Background While China’s socioeconomic transformation has driven divergent trends in gastrointestinal cancers,comprehensive data on esophageal,gastric,and liver cancer burden remain limited.This study examines the gl...Background While China’s socioeconomic transformation has driven divergent trends in gastrointestinal cancers,comprehensive data on esophageal,gastric,and liver cancer burden remain limited.This study examines the global burden of esophageal,gastric,and liver cancers in 2022 and analyzes the trends of age-standardized incidence and mortality rate(ASRs)in China from 2000 to 2018,thereby providing evidence for the formulation of cancer control strategies.Methods The global burden of esophageal,gastric and liver cancers including the estimated number of cases and deaths and the ASRs for incidence and mortality were from GLOBALCAN 2022 dataset.Data from 22 cancer registries in China were employed for the trend analysis of the ASRs for incidence and mortality of these three cancers.The Joinpoint model was used to compute the average annual percentage change(AAPC)of the incidence and mortality of the three cancers from 2000 to 2018.Results Globally,esophageal,gastric and liver cancers accounted for 11.8%of incident cancer cases and 19.1%of cancer deaths.China bore a disproportionately high burden,representing 43.8%,37.0%,and 42.4%of global esophageal,gastric,and liver cancer cases respectively,and 42.1%,39.4%,and 41.7%of corresponding deaths.However,the ASRs for incidence and mortality for all three cancers declined significantly in China(2000–2018),with absolute case numbers decreasing for gastric and esophageal cancers during 2010–2022.Age-specific analysis revealed most pronounced declines in incidence and mortality in populations under 40 years old,with AAPCs of less than–6.0%for esophageal cancer,around–4.0%for gastric cancer,and approximately–2.0%for liver cancer.Conclusions China has achieved remarkable progress in controlling esophageal,gastric and liver cancers,yet these malignancies remain major public health challenges.Future efforts should intensify existing prevention measures while expanding screening programs,particularly for aging populations.These findings offer valuable insights for regions undergoing similar epidemiological transitions.展开更多
In recent years,the rapid evolution of cancer therapies has markedly increased patient survival rates.However,the incidence of adverse events caused by anticancer treatments remains high,leading to significant clinica...In recent years,the rapid evolution of cancer therapies has markedly increased patient survival rates.However,the incidence of adverse events caused by anticancer treatments remains high,leading to significant clinical challenges.As the central hub of drug metabolism and detoxification,the liver is susceptible to therapeutic insults.The specific mechanisms of liver injury caused by different types of antineoplastic treatments vary.Chemotherapy induces hepatic damage via oxidative stress and mitochondrial dysfunction,whereas targeted therapy disrupts signaling pathways in hepatic cells.Immunotherapy triggers immunemediated hepatitis through cytokine storms and immune cell infiltration,and radiation therapy causes hepatic microvascular injury.Additionally,patients with preexisting chronic liver diseases(such as cirrhosis,hepatitis B/C,or nonalcoholic fatty liver disease)are more likely to face increased risks of hepatic injury during cancer treatment.Therefore,early detection and timely treatment are crucial for these high-risk populations.This review introduces the emerging field of“oncohepatology”,which illuminates the mechanisms underlying hepatic injury due to cancer treatments,summarizes the influence and management of preexisting liver disease during cancer treatment,analyzes diagnostic and therapeutic strategies for cancer treatment-associated liver function damage,and discusses potential future research directions to provide valuable insights for liver injury management in clinical oncology.展开更多
BACKGROUND The treatment of patients with liver cancer after surgery with the artificial liver support system combined with traditional Chinese medicine(TCM)for strengthening the body and removing blood stasis is a ne...BACKGROUND The treatment of patients with liver cancer after surgery with the artificial liver support system combined with traditional Chinese medicine(TCM)for strengthening the body and removing blood stasis is a new idea.AIM To analyze the post-surgical effect of the artificial liver support system with TCM in patients with liver cancer.METHODS Ninety-eight patients with liver cancer who underwent surgical treatment at the Fifth People’s Hospital of Huai’an from January 2023-2024 were selected and divided into two groups(49 patients each)via random lottery method.Both groups underwent surgery.The control group received artificial liver support,and the observation group was additionally treated with TCM for strengthening the body and removing blood stasis.Gastrointestinal recovery,liver function,tumor marker levels,immune function,and safety were compared between both groups.RESULTS There were significant differences in the levels of indicators related to gastrointestinal recovery between the groups(P<0.05).After treatment,the levels of alanine aminotransferase,aspartate aminotransferase,total bilirubin,and gamma-glutamyl transpeptidase in the observation group were lower,whereas the albumin level was higher(P<0.05).After treatment,tumor marker levels in the observation group were relatively lower(P<0.05).After treatment,compared to the control group,the CD4+level in the observation group was higher and the CD8+level was lower(P<0.05).There was no significant difference in the incidence of adverse reactions between both groups(P>0.05).CONCLUSION Combining the artificial liver support system with TCM significantly improves liver and gastrointestinal functions,enhances immune responses,and reduces tumor marker levels with high safety,suggesting that it could be a promising approach for optimizing postoperative care and improving patient outcomes,potentially reducing complications and enhancing quality of life.展开更多
BACKGROUND: The increasing morbidity of liver cancer has led to a growing demand for transplantation. Split liver transplantation(SLT) is a promising way to ameliorate organ shortages. However, the safety and efficacy...BACKGROUND: The increasing morbidity of liver cancer has led to a growing demand for transplantation. Split liver transplantation(SLT) is a promising way to ameliorate organ shortages. However, the safety and efficacy of SLT are still controversial. The aim of this study was to assess the clinical outcome of SLT in liver cancer patients at our center. METHODS: A total of 74 patients who received liver transplantation at a tertiary hospital from March 2019 to July 2023 were retrospectively studied, of whom 37 recipients underwent SLT and 37 recipients underwent whole-graft liver transplantation(WGLT). Clinical data were analyzed and compared between patients who underwent SLT and WGLT.RESULTS: SLT and WGLT were successfully performed, with no intraoperative transplantrelated mortality. Postoperatively, no significant differences in total bilirubin(TB, P=0.266), alanine transaminase(ALT, P=0.403) and aspartate transaminase(AST, P=0.160) levels within 30 d were detected between the two groups. The transplant-related mortality rates were 8.1% in the SLT group and 5.4% in the WGLT group within 30 d of surgery(P=1.000), and 10.8% and 8.1%, respectively, at 90 d after surgery(P=1.000). There were no significant differences in overall survival(OS) and progress-free survival(PFS) between the SLT and WGLT groups(P=0.910, P=0.190). CONCLUSION: Our results show that SLT does not imply additional risks in treating liver cancer compared with WGLT.展开更多
The incidence of colorectal cancer is gradually increasing,and a majority of patients are diagnosed with distant metastases at the time of initial diagnosis,with the liver being the most common site of metastasis.Unli...The incidence of colorectal cancer is gradually increasing,and a majority of patients are diagnosed with distant metastases at the time of initial diagnosis,with the liver being the most common site of metastasis.Unlike most malignant tumors,patients with distant metastases can still achieve favorable prognoses if both the primary tumor and liver metastases are surgically resected.With ad-vances in systemic therapies,many patients with initially unresectable liver me-tastases from colorectal cancer can undergo systemic treatment to achieve con-version therapy,thereby gaining the opportunity for surgery.However,there is still no consensus on several issues,including the timing of systemic therapy before and after surgery,whether neoadjuvant therapy should be employed,and the choice between simultaneous or staged surgeries.This review aims to system-atically describe the current treatment landscape for colorectal cancer with liver metastases and highlight several unresolved controversial issues,providing valuable insights for the diagnosis and treatment of colorectal liver metastases.展开更多
