BACKGROUND The liver represents a common site of distant metastasis in patients with esophageal cancer(EC).Conventional chemotherapy(CMT)presents limited efficacy for EC,and EC patients with liver metastases typically...BACKGROUND The liver represents a common site of distant metastasis in patients with esophageal cancer(EC).Conventional chemotherapy(CMT)presents limited efficacy for EC,and EC patients with liver metastases typically experience a poor prognosis,highlighting an urgent need to explore novel treatment approaches.This study evaluated the overall efficacy and safety of CMT vs CMT combined with immune checkpoint inhibitors(ICIs)in the treatment of EC patients with liver metastases.Furthermore,prognostic factors influencing outcomes in this patient population were identified.AIM To evaluate the efficacy and safety of first-line chemoimmunotherapy for EC patients with liver metastases and to analyze prognostic factors.METHODS This retrospective study included 126 EC patients with liver metastases at Zhejiang Cancer Hospital between 2014 and 2024.Patients receiving CMT were compared with those receiving CMT+ICI.Analyzed variables included clinicopathological features,treatment history,characteristics of metastasis,systemic and local treatments,overall survival(OS),and treatment-related adverse events(TRAEs).Prognostic factors were evaluated using univariate and multivariate Cox proportional-hazards regression models.Finally,efficacy outcomes and TRAE profiles were compared between the two groups.RESULTS A significant difference in median OS was identified between the two groups(10.8 months in the CMT group vs 20.8 months in the CMT+ICI group,P=0.004).The CMT+ICI group also demonstrated a significantly longer median progression-free survival of 11.7 months(P<0.001).Patients receiving combination therapy exhibited significantly improved systemic objective response rate and disease control rate.Multivariate analysis identified key factors significantly influencing OS in EC patients with liver metastases:Karnofsky Performance Status score≥70,receipt of local therapy for liver metastases,and the number of cycles of CMT and immunotherapy received.Furthermore,the incidence of TRAEs did not significantly differ between the CMT+ICI and CMT groups.CONCLUSION For EC patients with liver metastases,the combination of CMT and ICIs demonstrates significantly superior efficacy compared with CMT alone,while maintaining manageable TRAEs.展开更多
In non-small cell lung cancer(NSCLC),poly(ADP-ribose)polymerase 1(PARP1)induces genomic instability and promotes tumor progression by impairing DNA repair pathways.Although PARP1-targeting proteolysis-targeting chimer...In non-small cell lung cancer(NSCLC),poly(ADP-ribose)polymerase 1(PARP1)induces genomic instability and promotes tumor progression by impairing DNA repair pathways.Although PARP1-targeting proteolysis-targeting chimeras(PROTACs)offer a promising strategy for selective protein degradation,their clinical application remains limited by poor water solubility and insufficient tumor selectivity.Here,we report a pHresponsive magnetic nanoparticle system co-delivering β-lapachone(β-lap)and a PARP1-targeted PROTAC(PRO)for synergistic and tumor-targeting therapy.Designed with a hydrophobic self-assembled core and a magnetic coating,the nanoparticle(NP_(β-lap+PRO))enables pHresponsive drug release and magnetic resonance imaging(MRI)monitoring.β-Lap is a bioactivated drug that relies on NAD(P)H:quinone oxidoreductase 1(NQO1),which is overexpressed in NSCLC cells.It has the potential to deliver tumor-selective DNA damage and induce cell death.The NP_(β-lap+PRO) exploits elevated NQO1 levels in NSCLC to initiate β-lap-driven oxidative stress and DNA damage,while simultaneously enhancing PROTAC-mediated PARP1 degradation within the acidic tumor microenvironment synergistically induces apoptosis.In A549 NSCLC tumor models,this system effectively induces PARP1 degradation,blocks DNA repair,and preserves NAD(P)H pools,thereby amplifying β-lapinduced reactive oxygen species production,leading to enhanced DNA double-strand breaks and apoptosis.This study presents a biomarker-driven nanotherapeutic strategy that integrates PROTAC technology with redox-targeted combination therapy,offering a promising approach for precision treatment of NSCLC.展开更多
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
