence of major complications in the present study was 13.3%. No treatment-related death occurred in both groups. Metronomic chemotherapy with low-dose Tegafur after RFA can slow down tumor progression and prolong the progression-free survival of PHC patients.

The differentially expressed circular ribonucleic acids of primary hepatic carcinoma following liver transplantation as new diagnostic biomarkers for primary hepatic carcinoma.

Recent studies have shown that circular ribonucleic acids have differential expression in some diseases. This study compared the expression levels of five circular ribonucleic acids between patients of primary hepatic carcinoma following liver transplantation and healthy individuals for searching a new diagnostic biomarker about primary hepatic carcinoma. We chose differentially expressed targeted circular ribonucleic acids according to fold change ≥2.0 or ≤-2.0 between circular ribonucleic acids microarray of perioperative liver transplantation and normal controls. Then we used the Arraystar home-made micro-ribonucleic acid target prediction software based on TargetScan and miRanda to predict circular ribonucleic acid/micro-ribonucleic acid interactions. And we assess the expression levels of hsa_circ_100571, hsa_circ_400031, hsa_circ_102032, hsa_circ_103096, and hsa_circ_102347 in the peripheral blood of normal controls and liver transplantation patients before transplantation and on the first, third, and seventh days after transplantation by real-time quantitative polymerase chain reaction. We chose five circular ribonucleic acids, two of which have been correlated with micro-ribonucleic acid-related carcinoma recurrence after liver transplantation, hepatocellular carcinoma and analyzed their expression with 2-△△Ct method. The expression level of hsa_circ_100571 and hsa_circ_400031 on day 1 after liver transplantation was higher than pre-transplantation (p < 0.01), and these levels showed a declining trend on post-transplantation. The expression level of hsa_circ_102032 and hsa_circ_103096 on day 1 after liver transplantation was lower than pre-transplantation (p < 0.01) and decreased on post-transplantation. There were the significantly different expressions between the post-transplantation day 7 and normal control (p < 0.01). The expression level of hsa_circ_102347 on day 1 after liver transplantation was lower than pre-transplantation (p < 0.01). This expression showed a declining trend on post-transplantation, and the postoperative day 7 level was similar to normal control (p > 0.05). Five types of circular ribonucleic acid-related micro-ribonucleic acids had varying degrees of upregulation and downregulation between perioperative transplantation of primary hepatic carcinoma patients and normal controls; the hsa_circ_102347 is most likely to have association with primary hepatic carcinoma.

Rule of changes in serum GGT levels and GGT/ALT and AST/ALT ratios in primary hepatic carcinoma patients with different AFP levels.

This study aims to explore the rule of changes in serum GGT activity, as well as GGT/ALT and AST/ALT ratios, in primary hepatic carcinoma (PHC) patients with different alpha-fetal protein (AFP) levels. GGT, AST and ALT were detected in 370 PHC patients with positive HBs-Ag using a automatic biochemical analyzer, and AFP was detected using a Roche E170 modular analytics immunoassay analyzer. GGT level, as well as AST/ALT and GGT/ALT, ratios were compared among PHC patients with different AFP levels. As shown in Table 1, GGT levels were 109.59 ± 111.06, 151.13 ± 190.43, 135.86 ± 107.62, 151.36 ± 176.59 and 172.58 ± 188.84, respectively, in the groups of primary PHC patients with AFP levels of ⩽ 10, 10-100, 100-200, 200-400 and ⩾ 400 ng/ml; and the differences among these groups were not statistically significant (P> 0.05). AST/ALT ratios were 1.55 ± 1.02, 1.30 ± 0.81, 2.02 ± 1.89, 2.12 ± 1.11 and 1.73 ± 1.25, respectively; and the differences among these groups were not statistically significant (P> 0.05). GGT/ALT ratios were 3.43 ± 3.12, 3.57 ± 5.70, 3.57 ± 2.94, 3.89 ± 4.58 and 3.43 ± 3.61, respectively; and the differences among these groups were not statistically significant (P> 0.05). For patients with chronic hepatitis B and cirrhosis after hepatitis B, no matter how AFP level is, when liver function report reveals increased GGT, AST/ALT > 1 and GGT/ALT > 1 (that is, AST > ALT and GGT > ALT), even if AFP is negative, we should also be alert to the existence of PHC.

Th17, synchronically increased with Tregs and Bregs , promoted by tumour cells via cell-contact in primary hepatic carcinoma.

