AIM: To investigate transarterial chemoembolization(TACE) with hepatic infusion of oxaliplatin and 5-fluorouracil and Lipiodol chemoembolization in large hepatocellular carcinoma(HCC).METHODS: In this retrospective st...AIM: To investigate transarterial chemoembolization(TACE) with hepatic infusion of oxaliplatin and 5-fluorouracil and Lipiodol chemoembolization in large hepatocellular carcinoma(HCC).METHODS: In this retrospective study, 132 patients with unresectable HCCs larger than 10 cm were treated with hepatic infusion of oxaliplatin and 5-fluorouracil followed by Lipiodol chemoembolization. The primary endpoint was overall survival(OS). Sixteen-week disease-control rate, time to progression(TTP), and major complications were also studied. Univariate and multivariate analyses were performed to identify prognostic factors affecting OS and TTP.RESULTS: A total of 319 procedures were performed in the 132 patients. Eleven(8.3%) patients received radical resection following TACE treatment(median time to initial TACE 4.3 ± 2.3 mo). The median OS and TTP were 10.3 and 3.0 mo respectively, with a 50.0% 16-wk disease-control rate. Major complications were encountered in 6.0%(8/132) of patients following TACE and included serious jaundice in 1.5%(2/132) patients, aleukia in 1.5%(2/132), and hepatic failure in 3.0%(4/132). One patient died within one month due to serious hepatic failure and severe sepsis after receiving the second TACE. The risk factor associated with TTP was baseline alpha-fetoprotein level, and vascular invasion was an independent factor related to OS.CONCLUSION: Hepatic infusion of oxaliplatin and 5-fluorouracil followed by lipiodolized-chemoembolization is a safe and promising treatment for patients with HCCs larger than 10 cm in diameter.展开更多
BACKGROUND： Radiofrequency ablation （RFA） is related to a high intrahepatic distant recurrence （IDR） rate, and the associations between IDR and relevant imaging features have not yet been fully investigated. This...BACKGROUND： Radiofrequency ablation （RFA） is related to a high intrahepatic distant recurrence （IDR） rate, and the associations between IDR and relevant imaging features have not yet been fully investigated. This study aimed to determine both clinical and imaging risk factors of IDR after complete RFA for HBV-related small hepatoceUular carcinoma （HCC） （〈3 cm）.展开更多
Background： Antiphospholipid syndrome （APS）-related immune factors are considered as an important cause of recurrent spontaneous abortion （RSA）. Anticoagulant and anti-inflammatory treatments are believed to effe...Background： Antiphospholipid syndrome （APS）-related immune factors are considered as an important cause of recurrent spontaneous abortion （RSA）. Anticoagulant and anti-inflammatory treatments are believed to effectively improve adverse pregnancy outcomes by affecting the abnormal autoimmune response of the maternal-fetal interface. The aim of this study was to observe the clinical characteristics and treatment outcomes of anticoagulant regimens and anti-inflammatory plus anticoagulation regimens for APS-related RSA. Methods： APS-related RSA cases from September 2011 to September 2016 at Peking University Third Hospital were retrospectively analyzed. The patients were assigned to study group （anti-inflammation plus anticoagulation） and control group （simple anticoagulation）, The incidence of repeat abortion, the incidence of placental dysfunction, the gestational weeks of pregnancy, and the mean weight of the fetus were observed. Results： The pregnancy and neonatal outcome indicators of the repeat pregnancy loss rate （ 11. 11% vs. 22.70%）, placental dysfunction-related diseases （6.35% vs. 15.60%）, the mean birth weight of infants born after 24 weeks gestation （3152.4 ± 844.67 g vs. 2765.76 ± 816.40 g）, full-ternl delivery weight （3456.28 ±419.79 g vs. 3076.18±518.79 g）, the proportions of low birth weight infants （ 12.70% vs. 21.98%）, and small for gestational age （6.35% vs. 14.18%） differed significantly between the study and control groups （all P 〈 0.05）. The incidence of preterm delivery, term delivery, and stillbirth was not significantly different between the two groups, and there was no significant difference between the study and control groups in gestational age at birth （37.6 ± 3.3 weeks vs. 36.9 ± 3.2 weeks： P 〉 0.05）. Conclusion： The anti-inflammatory and anticoagulation regimen is more effective than the simple anticoagulation regimen in the treatlnent of APS recurrent abortion.展开更多
Intrahepatic cholangiocarcinoma(iCCA)can originate from the large bile duct group(segment bile ducts and area bile ducts),small bile duct group(septal bile ducts and interlobular bile ducts),and terminal bile duct gro...Intrahepatic cholangiocarcinoma(iCCA)can originate from the large bile duct group(segment bile ducts and area bile ducts),small bile duct group(septal bile ducts and interlobular bile ducts),and terminal bile duct group(bile ductules and canals of Hering)of the intrahepatic biliary tree,which can be histopathological corresponding to large duct type iCCA,small duct type iCCA and iCCA with ductal plate malformation pattern,and cholangiolocarcinoma,respectively.The challenge in pathological diagnosis of above subtypes of iCCA falls in the distinction of cellular morphologies,tissue structures,growth patterns,invasive behaviors,immunophenotypes,molecular mutations,and surgical prognoses.For these reasons,this expert consensus provides nine recommendations as a reference for standardizing and refining the diagnosis of pathological subtypes of iCCA,mainly based on the 5th edition of the World Health Organization Classification of Tumours of the Digestive System.展开更多