Liver cancer is a leading cause of death worldwide,and hepatocellular carcinoma(HCC)is the most frequent primary liver tumour,followed by cholangiocarcinoma.Notably,secondary tumours represent up to 90% of liver tumou...Liver cancer is a leading cause of death worldwide,and hepatocellular carcinoma(HCC)is the most frequent primary liver tumour,followed by cholangiocarcinoma.Notably,secondary tumours represent up to 90% of liver tumours.Chronic liver disease is a recognised risk factor for liver cancer development.Up to 90% of the patients with HCC and about 20% of those with cholangiocarcinoma have an underlying liver alteration.The gut microbiota-liver axis represents the bidirectional relationship between gut microbiota,its metabolites and the liver through the portal flow.The interplay between the immune system and gut microbiota is also well-known.Although primarily resulting from experiments in animal models and on HCC,growing evidence suggests a causal role for the gut microbiota in the development and progression of chronic liver pathologies and liver tumours.Despite the curative intent of“traditional”treatments,tumour recurrence remains high.Therefore,microbiota modulation is an appealing therapeutic target for liver cancer prevention and treatment.Furthermore,microbiota could represent a non-invasive biomarker for early liver cancer diagnosis.This review summarises the potential role of the microbiota and immune system in primary and secondary liver cancer development,focusing on the potential therapeutic implications.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 Cancer-associated fibroblasts(CAFs),crucial components of the tumor microenvironment in primary and metastatic tumors,can impact the activity of cancer cells and contribute to their progression.Given their ...BACKGROUND Cancer-associated fibroblasts(CAFs),crucial components of the tumor microenvironment in primary and metastatic tumors,can impact the activity of cancer cells and contribute to their progression.Given their extensive interactions with cancer cells and other stromal cells,we aimed to evaluate the prognostic value of CAFs in patients with liver cancer(LC).AIM To investigate the association between CAF expression and clinicopathological characteristics as well as overall survival(OS)in patients with LC,including hepatocellular carcinoma(HCC)and intrahepatic cholangiocarcinoma(iCCA).METHODS We performed a meta-analysis of cohort studies with available data on the effects of CAF expression on both clinicopathological characteristics and OS via hazard ratios(HRs)and risk ratios with 95%confidence intervals(CIs).Studies were subgrouped on the basis of CAF markers and cancer type,and the subgroup effects of CAF expression on both HCC and iCCA were analyzed through meta-regression.The Newcastle-Ottawa Scale was used to evaluate the included studies to guarantee their quality and minimize the possibility of bias.RESULTS Nine trials were selected and included a total of 1518 patients.According to our primary meta-analysis,the expression of CAFs in LC patients was significantly associated with a decrease in OS(LC:HR:1.62;95%CI:1.34-1.97;P<0.001;HCC:HR:1.67;95%CI:1.34-2.07;P<0.001;iCCA:HR:1.47;95%CI:0.97-2.23;P=0.07);nevertheless,it was not significantly associated with almost all clinicopathologic characteristics,including tumor size,venous infiltration,alpha-fetoprotein level,and differentiation grade.According to the subgroup analysis of smooth muscle actin(SMA)markers in both HCC patients and iCCA patients,high CAF expression in HCC(HR:2.29;95%CI:1.01-5.22;P=0.048)and iCCA(HR:2.04;95%CI:1.09-3.81;P=0.025)patients was a significant indicator of poor OS.Moreover,the clinicopathological characteristics were also verified by the SMA marker,which had a nearly significant effect on the venous infiltration of iCCA(risk ratio:2.70;95%CI:0.97-7.49;P=0.057).CONCLUSION High CAF expression,evaluated by both mixed markers and SMAs,is significantly associated with poor OS in patients with LC,including both HCC patients and iCCA patients.However,further research is necessary since how CAF expression and clinicopathologic features are related is yet unknown.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