Colorectal cancer (CRC) is the third most common cancer globally, with 20%-25%of patients diagnosed at stage IV, significantly affecting overall survival (OS).Only 14% of stage IV patients survive for 5 years with pal...Colorectal cancer (CRC) is the third most common cancer globally, with 20%-25%of patients diagnosed at stage IV, significantly affecting overall survival (OS).Only 14% of stage IV patients survive for 5 years with palliative chemotherapy.However, the role of liver transplantation (LT) in the management of CRC livermetastasis (CRCLM) is an evolving area of interest. Recent advancements inoncologic outcomes and clinical understanding have prompted the re-evaluationof LT as a viable treatment option for CRCLM. A promising result from someprospective pilot studies reported a 5-year OS rate of 60% after LT for patientswith CRCLM. Key factors influencing eligibility include tumor biology, absence ofextrahepatic disease, and the patient's performance status. By synthesizing thelatest research findings, we aim to provide a comprehensive overview that summarizesthe most relevant data related to the clinical outcomes of patients whounderwent LT for CRCLM. We aim to provide a comprehensive overview by synthesizingthe latest research findings. This review discusses the inclusion criteriaand eligibility for LT in CRCLM, which are of great importance to patient outcomes.展开更多
BACKGROUND Multiple primary malignant tumors refer to the occurrence of two or more primary malignant tumors in the same organ or multiple organs or tissues at the same time or successively in the same patient,and can...BACKGROUND Multiple primary malignant tumors refer to the occurrence of two or more primary malignant tumors in the same organ or multiple organs or tissues at the same time or successively in the same patient,and can occur anywhere in the body.The treatment guidelines for patients with multiple primary malignant tumors are currently controversial.CASE SUMMARY A 51-year-old male patient with liver cancer and portal hypertension received 42 months of co-treatment with atezolizumab and bevacizumab.After that,the disease was rated stable disease.The patient was then diagnosed with gastric cancer.Since the patient was not sensitive to anti-programmed death ligand 1 immunosuppressive agents,a co-treatment with oxaliplatin,tegafur,apatinib,and cadonilimab was selected after multidisciplinary consultation and the patient’s agreement.After four cycles of treatment,partial response and stable disease were observed in gastric and liver cancers,respectively.Surgical treatment was performed considering the high-risk factors of gastrointestinal bleeding in patients with gastroesophageal varices.Postoperative pathology showed that the Tumor Regression Grade was 1.Moreover,the genetic testing of postoperative tumor specimens indicated negative programmed death ligand 1 and microsatellite stability.In addition,the latest follow-up indicated an 8 and 40-month progression-free survival in gastric and liver cancer patients,respectively.Currently,the patient is receiving postoperative immunotherapy with cadonilimab.CONCLUSION Cadonilimab not only treats microsatellite stability gastric cancer patients but can also be used for liver cancer treatment.展开更多
BACKGROUND In-depth comparative investigations in terms of clinical efficacies of liver tumor microwave ablation(MWA)and laparoscopic hepatectomy(LH),which are both important treatment modalities for liver neoplasms,h...BACKGROUND In-depth comparative investigations in terms of clinical efficacies of liver tumor microwave ablation(MWA)and laparoscopic hepatectomy(LH),which are both important treatment modalities for liver neoplasms,have been limited in patients diagnosed with primary small liver cancer(PSLC).AIM To compare and analyze the clinical efficacy of liver tumor MWA and LH for PSLC.METHODS This study retrospectively analyzed the medical records of 123 patients with PSLC admitted to Xuzhou Central Hospital from January 2015 to November 2022 and categorized them based on treatment modalities into the LH and MWA groups.The LH group,consisting of 61 cases,received LH,and the MWA group,which included 62 cases,underwent liver tumor MWA.Basic data and various periop-erative indicators were compared between the two groups,including changes in liver function indicators[alanine aminotransferase(ALT),glutamic aminotrans-ferase(AST),and total bilirubin(TBIL)]pre-and post-treatment,and efficacy and postoperative complications were analyzed.RESULTS No statistically significant difference was observed between the two groups in terms of age,gender,tumor diameter,liver function Child-Pugh classification and number of tumors,body mass index,and educational status(P>0.05).The overall effective rate was higher in the MWA group than in the LH group(98.39%vs 88.52%)(χ2=4.918,P=0.027).The MWA group exhibited less operation time,intraoperative bleeding,defecation time,and hospital stay than the LH group(P<0.05).No difference was found in liver function indicators between the two groups pre-treatment(P>0.05),and ALT,AST,and TBIL levels decreased in both groups post-treatment,with the MWA group demonstrating lower levels(P<0.05).The MWA and LH groups exhibited postoperative complication rates of 4.84%and 19.67%,respectively,with statistically significant differences between the two groups(P=0.012,χ2=6.318).CONCLUSION MWA is more effective in treating PSLC,and it promotes faster postoperative recovery for patients,and more security improves liver function and reduces postoperative complications compared to LH.展开更多
Cancer stem cells(CSCs)are a major challenge in cancer therapy.Stem cell-like cells form a unique subpopulation within many tumors,which govern the degree of malignancy by promoting metastasis,recurrence,heterogeneity...Cancer stem cells(CSCs)are a major challenge in cancer therapy.Stem cell-like cells form a unique subpopulation within many tumors,which govern the degree of malignancy by promoting metastasis,recurrence,heterogeneity,and resistance to drug and radiation.Furthermore,these cells can persist in patients even after undergoing multiple cycles of conventional cancer therapy via dormancy,where they no longer dividing but remain active.These may cause cancer recurrence at any time,even years after a supposed cure,and remain invisible to the immune system.Targeting specific surface markers,signaling pathways and tumor microenvironment,which all have a significant effect on CSC function and maintenance,could help to eradicate CSCs and improve patient survival.Combinations of traditional therapies with nano-based drug delivery systems can efficiently target CSCs.Considering the biology and properties of CSCs,we classify recent approaches involving nanoparticle engineering,extracellular matrix modulation,cocktail strategies,multi-stage therapy,CSC defanging,Trojan horse systems,targeted therapy and organelle targeting.We highlight the most recent advances in nanocarrier design and drug delivery technologies to target CSCs,combined with conventional treatment in preclinical and clinical trials.The prospects of these approaches for CSCs elimination and recurrent cancer treatment are discussed.展开更多
Liver cancer is the fourth cause of cancer-related deaths and the primary cause of death in patients with compensated cirrhosis.In recent years,the role of traditional Chinese medicine in the treatment of liver cancer...Liver cancer is the fourth cause of cancer-related deaths and the primary cause of death in patients with compensated cirrhosis.In recent years,the role of traditional Chinese medicine in the treatment of liver cancer has attracted more and more attention and recognition.Luteolin(LUT)and glycyrrhetinic(GA)are natural compounds extracted from Chinese herbal medicine.LUT exhibits various biological activity including anti-inflammatory,antibacterial,antiviral,anti-tumor,and neuroprotective effects.GA significantly inhibits the growth and metastasis of cancer cells.However,the low water solubility of both compounds hinders their clinical applications.In this study,rod-shaped nanoparticles(NPs)self-assembled from LUT and GA were designed to enhance drug solubility and tumor-targeting capability.We verified that the assembly mechanism of the NPs was π-π stacking.These NPs significantly inhibited the proliferation of liver cancer cells while had no significant effect on normal liver cells.In a mouse model of liver cancer,these NPs demonstrated superior tumor-targeting ability due to the enhanced permeability and retention effect,and the affinity of GA for liver cancer cells,resulting in better therapeutic efficacy with lower systemic toxicity.Results of network pharmacology analysis showed that LUT and GA respectively targeted estrogen receptor 1(ESR1)protein and cyclin-dependent kinase 1(CDK1)protein to corporately induce tumor cell cycle arrest,which induced the inhibition of tumor cell proliferation.In conclusion,this study provides a novel reference for the treatment of liver cancer.展开更多