文摘AIM: To investigate transarterial chemoembolization(TACE) with hepatic infusion of oxaliplatin and 5-fluorouracil and Lipiodol chemoembolization in large hepatocellular carcinoma(HCC).METHODS: In this retrospective study, 132 patients with unresectable HCCs larger than 10 cm were treated with hepatic infusion of oxaliplatin and 5-fluorouracil followed by Lipiodol chemoembolization. The primary endpoint was overall survival(OS). Sixteen-week disease-control rate, time to progression(TTP), and major complications were also studied. Univariate and multivariate analyses were performed to identify prognostic factors affecting OS and TTP.RESULTS: A total of 319 procedures were performed in the 132 patients. Eleven(8.3%) patients received radical resection following TACE treatment(median time to initial TACE 4.3 ± 2.3 mo). The median OS and TTP were 10.3 and 3.0 mo respectively, with a 50.0% 16-wk disease-control rate. Major complications were encountered in 6.0%(8/132) of patients following TACE and included serious jaundice in 1.5%(2/132) patients, aleukia in 1.5%(2/132), and hepatic failure in 3.0%(4/132). One patient died within one month due to serious hepatic failure and severe sepsis after receiving the second TACE. The risk factor associated with TTP was baseline alpha-fetoprotein level, and vascular invasion was an independent factor related to OS.CONCLUSION: Hepatic infusion of oxaliplatin and 5-fluorouracil followed by lipiodolized-chemoembolization is a safe and promising treatment for patients with HCCs larger than 10 cm in diameter.
文摘BACKGROUND： Radiofrequency ablation （RFA） is related to a high intrahepatic distant recurrence （IDR） rate, and the associations between IDR and relevant imaging features have not yet been fully investigated. This study aimed to determine both clinical and imaging risk factors of IDR after complete RFA for HBV-related small hepatoceUular carcinoma （HCC） （〈3 cm）.
文摘Background： Antiphospholipid syndrome （APS）-related immune factors are considered as an important cause of recurrent spontaneous abortion （RSA）. Anticoagulant and anti-inflammatory treatments are believed to effectively improve adverse pregnancy outcomes by affecting the abnormal autoimmune response of the maternal-fetal interface. The aim of this study was to observe the clinical characteristics and treatment outcomes of anticoagulant regimens and anti-inflammatory plus anticoagulation regimens for APS-related RSA. Methods： APS-related RSA cases from September 2011 to September 2016 at Peking University Third Hospital were retrospectively analyzed. The patients were assigned to study group （anti-inflammation plus anticoagulation） and control group （simple anticoagulation）, The incidence of repeat abortion, the incidence of placental dysfunction, the gestational weeks of pregnancy, and the mean weight of the fetus were observed. Results： The pregnancy and neonatal outcome indicators of the repeat pregnancy loss rate （ 11. 11% vs. 22.70%）, placental dysfunction-related diseases （6.35% vs. 15.60%）, the mean birth weight of infants born after 24 weeks gestation （3152.4 ± 844.67 g vs. 2765.76 ± 816.40 g）, full-ternl delivery weight （3456.28 ±419.79 g vs. 3076.18±518.79 g）, the proportions of low birth weight infants （ 12.70% vs. 21.98%）, and small for gestational age （6.35% vs. 14.18%） differed significantly between the study and control groups （all P 〈 0.05）. The incidence of preterm delivery, term delivery, and stillbirth was not significantly different between the two groups, and there was no significant difference between the study and control groups in gestational age at birth （37.6 ± 3.3 weeks vs. 36.9 ± 3.2 weeks： P 〉 0.05）. Conclusion： The anti-inflammatory and anticoagulation regimen is more effective than the simple anticoagulation regimen in the treatlnent of APS recurrent abortion.
基金Shanghai Municipal Key Clinical Specialty(shslczdzk01302)Shanghai Shenkang Hospital Development Center Clinical Science and Technology Innovation Project(SHDC12021109).
文摘Intrahepatic cholangiocarcinoma(iCCA)can originate from the large bile duct group(segment bile ducts and area bile ducts),small bile duct group(septal bile ducts and interlobular bile ducts),and terminal bile duct group(bile ductules and canals of Hering)of the intrahepatic biliary tree,which can be histopathological corresponding to large duct type iCCA,small duct type iCCA and iCCA with ductal plate malformation pattern,and cholangiolocarcinoma,respectively.The challenge in pathological diagnosis of above subtypes of iCCA falls in the distinction of cellular morphologies,tissue structures,growth patterns,invasive behaviors,immunophenotypes,molecular mutations,and surgical prognoses.For these reasons,this expert consensus provides nine recommendations as a reference for standardizing and refining the diagnosis of pathological subtypes of iCCA,mainly based on the 5th edition of the World Health Organization Classification of Tumours of the Digestive System.