The integration of ferroptosis induction with cancer immunotherapy has emerged as a promising approach in oncology,offering dual mechanisms to overcome therapeutic resistance and tumor heterogeneity.Nevertheless,the d...The integration of ferroptosis induction with cancer immunotherapy has emerged as a promising approach in oncology,offering dual mechanisms to overcome therapeutic resistance and tumor heterogeneity.Nevertheless,the dynamic and complicated crosstalk between ferroptosis processes and immune regulation in tumor microenvironments presents both opportunities and challenges.By inducing lipid peroxidation in tumor tissues,ferroptotic tumor cell death can stimulate immunogenicity.Nevertheless,excessive lipid peroxidation may paradoxically impair the functionality of multiple immune cells,thereby presenting crosstalk challenges in therapeutic strategies.To address these crosstalk challenges,several advanced drug delivery strategies have been proposed,such as immunostimulatory active pharmaceutical ingredients co-delivery,tumor-targeted delivery,and stimuli-responsive delivery.These drug delivery strategies demonstrate dual therapeutic efficacy by synergistically potentiating ferroptosis induction in malignant cells while concurrently mitigating immunotoxicity and even augmenting antitumor immunity.This review offers detailed insights into the crosstalk between ferroptosis and tumor immunity,along with a guiding overview of the three delivery strategies.The current obstacles and translational potential were thoroughly analyzed,providing valuable perspectives for future research.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
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
Liver cancer is a major killer threatening human health worldwide.At this stage the clinical choice to the treatment of liver cancer is a combination of surgery,chemotherapy and radiotherapy.Alternatively,using hydrog...Liver cancer is a major killer threatening human health worldwide.At this stage the clinical choice to the treatment of liver cancer is a combination of surgery,chemotherapy and radiotherapy.Alternatively,using hydrogen to treat cancer has great prospects and development space.Herein,we fabricated a hierarchical and flexible electrode that being able to continuously generate hydrogen in vivo in the deep abdominal liver through efficient water electrolysis to kill tumor cells and regulate the tumor microenvironment.The flexibility of the electrode facilitated to fit the tumor surface and thus improved the contact area of hydrogen therapy.By in situ growth of molybdenum disulfide on a hierarchical carbon skeleton,improved reaction kinetics and smaller impedance with a low overpotential of 1.02 V at-10 m A/cm^(2)in cell culture medium and Tafel slope of 73 m V/dec were achieved.Animal experiments showed that the electrode could effectively inhibit the growth of human hepatocellular carcinoma cells in nude mice by efficient H_(2)-production in vivo.The apoptosis rate of cancer cells reached 81.8%,and the proliferation rate decreased to 3.39%.Moreover,this treatment does not affect the growth of normal hepatocytes according to the results of cell experiments.This study demonstrated that the in vivo hydrogen production by our flexible electrode is a safe and effective treatment for liver cancer,with the advantages of minimal invasiveness,simple operation,low side effects and low cost.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
In this paper,the mechanism of the Wnt/β-catenin pathway is introduced,and the process and principle of the experiment conducted by Huang et al is explained.We discussed the reliability of the conclusion that Calculu...In this paper,the mechanism of the Wnt/β-catenin pathway is introduced,and the process and principle of the experiment conducted by Huang et al is explained.We discussed the reliability of the conclusion that Calculus bovis(C.bovis)inhibits M2 tumor-associated macrophage polarization via Wnt/β-catenin pathway modulation to suppress liver cancer.We also offer suggestions for further studies of the use of C.bovis in the treatment of liver cancer.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
Evaluation of response to chemotherapy in colorectal cancer patients with synchronous liver metastases is important in terms of treatment management.In this Letter to the Editor,several issues in the article are discu...Evaluation of response to chemotherapy in colorectal cancer patients with synchronous liver metastases is important in terms of treatment management.In this Letter to the Editor,several issues in the article are discussed.For the comparison of carbohydrate antigen 19-9(CA19-9)values referenced in the study,the patient group was not matched for cancer stage.Therefore,it may be more appropriate to select and compare CA19-9 values in patients with same-stage cancer.展开更多
基金Supported by National Natural Science Foundation of China,No.82303672Zhejiang Provincial Health Commission and Zhejiang Provincial Administration of Traditional Chinese Medicine through the Targeted Project for Medical and Health Research,No.2025ZL017and China Primary Health Care Foundation,No.ZLMY20240311001ZJ.