BACKGROUND The development of hepatocellular carcinoma(HCC)is influenced by multiple factors.Interventional therapy offers an effective treatment option for patients with unresectable intermediate-to-advanced HCC.Inte...BACKGROUND The development of hepatocellular carcinoma(HCC)is influenced by multiple factors.Interventional therapy offers an effective treatment option for patients with unresectable intermediate-to-advanced HCC.Interventional therapy can induce electrocardiographic(ECG)abnormalities that may be associated with liver dysfunction,electrolyte disorders,and cardiac injury.AIM To explore the ECG alterations and determinants following interventional therapy in patients with HCC.METHODS Sixty patients undergoing interventional treatment for liver cancer were selected as study participants.According to the results of the dynamic ECG examination 1 day after surgery,the patients were divided into an abnormal group(n=21)and a nonabnormal group(n=39).With the help of dynamic ECG examination,the ECG parameters were compared and the baseline data of patients was recorded in the two groups.RESULTS The 24 hours QT interval variability,24 hours normal atrial polarization to ventricular polarization(R-R)interval(standard deviation),24 hours consecutive 5 minutes normal R-R interval,and 24 hours continuous 5 minutes normal R-R interval(standard deviation mean)were lower than patients in the nonabnormal group(P<0.05).The logistic analysis showed that age>60 years,liver function grade B,and postoperative body temperature 38°C were risk factors for abnormal dynamic electrocardiogram in patients with liver cancer intervention(P<0.05).CONCLUSION Interventional therapy for HCC can lead to ECG abnormalities,underscoring the clinical need for enhanced cardiac monitoring to mitigate myocardial complications.展开更多
BACKGROUND Hepatocellular carcinoma ranks among the most prevalent malignant neoplasms.Surgical intervention constitutes a critical therapeutic approach for this condition.Nonetheless,postoperative recovery is frequen...BACKGROUND Hepatocellular carcinoma ranks among the most prevalent malignant neoplasms.Surgical intervention constitutes a critical therapeutic approach for this condition.Nonetheless,postoperative recovery is frequently influenced by the patient's nutritional status and the quality of nursing care provided.AIM To examine the comprehensive impact of personalized nutritional support and nursing strategies on the postoperative rehabilitation of patients with liver cancer.METHODS In this study,a retrospective comparative analysis was conducted involving 60 post-operative liver cancer patients.The subjects were selected as subjects and divided into two groups based on differing nursing interventions,with each group comprising 30 patients.The control group received standard nutritional support and care,whereas the experimental group received individualized nutritional support and nursing strategies.The study aimed to evaluate the impact of individualized nutrition by comparing the rehabilitation indices,nutritional status,quality of life(QoL),and complication rates between the two groups.RESULTS The results showed that the recovery index of the experimental group was significantly better than that of the control group 2 weeks after surgery,and the average liver function recovery index of the experimental group was 85.significantly higher than that of the control group(73.67±7.19).In terms of nutritional status,the serum albumin level and body weight stabilization rate of the experimental group were also significantly higher than those of the control group,which were 42.33±2.4 g/L and 93.3%,respectively,compared with 36.01±3.85 g/L and 76.7%of the control group.In addition,the average QoL score of the experimental group was 84.66±3.7 points,which was significantly higher than that of the control group(70.92±4.28 points).At the psychological level,the average anxiety score of the experimental group was 1.17±0.29,and the average depression score was 1.47±0.4,which were significantly lower than the 2.26±0.42 and 2.57±0.45 of the control group.This showed that patients in the experimental group were better relieved of anxiety and depression under the individualized nutrition support and nursing strategy.More importantly,the complication rate in the experimental group was only 10%,much lower than the 33.3%in the control group.CONCLUSION Personalized nutritional support and tailored nursing strategies significantly enhance the postoperative rehabilitation of liver cancer patients.Consequently,it is recommended to implement and advocate for these individualized approaches to improve both the recovery outcomes and QoL for these patients.展开更多
BACKGROUND Transcatheter arterial chemoembolization(TACE)is a key treatment approach for advanced invasive liver cancer(infiltrative hepatocellular carcinoma).However,its therapeutic response can be difficult to evalu...BACKGROUND Transcatheter arterial chemoembolization(TACE)is a key treatment approach for advanced invasive liver cancer(infiltrative hepatocellular carcinoma).However,its therapeutic response can be difficult to evaluate accurately using conventional two-dimensional imaging criteria due to the tumor’s diffuse and multifocal growth pattern.Volumetric imaging,especially enhanced tumor volume(ETV),offers a more comprehensive assessment.Nonetheless,bias field inhomogeneity in magnetic resonance imaging(MRI)poses challenges,potentially skewing volumetric measurements and undermining prognostic evaluation.AIM To investigate whether MRI bias field correction enhances the accuracy of volumetric assessment of infiltrative hepatocellular carcinoma treated with TACE,and to analyze how this improved measurement impacts prognostic prediction.METHODS We retrospectively collected data from 105 patients with invasive liver cancer who underwent TACE treatment at the Affiliated Hospital of Xuzhou Medical University from January 2020 to January 2024.The improved N4 bias field correction algorithm was applied to process MRI images,and the ETV before and after treatment was calculated.The ETV measurements before and after correction were compared,and their relationship with patient prognosis was analyzed.A Cox proportional hazards model was used to evaluate prognostic factors,with Martingale residual analysis determining the optimal cutoff value,followed by survival analysis.RESULTS Bias field correction significantly affected ETV measurements,with the corrected baseline ETV mean(505.235 cm^(3))being significantly lower than before correction(825.632 cm^(3),P<0.001).Cox analysis showed that the hazard ratio(HR)for corrected baseline ETV(HR=1.165,95%CI:1.069-1.268)was higher than before correction(HR=1.063,95%CI:1.031-1.095).Using 412 cm^(3) as the cutoff,the group with baseline ETV<415 cm^(3) had a longer median survival time compared to the≥415 cm^(3) group(18.523 months vs 8.926 months,P<0.001).The group with an ETV reduction rate≥41%had better prognosis than the<41%group(17.862 months vs 9.235 months,P=0.006).Multivariate analysis confirmed that ETV reduction rate(HR=0.412,P<0.001),Child-Pugh classification(HR=0.298,P<0.001),and Barcelona Clinic Liver Cancer stage(HR=0.578,P=0.045)were independent prognostic factors.CONCLUSION Volume imaging based on MRI bias field correction can improve the accuracy of evaluating the efficacy of TACE treatment for invasive liver cancer.The corrected ETV and its reduction rate can serve as independent indicators for predicting patient prognosis,providing important reference for developing individualized treatment strategies.展开更多
BACKGROUND The liver,as the main target organ for hematogenous metastasis of colorectal cancer,early and accurate prediction of liver metastasis is crucial for the diagnosis and treatment of patients.Herein,this study...BACKGROUND The liver,as the main target organ for hematogenous metastasis of colorectal cancer,early and accurate prediction of liver metastasis is crucial for the diagnosis and treatment of patients.Herein,this study aims to investigate the application value of a combined machine learning(ML)based model based on the multiparameter magnetic resonance imaging for prediction of rectal metachronous liver metastasis(MLM).AIM To investigate the efficacy of radiomics based on multiparametric magnetic resonance imaging images of preoperative first diagnosed rectal cancer in predicting MLM from rectal cancer.METHODS We retrospectively analyzed 301 patients with rectal cancer confirmed by surgical pathology at Jingzhou Central Hospital from January 2017 to December 2023.All participants were randomly assigned to the training or validation queue in a 7:3 ratio.We first apply generalized linear regression model(GLRM)and random forest model(RFM)algorithm to construct an MLM prediction model in the training queue,and evaluate the discriminative power of the MLM prediction model using area under curve(AUC)and decision curve analysis(DCA).Then,the robustness and generalizability of the MLM prediction model were evaluated based on the internal validation set between the validation queue groups.RESULTS Among the 301 patients included in the study,16.28%were ultimately diagnosed with MLM through pathological examination.Multivariate analysis showed that carcinoembryonic antigen,and magnetic resonance imaging radiomics were independent predictors of MLM.Then,the GLRM prediction model was developed with a comprehensive nomogram to achieve satisfactory differentiation.The prediction performance of GLRM in the training and validation queue was 0.765[95%confidence interval(CI):0.710-0.820]and 0.767(95%CI:0.712-0.822),respectively.Compared with GLRM,RFM achieved superior performance with AUC of 0.919(95%CI:0.868-0.970)and 0.901(95%CI:0.850-0.952)in the training and validation queue,respectively.The DCA indicated that the predictive ability and net profit of clinical RFM were improved.CONCLUSION By combining multiparameter magnetic resonance imaging with the effectiveness and robustness of ML-based predictive models,the proposed clinical RFM can serve as an insight tool for preoperative assessment of MLM risk stratification and provide important information for individual diagnosis and treatment of rectal cancer patients.展开更多