Documented reports about T helper type 17 (Th17) cells have revealed that Th17 plays a critical role in inflammation and autoimmunity diseases. However, the role of Th17 in cancer remains contradictory. The interplay between Th17 and tumour cells in the tumour microenvironment of primary hepatic carcinoma (PHC) needs to be explored further and the relationship between Th17, regulatory T cells (Tregs ) and regulatory B cells (Bregs ) has not been defined completely. In this study, numerous experiments were undertaken to elucidate the interaction of Th17 and Treg /Breg cells involved in PHC. Our work demonstrated that an increased Th17 was detected in the peripheral circulation and in tumour tissues in PHC patients. In addition, increases in peripheral blood Th17 corresponded with tumour-node-metastasis (TNM) stage progression. Also, further studies indicated that Th17 cells were promoted by tumour cells in the PHC tumour microenvironment through both contact-dependent and -independent mechanisms, but cell-contact played the major important role in promoting the production and proliferation of Th17. When isolated CD4+ CD25+ CD127low Tregs and CD4+ CD25- CD127+ non-Tregs were cultured with autologous tumour cells, it implied that the phenotype of Th17 and Tregs was modified by tumour cells in the tumour microenvironment. As well as this, Th17 cells were also found to correlate positively with CD4+ forkhead box protein 3+ Tregs and CD19+ CD5+ CD1dhi Bregs in PHC. Notably, Th17 increased synchronically with Tregs and Bregs in PHC. These findings may provide new clues to reveal the mechanisms of immune escape in PHC.

Survival Rates In Primary Hepatic Carcinoma Patients With Cirrhosis In South Korea: A Retrospective Analysis of 68,328 Patients In The National Cancer Registry

Survival Rates In Primary Hepatic Carcinoma Patients With Cirrhosis In South Korea: A Retrospective Analysis of 68,328 Patients In The National Cancer Registry

原发性肝癌射频消融术后胸腔积液的研究

目的：探讨原发性肝癌射频消融术后胸腔积液形成的影响因素，从而更好的评估射频消融的安全性。方法：对45例采用一次性完全射频消融治疗的肝癌患者进行回顾性分析，根据肿瘤位置不同分为(靠近膈肌组，≤10 mm)A组和(远离膈肌组，>10 mm)B组，观察是否出现胸腔积液并进行统计学分析，从而判定肿瘤位置是否是影响射频消融术后胸腔积液出现与否的因素。结果：A组和B组射频术后胸腔积液的发生率有显著差异。结论：肿瘤位置是影响肝癌射频消融术后是否出现胸腔积液的重要因素。 Objective: To investigate the factors influencing the formation of pleural effusion in patients with primary liver cancer after radiofrequency ablation, and to evaluate the safety of RFA. Methods: We retrospectively reviewed 45 primary hepatic carcinoma patients who accepted one-off complete radiofrequency ablation (RFA). According to the tumor location, they were divided into group A (close to the diaphragm, less than 10 mm) and group B (away from the diaphragm, more than 10 mm). Then we observed whether pleural effusion occurred or not in each case. The outcomes were analyzed statistically to determine whether the location of the tumor affects the occurrence of pleural effusion after RFA or not. Results: There was a significant difference in the incidence of pleural effusion between group A and group B. Conclusion: The location of tumor is an important factor that affects the occurrence of pleural effusion after RFA for liver cancer.

Effect of fast-track based clinical nursing pathway of hepatic carcinoma on patient satisfaction and job satisfaction of nurses

Objective To investigate the effect of a fast-track based clinical nursing pathway of hepatic carcinoma on patient satisfaction and job satisfaction of nurses. Methods A total of 91 primary hepatic carcinoma(PHC)patients undergoing elective hepatectomy were enrolled and were divided into two groups by admission time, namely the control group(48 cases)and the experimental group(43 cases). The patients in the control group received traditional perioperative nursing care of hepatectomy, while the cases in the experimental group participated in fast-track nursing pathway. Patient satisfaction and nurse job satisfaction were measured before and after implementation. Results Final analysis included 45 patients in the control group and 40 patients in the experimental group. In the experimental group, the total score of patient satisfaction and the scores of all dimensions(including services and techniques, concern and care, services and techniques and overall satisfaction)were(132.75 ± 13.71),(48.30 ± 6.53),(42.60±4.62),(35.98±3.85),(5.88±0.94), while they were(122.89±16.62),(44.53±7.74),(39.49±5.67),(33.53±4.40),(5.33±1.13)in the control group. And the scores of the experimental group were significantly higher than that of the control group(t =-2.961, t =-2.409, t =-2.753, t =-2.709, t =-2.389, P 0.05)since the scores after implementation were(13.86± 2.12),(7.45 ± 1.57), while that of(13.18 ± 2.30)、(7.23 ± 1.41)were obtained before performance. Conclusions Application of fast-track nursing pathway in perioperative patients with PHC can contribute to promoting the level of patient satisfaction and job satisfaction of nurses and improving nursing quality. It is suggested that this nursing pathway will have more potential value for PHC patients. Key words: Job satisfaction; Patient satisfaction; Liver neoplasms; Hepatectomy; Fast-track surgery

Ezrin expression in the primary hepatocellular carcinoma patients and associated with clinical, pathological characteristics.

