Risk Factor For Hepatic Metastasis Research Articles

Newly Appearing Hepatic Lesion After Curative Surgery For Colorectal Cancer: Single-phase CT Findings Implying Metastasis.

In patients treated with curative surgery for colorectal cancer, the single-phase (portal phase) abdomen-pelvic computed tomography (CT) follow-up is routinely performed to detect any recurrent lesions. The objective of this study is to evaluate CT features implying metastasis in newly appearing hepatic lesions on single-phase CT after colorectal cancer surgery. Of 1,227 patients who underwent curative colorectal surgery between 2011 and 2014, 267 patients with new hepatic lesions on follow-up single-phase CT (metastasis, n=192; benign, n=75) were included. The CT features of the hepatic lesions were analyzed by two radiologists retrospectively, and clinical information, including carcinoembryonic antigen (CEA) level was also reviewed. The risk factors for hepatic metastasis were evaluated by multivariable logistic regression. In this study, independent CT features associated with metastasis were spherical shape (p < 0.001), circumscribed margin (p = 0.021), heterogeneous attenuation (p = 0.024) and bulging appearance (p = 0.007). Among the clinical factors, increased CEA level (p = 0.013), higher preoperative stage (p = 0.014) and lymphovascular invasion (p = 0.003) were associated with metastasis. However, on multivariable analysis, spherical shape was the only significant predictive factor for hepatic metastasis. The diagnostic performance of 'spherical shape' for detection of hepatic metastasis showed an accuracy of 84.6%, sensitivity of 83.9%, and specificity of 86.7%. Specific single-phase CT features could be useful in distinguishing hepatic metastasis from benign, resulting in continuing routine CT follow-up without liver magnetic resonance imaging (MRI) when metastasis is unlikely.

Hepatic metastases after cervical cancer surgery: clinical analysis of 13 cases

Objective: To investigate the clinical characteristics of patients with hepatic metastasis after cervical cancer operation, and analyze the risk factors and prognostic factors of hepatic metastasis. Methods: A total of 1 312 patients with stage Ⅰa2-Ⅱb2 cervical cancer received radical surgery from January 2013 to January 2016 in the First Affiliated Hospital of Zhengzhou University were collected, of which 13 cases (0.99%, 13/1 312) had hepatic metastasis after operation. A retrospective analysis was conducted on clinical features of patients with hepatic metastasis after cervical cancer operation. T-test, chi-square test, rank sum test and logistic regression were used to analyze the risk factors of hepatic metastasis after surgery of cervical cancer operation. Kaplan-Meier method was used for survival analysis. Log-rank test was used for screening of prognostic factors in patients with postoperative hepatic metastasis. Results: (1) Clinical features: there were 3 cases of simple hepatic metastasis without obvious clinical symptoms, 2 patients with perihepatic lymph node metastasis showed only low back pain, 8 patients with multiple extrahepatic metastases, and their clinical symptoms were related to the site of metastasis. Five cases out of 9 (5/9) with liver metastasis had abnormal tumor marker results. The abnormal kinds of tumor markers were mainly carcinoembryonic antigen (CEA), CA(125), CA(199), and CA(72-4). The interval time of hepatic metastasis after operation was 2-22 months. (2) Analysis of risk factors for hepatic metastasis: univariate analysis showed that lymph node metastasis, histological type, infiltration depth, and lymph-vascular space invasionwere associated with hepatic metastasis after cervical cancer surgery (P<0.05).Multivariate analysis showed that lymph node metastasis and small cell carcinoma were independent risk factors for postoperative hepatic metastasis (P<0.05). (3) Prognostic factors in patients with hepatic metastasis:among 13 patients with postoperative hepatic metastases from cervical cancer, 9 died during the follow-up period and 4 survived. The median total survival time after hepatic metastases was 7 months (range 3-32 months). Univariate analysis showed that multiple extrahepatic metastases and treatment after hepatic metastasis had significant effects on the prognosis of patients with hepatic metastasis after cervical cancer operation (P<0.05). Conclusions: The interval of hepatic metastasis after surgery for cervical cancer operation is within 2 years. Patients with lymph node metastasis and small cell carcinoma are more prone to postoperative hepatic metastasis. The prognosis of patients with extrahepatic multiple metastases is poor, and individualized treatment should be carried out after comprehensive analysis for patients with hepatic metastasis after cervical cancer operation.

Depletion of tissue factor suppresses hepatic metastasis and tumor growth in colorectal cancer via the downregulation of MMPs and the induction of autophagy and apoptosis

Tissue factor (TF) is a significant risk factor for hepatic metastasis in patients with colorectal cancer (CRC). However, the mechanism by which TF promotes hepatic metastasis in CRC remains elusive. In this study, we first confirmed that TF expression was significantly correlated with lymph node metastasis, hepatic metastasis and TNM staging in clinical CRC samples, and found that TF expression in colon cancer cell lines was correlated with the invasion ability. Next, by employing TF-overexpressing LOVO cell line as a model we demonstrated that lentivirus mediated knockdown of TF suppressed the migration and invasion of LOVO cells in vitro, and hepatic metastasis of colorectal cancer in nude mice orthotopic model. Mechanistically, we found that TF knockdown decreases colony formation ability and induced autophagy and apoptosis of LOVO cells, and this was at least partly mediated by the activation of unfolded protein response/PERK signaling. In conclusion, our data provide new insight into hepatic metastasis of CRC. Agents targeting TF should be developed as adjuvant therapeutics for CRC metastasis.