Hepatocellular carcinoma is one of the leading causes of cancer-related deaths globally,and effective treatments are urgently needed.The present study aimed to investigate the inhibitory effect of Calculus Bovis(CB)on...Hepatocellular carcinoma is one of the leading causes of cancer-related deaths globally,and effective treatments are urgently needed.The present study aimed to investigate the inhibitory effect of Calculus Bovis(CB)on liver cancer and the underlying mechanisms.CB inhibited M2 tumor-associated macrophage polarization and modulated the Wnt/β-catenin signaling pathway,thereby suppressing the proliferation of liver cancer cells.The inhibitory effect on liver cancer growth was confirmed by both in vivo and in vitro experiments(detailed by Huang et al).The present study provides a theoretical basis for the application of CB for the treatment of liver cancer,providing new avenues for liver cancer treatment.展开更多
BACKGROUND Patients undergoing interventional therapy for liver cancer experience severe psychological pain and are prone to anxiety and depression.AIM To explore factors influencing anxiety and depression symptoms in...BACKGROUND Patients undergoing interventional therapy for liver cancer experience severe psychological pain and are prone to anxiety and depression.AIM To explore factors influencing anxiety and depression symptoms in 200 patients diagnosed with primary liver cancer.METHODS Data from 200 individuals diagnosed with primary liver cancer and admitted to the authors’hospital(January 2022 to January 2024)were divided into 2 groups according to psychological status:Normal(n=100);and anxiety and depression(n=100).Through a questionnaire survey of patients and their families,single and multifactor factors of anxiety and depression in the postoperative interven-tional treatment of patients with primary liver cancer were analyzed.RESULTS Univariate analysis revealed no statistical differences between the 2 groups in terms of chronic disease,sex,liver function,Child grade,and age(P>0.05).How-ever,there were statistical differences in payment method,disease cognition,number of interventional treatments,per capita income,and educational level(P<0.05).Multivariate logistic regression analysis revealed that educational level,per capita income,disease cognition,payment method,and number of interven-tional treatments were all independent factors influencing postoperative anxiety and depression symptoms after interventional therapy in patients diagnosed with primary liver cancer,and the comparisons were statistically significant(P<0.05).CONCLUSION Analysis of associated risk factors can strengthen the clinical screening of patients with liver cancer at high risk for postoperative anxiety and depression symptoms and improve their prognosis.展开更多
Colorectal cancer(CRC)is a common malignant tumor with a high mortality rate worldwide.Advanced CRC often leads to liver metastasis,which has a poor prognosis,highlighting the need to investigate the underlying mechan...Colorectal cancer(CRC)is a common malignant tumor with a high mortality rate worldwide.Advanced CRC often leads to liver metastasis,which has a poor prognosis,highlighting the need to investigate the underlying mechanisms.Omics,encompassing genomics,epigenomics,transcriptomics,proteomics,metabolomics,and microbiomics,enables comprehensive molecular analysis of cells and tissues.Tumor-omics research has advanced rapidly,with growing attention on CRC-related omics.However,systematic reviews on omics research specific to colorectal cancer liver metastasis(CRLM)are limited.This review summarizes the current status and progress of multi-omics research on CRLM and discusses the application of multi-omics technologies in basic research and the significant clinical implications.展开更多
BACKGROUND Many studies have found that sarcopenia is related to the survival of patients with liver cancer,which may lead to worse prognosis.AIM To investigate the relationship between skeletal muscle mass and progno...BACKGROUND Many studies have found that sarcopenia is related to the survival of patients with liver cancer,which may lead to worse prognosis.AIM To investigate the relationship between skeletal muscle mass and prognosis in patients with liver cancer receiving targeted therapy by meta-analysis.METHODS PubMed,Embase,Cochrane Library,and Web of Science were searched for clinical studies on the relationship between skeletal muscle index(SMI)and the prognosis of patients with liver cancer receiving targeted therapy from inception to March 1,2022.Meta-analysis and sensitivity analysis of the data were performed using Stata 16.0 software.RESULTS A total of 6877 studies were searched,and finally 12 articles with 1715 cases were included.Meta-analysis result of 8 articles showed that compared with non-low SMI group,the overall survival(OS)of patients with liver cancer in the low SMI group was significantly shorter(hazard ratio=1.60,95%confidence interval:1.44-1.77,P=0.000).Meta-analysis result of 4 articles showed that,compared with low SMI group,patients in the nonlow SMI group had longer OS(hazard ratio=0.59,95%confidence interval:0.38-0.91,P=0.018).CONCLUSION Skeletal muscle mass is positively correlated with OS in patients with liver cancer receiving targeted therapy.展开更多
Objective: This study aims to quantify the potential impact of controlling major risk factors on liver cancer deaths in China from 2021 to 2050 under various intervention scenarios.Methods: We developed a macro-level ...Objective: This study aims to quantify the potential impact of controlling major risk factors on liver cancer deaths in China from 2021 to 2050 under various intervention scenarios.Methods: We developed a macro-level simulation model based on comparative risk assessment to estimate population attributable fractions and avoidable liver cancer deaths. Risk factor prevalence data were obtained from national surveys and epidemiological estimates. Three intervention scenarios for each risk factor were projected:elimination(Scenario 1), ambitious reduction(Scenario 2), and manageable targets aligned with national/global goals(Scenario 3). The impact of secondary prevention through liver cancer screening at different coverage was evaluated.Results: Between 2021 and 2050, liver cancer deaths in China are projected to reach 9.44 million in males and4.29 million in females. Eliminating hepatitis B virus and hepatitis C virus could prevent 65.62%(57.47%-73.77%)and 28.47%(24.93%-32.00%) of liver cancer deaths, respectively. Achieving manageable targets in reducing the prevalence of smoking and alcohol drinking could prevent 6.57%(5.75%-7.38%) and 0.85%(0.75%-0.96%) of liver cancer deaths, with a more pronounced effect observed in males. Eliminating high body mass index(BMI)could avert 45,000 male and 25,000 female deaths annually by 2050, while diabetes elimination could prevent60,000 male and 21,000 female deaths. Secondary prevention through liver cancer screening with 80% coverage could reduce liver cancer deaths by 3.59%(3.14%-4.04%) for the total population. Combining all interventions under Scenario 1 could prevent up to 88.39%(76.65%-99.81%) of male and 77.80%(67.42%-87.88%) of female liver cancer deaths by 2050.Conclusions: Comprehensive risk factor control could prevent over 80% of liver cancer deaths in China by2050. Secondary prevention through screening may offer modest additional benefits. These findings provide strong quantitative support for targeted, evidence-based interventions and underscore the need for policy action to address key risk factors.展开更多
Liver cancer remains one of the leading causes of cancer-related mortality worldwide,with hepatocellular carcinoma representing its most prevalent form.This review provides a comprehensive summary of the key factors d...Liver cancer remains one of the leading causes of cancer-related mortality worldwide,with hepatocellular carcinoma representing its most prevalent form.This review provides a comprehensive summary of the key factors driving the initiation and progression of hepatocellular carcinoma,with a particular emphasis on immune-related mechanisms.Furthermore,we delve into the emerging roles of galectins,particularly galectin-1 and galectin-3,in hepatocellular carcinoma pathobiology,underscoring their potential utility as biomarkers for assessing disease severity and progression.These insights contribute to a better understan-ding of the molecular and immunological underpinnings of hepatocellular carcinoma,paving the way for more targeted therapeutic strategies.展开更多
基金supported by the National Natural Science Foundation of China(grant numbers:82273721,82304220)Cooperation Fund of CHCAMS and SZCH(grant number:CFA202201003).