The aim of this study was to assess Ezrin expression in the primary hepatic carcinoma patients and associated with clinical, pathological characteristics. Fifty-one patients with primary hepatocellular carcinoma (PHC) with completed clinical data were retrospectively analyzed in this study. The Ezrin expression in PHC and normal control liver tissue was tested by immunohistochemical assay. The Ezrin expression and relationship with clinical characteristics were evaluated. The Ezrin positive rate were 66.7% and 15.7% with expression score of 3.21 ± 1.46 and 0.60 ± 1.10, respectively, in the cancer tissue and control tissue with statistical difference (P < 0.05). The Ezrin expression was associated with the metastasis status of the patients (P < 0.05) but not associated with the age (P > 0.05), gender (P > 0.05), differentiation (P > 0.05), and tumor diameter (P > 0.05). Ezrin protein is highly expressed in human PHC tissue which can be used for the prediction of metastasis disease.

A Meta-Analysis of Arsenic Trioxide Combined with Transcatheter Arterial Chemoembolization for Treatment of Primary Hepatic Carcinoma.

Primary hepatic carcinoma (PHC) is one of the most common malignant tumours in the world. More and more research has shown that As2O3 combined with TACE has a good curative effect in treating PHC. The objectives of this study were to evaluate the therapeutic efficacy and safety of As2O3 combined with TACE in treating PHC. The CNKI, VIP, Wanfang, PubMed, and Cochrane databases were searched from their inception until December 2015. Randomized controlled trials (RCTs) comparing As2O3 combined with TACE versus TACE alone in treating PHC were identified. Stata SE 12.0 was used for data analysis. 17 RCTs with 1055 patients were included. Meta-analysis showed that, compared with TACE alone, As2O3 combined with TACE showed significant effects in improving the clinical efficacy rate (P < 0.01), decreasing the value of alpha-fetoprotein (P < 0.01), increasing the one-year survival rate (P < 0.01), and improving the quality of life of PHC patients (P < 0.01). Fifteen studies had mentioned adverse events, but no serious adverse effects were reported in any of the included trials. In conclusion, As2O3 combined with TACE therapy appears to be potentially effective in treating PHC and is generally safe. However, further studies with rigorous designs trials and multiregional cooperation trials are needed.

Clinicopathological features and survival of bone metastasis from primary hepatic carcinoma

To explore clinicopathological features and prognostic factors of bone metastasis from primary hepatic carcinoma (PHC). Eighty patients were enrolled with bone metastasis from PHC in Tianjin Medical University Cancer Institute and Hospital from January 2005 to June 2014 respectively. The clinicopathological features and prognostic factors of primary tumor were collected and bone metastases. Kaplan-Meier method was adopted for survival analysis. Log-rank method and Cox regression were used for univariate and multivariate analysis. The median survival was 4.7 (95% CI range from 3.4 to 6.0) months. The 6-, 12-, and 24-month survival was 42.5%, 17.5%, 2.5%, respectively. Univariate analysis indicated that Child-Pugh grading (P<0.01), ECOG score (P=0.014), serum cholinesterase (P=0.002), total bilirubin (P=0.006), ascites (P=0.003), TACE (P<0.01) were significant prognostic factors of survival. Multivariate analysis revealed that Child-Pugh classification (P<0.01), TACE (P<0.01) were independent prognostic factors of survival. Bone metastasis from PHC patients had poor survival. Patients can benefit from TACE and liver protecting treatment.

Simultaneous Detection of α-Fetoprotein and Carcinoembryonic Antigen Based on Si Nanowire Field-Effect Transistors.

Primary hepatic carcinoma (PHC) is one of the most common malignancies worldwide, resulting in death within six to 20 months. The survival rate can be improved by effective treatments when diagnosed at an early stage. The α-fetoprotein (AFP) and carcinoembryonic antigen (CEA) have been identified as markers that are expressed at higher levels in PHC patients. In this study, we employed silicon nanowire field-effect transistors (SiNW-FETs) with polydimethylsiloxane (PDMS) microfluidic channels to simultaneously detect AFP and CEA in desalted human serum. Dual-channel PDMS was first utilized for the selective modification of AFP and CEA antibodies on SiNWs, while single-channel PDMS offers faster and more sensitive detection of AFP and CEA in serum. During the SiNW modification process, 0.1% BSA was utilized to minimize nonspecific protein binding from serum. The linear dynamic ranges for the AFP and CEA detection were measured to be 500 fg/mL to 50 ng/mL and 50 fg/mL to 10 ng/mL, respectively. Our work demonstrates the promising potential of fabricated SiNW-FETs as a direct detection kit for multiple tumor markers in serum; therefore, it provides a chance for early stage diagnose and, hence, more effective treatments for PHC patients.