Analysis of Risk Factors for Hepatic Metastasis from Rectal Cancer after Radical Excision

Objective To analyze the risk factors for interval time Pattern of hepatic metastases from rectal cancer after radical surgery and provide supportive evidence for predicting and preventing hepatic metastasis from rectal cancer after radical surgery.Methods A retrospective study of 143 patients with hepatic metastasis from rectal cancer after radical surgery from 1995 to 2010.The data was analyzed to evaluate significant risk factors for interval time.Pattern of hepatic metastasis from rectal cancer after radical surgery.Results The histologic differentiation,Dukes criteria and extrahepatic metastasis were independently correlated with the interval time of hepatic metastasis,while the depth of invasion was independently correlated with the pattern of hepatic metastasis.Conclusion We could evaluate the interval time of hepatic metastasis with the histologic differentiation,Dukes criteria and extrahepatic metastasis,while the depth of invasion could be used to evaluate the pattern of hepatic metastasis from rectal cancer in patients with radical surgery.

Tissue Factor and Cancer Metastasis: The Role of Intracellular and Extracellular Signaling Pathways

Tissue factor (TF) initiates the coagulation cascade but also plays a role in cancer and metastasis. This transmembrane protein is frequently upregulated on tumor cells and cells that show metastatic behavior. Furthermore, it is a significant risk factor for hepatic metastasis in patients suffering from colon cancer. Recently, it has been shown that TF, together with its natural ligand factor VIIa, induces intracellular changes, such as signal transduction cascades, gene transcription, and protein synthesis. Moreover, TF:factor VIIa interaction leads to survival of cells that have been stimulated to undergo apoptosis. Together with TF-dependent processes such as angiogenesis, these intracellular phenomena form a plausible explanation for the influence of TF on metastasis. In this review, we will discuss these phenomena in more detail and hypothesize on their role in TF-driven metastasis.

Tissue factor expression in human colorectal carcinoma: correlation with hepatic metastasis and impact on prognosis.

It has been suggested that tissue factor (TF) plays an important role in tumor metastasis. Its expression in sarcoma cells was reported to up-regulate the vascular endothelial growth factor (VEGF) gene and thereby enhance tumor angiogenesis, which is essential to tumor metastasis. Although many malignant tumors have been reported to express this protein constitutively, recent clinical studies have focused mainly on the correlations among TF expression, tumor progression, and histologic grade. Therefore, to address the role of TF and the underlying mechanism of hematogenous metastasis of colorectal carcinoma, the authors analyzed the correlations among TF expression, hepatic metastasis, and VEGF gene expression in surgical specimens. Furthermore, they analyzed the prognostic significance of TF expression with respect to overall patient survival. Expression of TF and VEGF genes in 67 advanced colorectal carcinoma specimens was studied by immunohistochemistry and Northern blot analysis, respectively. The correlations among TF expression, hepatic metastasis, and other factors were analyzed with univariate and multivariate statistics. Survival rates were calculated using the Kaplan-Meier method. Univariate and multivariate analyses showed TF expression to be a significant (P = 0.0001) and independent risk factor for hepatic metastasis, whereas a weak but insignificant correlation was observed between TF and VEGF gene expression. The outcomes in the TF positive group were significantly worse in all cases (P = 0.0001) and in the cases without synchronous hepatic metastasis (P = 0.0156). Although the precise mechanisms are unknown, TF expression is a suitable indicator of both hepatic metastasis and prognosis for colorectal carcinoma patients.

Effect of packed red cell and whole blood transfusion on liver-associated immune function

In order to clarify the effect of allogeneic blood transfusion on liver metastases from primary cancer, liver-associated immune function after blood transfusion was evaluated in a murine model. Hepatic sinusoidal lymphocytes (HSL) were strongly cytotoxic to conventional natural killer cell-sensitive target (YAC-1), as well as to natural killer cell-resistant solid adenocarcinoma cells (colon 26), compared with splenic lymphocytes. Allogeneic whole blood transfusion strikingly suppressed the cytotoxic activities of HSL. Red blood cell transfusions also suppressed cytotoxicity to the same degree. In an animal model, allogeneic transfusion increased the rate of liver metastases. Flow cytometric analysis showed that transfusion caused a temporary decrease in the class II antigen positive cell fraction, mainly Kupffer's cells. This phenomenon occurred in parallel with changes in hepatic antitumor activity, indicating the possible importance of the involvement of Kupffer's cell in the development of the killer activity of HSL. These results suggest that blood transfusion may be a significant risk factor for hepatic metastasis by transiently suppressing the immunocompetence of the liver.