文摘Background While China’s socioeconomic transformation has driven divergent trends in gastrointestinal cancers,comprehensive data on esophageal,gastric,and liver cancer burden remain limited.This study examines the global burden of esophageal,gastric,and liver cancers in 2022 and analyzes the trends of age-standardized incidence and mortality rate(ASRs)in China from 2000 to 2018,thereby providing evidence for the formulation of cancer control strategies.Methods The global burden of esophageal,gastric and liver cancers including the estimated number of cases and deaths and the ASRs for incidence and mortality were from GLOBALCAN 2022 dataset.Data from 22 cancer registries in China were employed for the trend analysis of the ASRs for incidence and mortality of these three cancers.The Joinpoint model was used to compute the average annual percentage change(AAPC)of the incidence and mortality of the three cancers from 2000 to 2018.Results Globally,esophageal,gastric and liver cancers accounted for 11.8%of incident cancer cases and 19.1%of cancer deaths.China bore a disproportionately high burden,representing 43.8%,37.0%,and 42.4%of global esophageal,gastric,and liver cancer cases respectively,and 42.1%,39.4%,and 41.7%of corresponding deaths.However,the ASRs for incidence and mortality for all three cancers declined significantly in China(2000–2018),with absolute case numbers decreasing for gastric and esophageal cancers during 2010–2022.Age-specific analysis revealed most pronounced declines in incidence and mortality in populations under 40 years old,with AAPCs of less than–6.0%for esophageal cancer,around–4.0%for gastric cancer,and approximately–2.0%for liver cancer.Conclusions China has achieved remarkable progress in controlling esophageal,gastric and liver cancers,yet these malignancies remain major public health challenges.Future efforts should intensify existing prevention measures while expanding screening programs,particularly for aging populations.These findings offer valuable insights for regions undergoing similar epidemiological transitions.
文摘In recent years,the rapid evolution of cancer therapies has markedly increased patient survival rates.However,the incidence of adverse events caused by anticancer treatments remains high,leading to significant clinical challenges.As the central hub of drug metabolism and detoxification,the liver is susceptible to therapeutic insults.The specific mechanisms of liver injury caused by different types of antineoplastic treatments vary.Chemotherapy induces hepatic damage via oxidative stress and mitochondrial dysfunction,whereas targeted therapy disrupts signaling pathways in hepatic cells.Immunotherapy triggers immunemediated hepatitis through cytokine storms and immune cell infiltration,and radiation therapy causes hepatic microvascular injury.Additionally,patients with preexisting chronic liver diseases(such as cirrhosis,hepatitis B/C,or nonalcoholic fatty liver disease)are more likely to face increased risks of hepatic injury during cancer treatment.Therefore,early detection and timely treatment are crucial for these high-risk populations.This review introduces the emerging field of“oncohepatology”,which illuminates the mechanisms underlying hepatic injury due to cancer treatments,summarizes the influence and management of preexisting liver disease during cancer treatment,analyzes diagnostic and therapeutic strategies for cancer treatment-associated liver function damage,and discusses potential future research directions to provide valuable insights for liver injury management in clinical oncology.
文摘BACKGROUND The treatment of patients with liver cancer after surgery with the artificial liver support system combined with traditional Chinese medicine(TCM)for strengthening the body and removing blood stasis is a new idea.AIM To analyze the post-surgical effect of the artificial liver support system with TCM in patients with liver cancer.METHODS Ninety-eight patients with liver cancer who underwent surgical treatment at the Fifth People’s Hospital of Huai’an from January 2023-2024 were selected and divided into two groups(49 patients each)via random lottery method.Both groups underwent surgery.The control group received artificial liver support,and the observation group was additionally treated with TCM for strengthening the body and removing blood stasis.Gastrointestinal recovery,liver function,tumor marker levels,immune function,and safety were compared between both groups.RESULTS There were significant differences in the levels of indicators related to gastrointestinal recovery between the groups(P<0.05).After treatment,the levels of alanine aminotransferase,aspartate aminotransferase,total bilirubin,and gamma-glutamyl transpeptidase in the observation group were lower,whereas the albumin level was higher(P<0.05).After treatment,tumor marker levels in the observation group were relatively lower(P<0.05).After treatment,compared to the control group,the CD4+level in the observation group was higher and the CD8+level was lower(P<0.05).There was no significant difference in the incidence of adverse reactions between both groups(P>0.05).CONCLUSION Combining the artificial liver support system with TCM significantly improves liver and gastrointestinal functions,enhances immune responses,and reduces tumor marker levels with high safety,suggesting that it could be a promising approach for optimizing postoperative care and improving patient outcomes,potentially reducing complications and enhancing quality of life.
基金Key Project of Traditional Chinese Medicine Science and Technology Plan of Zhejiang Province (GZY-ZJ-KJ-24077)National Natural Science Foundation of China (No. U23A202181, 8207101520, 82272860)+2 种基金Central Guidance on Local Science and Technology Development Fund of Zhejiang Province (2023ZY1017)Fundamental Research Funds for the Central Universities (No. 226-2023-00038)Special Financial Support for Zhejiang Traditional Chinese Medicine Innovation Teams。
文摘BACKGROUND: The increasing morbidity of liver cancer has led to a growing demand for transplantation. Split liver transplantation(SLT) is a promising way to ameliorate organ shortages. However, the safety and efficacy of SLT are still controversial. The aim of this study was to assess the clinical outcome of SLT in liver cancer patients at our center. METHODS: A total of 74 patients who received liver transplantation at a tertiary hospital from March 2019 to July 2023 were retrospectively studied, of whom 37 recipients underwent SLT and 37 recipients underwent whole-graft liver transplantation(WGLT). Clinical data were analyzed and compared between patients who underwent SLT and WGLT.RESULTS: SLT and WGLT were successfully performed, with no intraoperative transplantrelated mortality. Postoperatively, no significant differences in total bilirubin(TB, P=0.266), alanine transaminase(ALT, P=0.403) and aspartate transaminase(AST, P=0.160) levels within 30 d were detected between the two groups. The transplant-related mortality rates were 8.1% in the SLT group and 5.4% in the WGLT group within 30 d of surgery(P=1.000), and 10.8% and 8.1%, respectively, at 90 d after surgery(P=1.000). There were no significant differences in overall survival(OS) and progress-free survival(PFS) between the SLT and WGLT groups(P=0.910, P=0.190). CONCLUSION: Our results show that SLT does not imply additional risks in treating liver cancer compared with WGLT.
基金Supported by the Project of Guizhou Provincial Department of Science and Technology,No.Qian Ke He Cheng Guo-LC[2024]109.