Diagnosis value of combined detection of serum golgi protein 73, desgamma carboxy prothrombin and α-fetoprotein in primary hepatic carcinoma

To analyze the clinical value of the detection of serum desgamma carboxy prothrombin (DCP), golgi glycoprotein 73 (GP73), heat-shock protein 70 (HSP70) in primary hepatic carcinoma (PHC) diagnosis. Enzyme-1inked immunosorbent assay and electrochemiluminescence immunoassay were used to detect the serum DCP, GP73, HSP70 and α-fetoprotein (AFP) levels in 35 PHC patients and 35 healthy controls. AFP, DCP and GP73 levels in PHC patients were 13.780 (1.140-8 487.000)µg/L, 3 213.953 (2.510-53 994.602)pg/ml and 76.838 (24.500-232.875)ng/ml respectively, significantly higher than those in healthy controls (1.240 (0.605-5.310)µg/L, 104.610 (0.000-4 138.770)pg/ml and 30.770 (16.343-87.453)ng/ml, U value were 134.50, 258.00 and 168.00, all P < 0.01); HSP70 could not be detected in any objects. The area under the ROC curve of DCP or GP73 was 0.789, 0.863 respectively. The sensitivity and specificity to PHC diagnosis were 54.3% and 97.1% by DCP (2 939.4 pg/ml as cut-off value), 85.7% and 74.3% by GP73 (41.3 ng/ml as cut-off value), 45.7% and 100% by AFP (20 µg/L as cut-off value). In combined detection the sensitivity, specificity and accuracy were 88.6%, 74.3%, 81.4% by GP73/AFP and 91.4%, 71.4%, 81.4% by GP73/DCP/AFP. GP73, DCP are new effective markers in the diagnosis of PHC, and the combined detection of GP73, DCP and AFP can improve the diagnosis value of PHC.

Investigation and factors analysis of postoperative self-management level of primary hepatic carcinoma patients

Objective To investigate the postoperative self-management level of primary hepatic carcinoma （ PHC ） patients and analyzed the associated factors .Methods Self-made questionnaires were distributed to 195 postoperative PHC patients , which included the factors such as diet , treatment, physical activity, patients’ emotional and psychology conditions .Results Patients’ self-management level ranged from the medium to higher level, with a total score of （6.80 ±1.33）.The lowest score was （6.42 ±1.82） related to the treatment . The related factors of postoperative self-management level were including age , education , insurance and per capita annual income .And the differences were significant （χ2 =11.021, 45.365, 87.468, 18.907;P〈0.05）.Conclusions Medical workers should ask and observe the condition of patients ’ self-management at their referral , and give targeted health education to improve their self-management skills to reduce the incidence of complications and improve their quality of life . Key words: Hepatic tumor,primary; Self-management; Data collection

Expression of miRNA-29b and its clinical significances in primary hepatic carcinoma

To explore the clinical value of miRNA-29b expression and the combined detection of serum miRNA-29b and alpha-fetoprotein (AFP) in the diagnosis of primary hepatic carcinoma(PHC). From January 2007 to May 2010, the serum levels of miRNA-29b and AFP from 96 healthy controls and 87 PHC patients were measured by quantitative reverse transcription-polymerase chain reaction (qRT-PCR) and enzyme-linked immunosorbent assay (ELISA) respectively. The relationship of miRNA-29b and various clinical parameters was analyzed. Serum levels of miRNA-29b in PHC pre-operative group (0.250 (0.124 - 0.381)) significantly decreased versus the control group [0.860 (0.587 - 1.338)] and the post-operative group (0.890 (0.637 - 1.414)) (P < 0.001). Also, the levels of AFP in PHC pre-operative group (65.4 (20.1 - 212.3)) was obviously higher than that in the control group (13.3 (7.1 - 19.8)) and the post-operative group (23.2 (11.6 - 55.7)) (P < 0.001). A lower expression of miRNA-29b was correlated with lower differentiation and higher TNM stages (P < 0.045, P < 0.001). Kaplan-Meier curve analysis revealed that PHC patients with a low serum expression of miRNA-29b had a significantly shortened overall survival when compared with a high serum expression of miRNA-29b (25.52 vs 36.94 months, P = 0.008). Multivariable Cox regression analysis indicated that the serum expression of miRNA-29b was an independent risk factor for overall survival. Relative risk was 0.482 (95% confidence interval: 0.236 - 0.985). The critical values for miRNA-29b and AFP were determined at 0.38 and 23.1 µg/L through the ROC curves. Under the critical value, the sensitivity of miRNA-29b and AFP were 75.9% and 70.1% and the specificity of miRNA-29b and AFP 89.5% and 92.7% respectively. Combined detection could increase the sensitivity up to 87.3%, and achieve a specificity of 88.5%. The combined detection of miRNA-29b and AFP aids the diagnosis of PHC and the prediction of its prognosis.