文摘The incidence of colorectal cancer is gradually increasing,and a majority of patients are diagnosed with distant metastases at the time of initial diagnosis,with the liver being the most common site of metastasis.Unlike most malignant tumors,patients with distant metastases can still achieve favorable prognoses if both the primary tumor and liver metastases are surgically resected.With ad-vances in systemic therapies,many patients with initially unresectable liver me-tastases from colorectal cancer can undergo systemic treatment to achieve con-version therapy,thereby gaining the opportunity for surgery.However,there is still no consensus on several issues,including the timing of systemic therapy before and after surgery,whether neoadjuvant therapy should be employed,and the choice between simultaneous or staged surgeries.This review aims to system-atically describe the current treatment landscape for colorectal cancer with liver metastases and highlight several unresolved controversial issues,providing valuable insights for the diagnosis and treatment of colorectal liver metastases.
基金Supported by the European Union-NextGenerationEU,through the National Recovery and Resilience Plan of the Republic of Bulgaria,No.BG-RRP-2.004-0008.
文摘Colorectal cancer (CRC) is the third most common cancer globally, with 20%-25%of patients diagnosed at stage IV, significantly affecting overall survival (OS).Only 14% of stage IV patients survive for 5 years with palliative chemotherapy.However, the role of liver transplantation (LT) in the management of CRC livermetastasis (CRCLM) is an evolving area of interest. Recent advancements inoncologic outcomes and clinical understanding have prompted the re-evaluationof LT as a viable treatment option for CRCLM. A promising result from someprospective pilot studies reported a 5-year OS rate of 60% after LT for patientswith CRCLM. Key factors influencing eligibility include tumor biology, absence ofextrahepatic disease, and the patient's performance status. By synthesizing thelatest research findings, we aim to provide a comprehensive overview that summarizesthe most relevant data related to the clinical outcomes of patients whounderwent LT for CRCLM. We aim to provide a comprehensive overview by synthesizingthe latest research findings. This review discusses the inclusion criteriaand eligibility for LT in CRCLM, which are of great importance to patient outcomes.
文摘BACKGROUND Multiple primary malignant tumors refer to the occurrence of two or more primary malignant tumors in the same organ or multiple organs or tissues at the same time or successively in the same patient,and can occur anywhere in the body.The treatment guidelines for patients with multiple primary malignant tumors are currently controversial.CASE SUMMARY A 51-year-old male patient with liver cancer and portal hypertension received 42 months of co-treatment with atezolizumab and bevacizumab.After that,the disease was rated stable disease.The patient was then diagnosed with gastric cancer.Since the patient was not sensitive to anti-programmed death ligand 1 immunosuppressive agents,a co-treatment with oxaliplatin,tegafur,apatinib,and cadonilimab was selected after multidisciplinary consultation and the patient’s agreement.After four cycles of treatment,partial response and stable disease were observed in gastric and liver cancers,respectively.Surgical treatment was performed considering the high-risk factors of gastrointestinal bleeding in patients with gastroesophageal varices.Postoperative pathology showed that the Tumor Regression Grade was 1.Moreover,the genetic testing of postoperative tumor specimens indicated negative programmed death ligand 1 and microsatellite stability.In addition,the latest follow-up indicated an 8 and 40-month progression-free survival in gastric and liver cancer patients,respectively.Currently,the patient is receiving postoperative immunotherapy with cadonilimab.CONCLUSION Cadonilimab not only treats microsatellite stability gastric cancer patients but can also be used for liver cancer treatment.
文摘BACKGROUND In-depth comparative investigations in terms of clinical efficacies of liver tumor microwave ablation(MWA)and laparoscopic hepatectomy(LH),which are both important treatment modalities for liver neoplasms,have been limited in patients diagnosed with primary small liver cancer(PSLC).AIM To compare and analyze the clinical efficacy of liver tumor MWA and LH for PSLC.METHODS This study retrospectively analyzed the medical records of 123 patients with PSLC admitted to Xuzhou Central Hospital from January 2015 to November 2022 and categorized them based on treatment modalities into the LH and MWA groups.The LH group,consisting of 61 cases,received LH,and the MWA group,which included 62 cases,underwent liver tumor MWA.Basic data and various periop-erative indicators were compared between the two groups,including changes in liver function indicators[alanine aminotransferase(ALT),glutamic aminotrans-ferase(AST),and total bilirubin(TBIL)]pre-and post-treatment,and efficacy and postoperative complications were analyzed.RESULTS No statistically significant difference was observed between the two groups in terms of age,gender,tumor diameter,liver function Child-Pugh classification and number of tumors,body mass index,and educational status(P>0.05).The overall effective rate was higher in the MWA group than in the LH group(98.39%vs 88.52%)(χ2=4.918,P=0.027).The MWA group exhibited less operation time,intraoperative bleeding,defecation time,and hospital stay than the LH group(P<0.05).No difference was found in liver function indicators between the two groups pre-treatment(P>0.05),and ALT,AST,and TBIL levels decreased in both groups post-treatment,with the MWA group demonstrating lower levels(P<0.05).The MWA and LH groups exhibited postoperative complication rates of 4.84%and 19.67%,respectively,with statistically significant differences between the two groups(P=0.012,χ2=6.318).CONCLUSION MWA is more effective in treating PSLC,and it promotes faster postoperative recovery for patients,and more security improves liver function and reduces postoperative complications compared to LH.
基金supported by Tabriz University of Medical Sciences,grant number 65364.
文摘Cancer stem cells(CSCs)are a major challenge in cancer therapy.Stem cell-like cells form a unique subpopulation within many tumors,which govern the degree of malignancy by promoting metastasis,recurrence,heterogeneity,and resistance to drug and radiation.Furthermore,these cells can persist in patients even after undergoing multiple cycles of conventional cancer therapy via dormancy,where they no longer dividing but remain active.These may cause cancer recurrence at any time,even years after a supposed cure,and remain invisible to the immune system.Targeting specific surface markers,signaling pathways and tumor microenvironment,which all have a significant effect on CSC function and maintenance,could help to eradicate CSCs and improve patient survival.Combinations of traditional therapies with nano-based drug delivery systems can efficiently target CSCs.Considering the biology and properties of CSCs,we classify recent approaches involving nanoparticle engineering,extracellular matrix modulation,cocktail strategies,multi-stage therapy,CSC defanging,Trojan horse systems,targeted therapy and organelle targeting.We highlight the most recent advances in nanocarrier design and drug delivery technologies to target CSCs,combined with conventional treatment in preclinical and clinical trials.The prospects of these approaches for CSCs elimination and recurrent cancer treatment are discussed.
基金the financial support from Henan Province Natural Science Foundation(No.252300420583)Henan Provincial Science and Technology Research Project(Nos.242102310455,242102310473,242102310517)the Key Project of Science and Technology Research funded by the Henan Provincial Department of Education(No.24A350002)。
文摘Liver cancer is the fourth cause of cancer-related deaths and the primary cause of death in patients with compensated cirrhosis.In recent years,the role of traditional Chinese medicine in the treatment of liver cancer has attracted more and more attention and recognition.Luteolin(LUT)and glycyrrhetinic(GA)are natural compounds extracted from Chinese herbal medicine.LUT exhibits various biological activity including anti-inflammatory,antibacterial,antiviral,anti-tumor,and neuroprotective effects.GA significantly inhibits the growth and metastasis of cancer cells.However,the low water solubility of both compounds hinders their clinical applications.In this study,rod-shaped nanoparticles(NPs)self-assembled from LUT and GA were designed to enhance drug solubility and tumor-targeting capability.We verified that the assembly mechanism of the NPs was π-π stacking.These NPs significantly inhibited the proliferation of liver cancer cells while had no significant effect on normal liver cells.In a mouse model of liver cancer,these NPs demonstrated superior tumor-targeting ability due to the enhanced permeability and retention effect,and the affinity of GA for liver cancer cells,resulting in better therapeutic efficacy with lower systemic toxicity.Results of network pharmacology analysis showed that LUT and GA respectively targeted estrogen receptor 1(ESR1)protein and cyclin-dependent kinase 1(CDK1)protein to corporately induce tumor cell cycle arrest,which induced the inhibition of tumor cell proliferation.In conclusion,this study provides a novel reference for the treatment of liver cancer.
文摘BACKGROUND The development of hepatocellular carcinoma(HCC)is influenced by multiple factors.Interventional therapy offers an effective treatment option for patients with unresectable intermediate-to-advanced HCC.Interventional therapy can induce electrocardiographic(ECG)abnormalities that may be associated with liver dysfunction,electrolyte disorders,and cardiac injury.AIM To explore the ECG alterations and determinants following interventional therapy in patients with HCC.METHODS Sixty patients undergoing interventional treatment for liver cancer were selected as study participants.According to the results of the dynamic ECG examination 1 day after surgery,the patients were divided into an abnormal group(n=21)and a nonabnormal group(n=39).With the help of dynamic ECG examination,the ECG parameters were compared and the baseline data of patients was recorded in the two groups.RESULTS The 24 hours QT interval variability,24 hours normal atrial polarization to ventricular polarization(R-R)interval(standard deviation),24 hours consecutive 5 minutes normal R-R interval,and 24 hours continuous 5 minutes normal R-R interval(standard deviation mean)were lower than patients in the nonabnormal group(P<0.05).The logistic analysis showed that age>60 years,liver function grade B,and postoperative body temperature 38°C were risk factors for abnormal dynamic electrocardiogram in patients with liver cancer intervention(P<0.05).CONCLUSION Interventional therapy for HCC can lead to ECG abnormalities,underscoring the clinical need for enhanced cardiac monitoring to mitigate myocardial complications.
文摘BACKGROUND Hepatocellular carcinoma ranks among the most prevalent malignant neoplasms.Surgical intervention constitutes a critical therapeutic approach for this condition.Nonetheless,postoperative recovery is frequently influenced by the patient's nutritional status and the quality of nursing care provided.AIM To examine the comprehensive impact of personalized nutritional support and nursing strategies on the postoperative rehabilitation of patients with liver cancer.METHODS In this study,a retrospective comparative analysis was conducted involving 60 post-operative liver cancer patients.The subjects were selected as subjects and divided into two groups based on differing nursing interventions,with each group comprising 30 patients.The control group received standard nutritional support and care,whereas the experimental group received individualized nutritional support and nursing strategies.The study aimed to evaluate the impact of individualized nutrition by comparing the rehabilitation indices,nutritional status,quality of life(QoL),and complication rates between the two groups.RESULTS The results showed that the recovery index of the experimental group was significantly better than that of the control group 2 weeks after surgery,and the average liver function recovery index of the experimental group was 85.significantly higher than that of the control group(73.67±7.19).In terms of nutritional status,the serum albumin level and body weight stabilization rate of the experimental group were also significantly higher than those of the control group,which were 42.33±2.4 g/L and 93.3%,respectively,compared with 36.01±3.85 g/L and 76.7%of the control group.In addition,the average QoL score of the experimental group was 84.66±3.7 points,which was significantly higher than that of the control group(70.92±4.28 points).At the psychological level,the average anxiety score of the experimental group was 1.17±0.29,and the average depression score was 1.47±0.4,which were significantly lower than the 2.26±0.42 and 2.57±0.45 of the control group.This showed that patients in the experimental group were better relieved of anxiety and depression under the individualized nutrition support and nursing strategy.More importantly,the complication rate in the experimental group was only 10%,much lower than the 33.3%in the control group.CONCLUSION Personalized nutritional support and tailored nursing strategies significantly enhance the postoperative rehabilitation of liver cancer patients.Consequently,it is recommended to implement and advocate for these individualized approaches to improve both the recovery outcomes and QoL for these patients.
文摘BACKGROUND Transcatheter arterial chemoembolization(TACE)is a key treatment approach for advanced invasive liver cancer(infiltrative hepatocellular carcinoma).However,its therapeutic response can be difficult to evaluate accurately using conventional two-dimensional imaging criteria due to the tumor’s diffuse and multifocal growth pattern.Volumetric imaging,especially enhanced tumor volume(ETV),offers a more comprehensive assessment.Nonetheless,bias field inhomogeneity in magnetic resonance imaging(MRI)poses challenges,potentially skewing volumetric measurements and undermining prognostic evaluation.AIM To investigate whether MRI bias field correction enhances the accuracy of volumetric assessment of infiltrative hepatocellular carcinoma treated with TACE,and to analyze how this improved measurement impacts prognostic prediction.METHODS We retrospectively collected data from 105 patients with invasive liver cancer who underwent TACE treatment at the Affiliated Hospital of Xuzhou Medical University from January 2020 to January 2024.The improved N4 bias field correction algorithm was applied to process MRI images,and the ETV before and after treatment was calculated.The ETV measurements before and after correction were compared,and their relationship with patient prognosis was analyzed.A Cox proportional hazards model was used to evaluate prognostic factors,with Martingale residual analysis determining the optimal cutoff value,followed by survival analysis.RESULTS Bias field correction significantly affected ETV measurements,with the corrected baseline ETV mean(505.235 cm^(3))being significantly lower than before correction(825.632 cm^(3),P<0.001).Cox analysis showed that the hazard ratio(HR)for corrected baseline ETV(HR=1.165,95%CI:1.069-1.268)was higher than before correction(HR=1.063,95%CI:1.031-1.095).Using 412 cm^(3) as the cutoff,the group with baseline ETV<415 cm^(3) had a longer median survival time compared to the≥415 cm^(3) group(18.523 months vs 8.926 months,P<0.001).The group with an ETV reduction rate≥41%had better prognosis than the<41%group(17.862 months vs 9.235 months,P=0.006).Multivariate analysis confirmed that ETV reduction rate(HR=0.412,P<0.001),Child-Pugh classification(HR=0.298,P<0.001),and Barcelona Clinic Liver Cancer stage(HR=0.578,P=0.045)were independent prognostic factors.CONCLUSION Volume imaging based on MRI bias field correction can improve the accuracy of evaluating the efficacy of TACE treatment for invasive liver cancer.The corrected ETV and its reduction rate can serve as independent indicators for predicting patient prognosis,providing important reference for developing individualized treatment strategies.
文摘BACKGROUND The liver,as the main target organ for hematogenous metastasis of colorectal cancer,early and accurate prediction of liver metastasis is crucial for the diagnosis and treatment of patients.Herein,this study aims to investigate the application value of a combined machine learning(ML)based model based on the multiparameter magnetic resonance imaging for prediction of rectal metachronous liver metastasis(MLM).AIM To investigate the efficacy of radiomics based on multiparametric magnetic resonance imaging images of preoperative first diagnosed rectal cancer in predicting MLM from rectal cancer.METHODS We retrospectively analyzed 301 patients with rectal cancer confirmed by surgical pathology at Jingzhou Central Hospital from January 2017 to December 2023.All participants were randomly assigned to the training or validation queue in a 7:3 ratio.We first apply generalized linear regression model(GLRM)and random forest model(RFM)algorithm to construct an MLM prediction model in the training queue,and evaluate the discriminative power of the MLM prediction model using area under curve(AUC)and decision curve analysis(DCA).Then,the robustness and generalizability of the MLM prediction model were evaluated based on the internal validation set between the validation queue groups.RESULTS Among the 301 patients included in the study,16.28%were ultimately diagnosed with MLM through pathological examination.Multivariate analysis showed that carcinoembryonic antigen,and magnetic resonance imaging radiomics were independent predictors of MLM.Then,the GLRM prediction model was developed with a comprehensive nomogram to achieve satisfactory differentiation.The prediction performance of GLRM in the training and validation queue was 0.765[95%confidence interval(CI):0.710-0.820]and 0.767(95%CI:0.712-0.822),respectively.Compared with GLRM,RFM achieved superior performance with AUC of 0.919(95%CI:0.868-0.970)and 0.901(95%CI:0.850-0.952)in the training and validation queue,respectively.The DCA indicated that the predictive ability and net profit of clinical RFM were improved.CONCLUSION By combining multiparameter magnetic resonance imaging with the effectiveness and robustness of ML-based predictive models,the proposed clinical RFM can serve as an insight tool for preoperative assessment of MLM risk stratification and provide important information for individual diagnosis and treatment of rectal cancer patients.
文摘Hepatocellular carcinoma is one of the leading causes of cancer-related deaths globally,and effective treatments are urgently needed.The present study aimed to investigate the inhibitory effect of Calculus Bovis(CB)on liver cancer and the underlying mechanisms.CB inhibited M2 tumor-associated macrophage polarization and modulated the Wnt/β-catenin signaling pathway,thereby suppressing the proliferation of liver cancer cells.The inhibitory effect on liver cancer growth was confirmed by both in vivo and in vitro experiments(detailed by Huang et al).The present study provides a theoretical basis for the application of CB for the treatment of liver cancer,providing new avenues for liver cancer treatment.
文摘BACKGROUND Patients undergoing interventional therapy for liver cancer experience severe psychological pain and are prone to anxiety and depression.AIM To explore factors influencing anxiety and depression symptoms in 200 patients diagnosed with primary liver cancer.METHODS Data from 200 individuals diagnosed with primary liver cancer and admitted to the authors’hospital(January 2022 to January 2024)were divided into 2 groups according to psychological status:Normal(n=100);and anxiety and depression(n=100).Through a questionnaire survey of patients and their families,single and multifactor factors of anxiety and depression in the postoperative interven-tional treatment of patients with primary liver cancer were analyzed.RESULTS Univariate analysis revealed no statistical differences between the 2 groups in terms of chronic disease,sex,liver function,Child grade,and age(P>0.05).How-ever,there were statistical differences in payment method,disease cognition,number of interventional treatments,per capita income,and educational level(P<0.05).Multivariate logistic regression analysis revealed that educational level,per capita income,disease cognition,payment method,and number of interven-tional treatments were all independent factors influencing postoperative anxiety and depression symptoms after interventional therapy in patients diagnosed with primary liver cancer,and the comparisons were statistically significant(P<0.05).CONCLUSION Analysis of associated risk factors can strengthen the clinical screening of patients with liver cancer at high risk for postoperative anxiety and depression symptoms and improve their prognosis.
基金supported by grants from the Natural Science Foundation of Chongqing(Grant No.CSTB2024NSCQ-MSX0478).
文摘Colorectal cancer(CRC)is a common malignant tumor with a high mortality rate worldwide.Advanced CRC often leads to liver metastasis,which has a poor prognosis,highlighting the need to investigate the underlying mechanisms.Omics,encompassing genomics,epigenomics,transcriptomics,proteomics,metabolomics,and microbiomics,enables comprehensive molecular analysis of cells and tissues.Tumor-omics research has advanced rapidly,with growing attention on CRC-related omics.However,systematic reviews on omics research specific to colorectal cancer liver metastasis(CRLM)are limited.This review summarizes the current status and progress of multi-omics research on CRLM and discusses the application of multi-omics technologies in basic research and the significant clinical implications.
基金Supported by Chongqing Young and Middle-aged Medical High-end Talents,No.YXGD202405Chongqing District and County Head Goose Talents,Chongqing Science and Technology and Health Joint Scientific Research Project on Traditional Chinese Medicine,No.2024ZYYB036Chongqing Banan District Science and Technology and Health Joint Scientific Research Project on Traditional Chinese Medicine,No.BNWJ202300112.
文摘BACKGROUND Many studies have found that sarcopenia is related to the survival of patients with liver cancer,which may lead to worse prognosis.AIM To investigate the relationship between skeletal muscle mass and prognosis in patients with liver cancer receiving targeted therapy by meta-analysis.METHODS PubMed,Embase,Cochrane Library,and Web of Science were searched for clinical studies on the relationship between skeletal muscle index(SMI)and the prognosis of patients with liver cancer receiving targeted therapy from inception to March 1,2022.Meta-analysis and sensitivity analysis of the data were performed using Stata 16.0 software.RESULTS A total of 6877 studies were searched,and finally 12 articles with 1715 cases were included.Meta-analysis result of 8 articles showed that compared with non-low SMI group,the overall survival(OS)of patients with liver cancer in the low SMI group was significantly shorter(hazard ratio=1.60,95%confidence interval:1.44-1.77,P=0.000).Meta-analysis result of 4 articles showed that,compared with low SMI group,patients in the nonlow SMI group had longer OS(hazard ratio=0.59,95%confidence interval:0.38-0.91,P=0.018).CONCLUSION Skeletal muscle mass is positively correlated with OS in patients with liver cancer receiving targeted therapy.
基金supported by the Capital’s Funds for Health Improvement and Research (No. 2024-1G-4023)。
文摘Objective: This study aims to quantify the potential impact of controlling major risk factors on liver cancer deaths in China from 2021 to 2050 under various intervention scenarios.Methods: We developed a macro-level simulation model based on comparative risk assessment to estimate population attributable fractions and avoidable liver cancer deaths. Risk factor prevalence data were obtained from national surveys and epidemiological estimates. Three intervention scenarios for each risk factor were projected:elimination(Scenario 1), ambitious reduction(Scenario 2), and manageable targets aligned with national/global goals(Scenario 3). The impact of secondary prevention through liver cancer screening at different coverage was evaluated.Results: Between 2021 and 2050, liver cancer deaths in China are projected to reach 9.44 million in males and4.29 million in females. Eliminating hepatitis B virus and hepatitis C virus could prevent 65.62%(57.47%-73.77%)and 28.47%(24.93%-32.00%) of liver cancer deaths, respectively. Achieving manageable targets in reducing the prevalence of smoking and alcohol drinking could prevent 6.57%(5.75%-7.38%) and 0.85%(0.75%-0.96%) of liver cancer deaths, with a more pronounced effect observed in males. Eliminating high body mass index(BMI)could avert 45,000 male and 25,000 female deaths annually by 2050, while diabetes elimination could prevent60,000 male and 21,000 female deaths. Secondary prevention through liver cancer screening with 80% coverage could reduce liver cancer deaths by 3.59%(3.14%-4.04%) for the total population. Combining all interventions under Scenario 1 could prevent up to 88.39%(76.65%-99.81%) of male and 77.80%(67.42%-87.88%) of female liver cancer deaths by 2050.Conclusions: Comprehensive risk factor control could prevent over 80% of liver cancer deaths in China by2050. Secondary prevention through screening may offer modest additional benefits. These findings provide strong quantitative support for targeted, evidence-based interventions and underscore the need for policy action to address key risk factors.
文摘Liver cancer remains one of the leading causes of cancer-related mortality worldwide,with hepatocellular carcinoma representing its most prevalent form.This review provides a comprehensive summary of the key factors driving the initiation and progression of hepatocellular carcinoma,with a particular emphasis on immune-related mechanisms.Furthermore,we delve into the emerging roles of galectins,particularly galectin-1 and galectin-3,in hepatocellular carcinoma pathobiology,underscoring their potential utility as biomarkers for assessing disease severity and progression.These insights contribute to a better understan-ding of the molecular and immunological underpinnings of hepatocellular carcinoma,paving the way for more targeted therapeutic strategies.