文摘BACKGROUND The liver represents a common site of distant metastasis in patients with esophageal cancer(EC).Conventional chemotherapy(CMT)presents limited efficacy for EC,and EC patients with liver metastases typically experience a poor prognosis,highlighting an urgent need to explore novel treatment approaches.This study evaluated the overall efficacy and safety of CMT vs CMT combined with immune checkpoint inhibitors(ICIs)in the treatment of EC patients with liver metastases.Furthermore,prognostic factors influencing outcomes in this patient population were identified.AIM To evaluate the efficacy and safety of first-line chemoimmunotherapy for EC patients with liver metastases and to analyze prognostic factors.METHODS This retrospective study included 126 EC patients with liver metastases at Zhejiang Cancer Hospital between 2014 and 2024.Patients receiving CMT were compared with those receiving CMT+ICI.Analyzed variables included clinicopathological features,treatment history,characteristics of metastasis,systemic and local treatments,overall survival(OS),and treatment-related adverse events(TRAEs).Prognostic factors were evaluated using univariate and multivariate Cox proportional-hazards regression models.Finally,efficacy outcomes and TRAE profiles were compared between the two groups.RESULTS A significant difference in median OS was identified between the two groups(10.8 months in the CMT group vs 20.8 months in the CMT+ICI group,P=0.004).The CMT+ICI group also demonstrated a significantly longer median progression-free survival of 11.7 months(P<0.001).Patients receiving combination therapy exhibited significantly improved systemic objective response rate and disease control rate.Multivariate analysis identified key factors significantly influencing OS in EC patients with liver metastases:Karnofsky Performance Status score≥70,receipt of local therapy for liver metastases,and the number of cycles of CMT and immunotherapy received.Furthermore,the incidence of TRAEs did not significantly differ between the CMT+ICI and CMT groups.CONCLUSION For EC patients with liver metastases,the combination of CMT and ICIs demonstrates significantly superior efficacy compared with CMT alone,while maintaining manageable TRAEs.
基金supported by the Key Laboratory of Advanced Interdisciplinary Studies,The First Affiliated Hospital of Guangzhou Medical University of China(No.2023A03J0355)OpenProject of State Key Laboratory of Respiratory Disease of China(No.SKIRD OP-202311)Guangdong Provincial Zhong Nanshan Medical Foundation of China(No.ZNS-XS-ZZ-202409-007).
文摘In non-small cell lung cancer(NSCLC),poly(ADP-ribose)polymerase 1(PARP1)induces genomic instability and promotes tumor progression by impairing DNA repair pathways.Although PARP1-targeting proteolysis-targeting chimeras(PROTACs)offer a promising strategy for selective protein degradation,their clinical application remains limited by poor water solubility and insufficient tumor selectivity.Here,we report a pHresponsive magnetic nanoparticle system co-delivering β-lapachone(β-lap)and a PARP1-targeted PROTAC(PRO)for synergistic and tumor-targeting therapy.Designed with a hydrophobic self-assembled core and a magnetic coating,the nanoparticle(NP_(β-lap+PRO))enables pHresponsive drug release and magnetic resonance imaging(MRI)monitoring.β-Lap is a bioactivated drug that relies on NAD(P)H:quinone oxidoreductase 1(NQO1),which is overexpressed in NSCLC cells.It has the potential to deliver tumor-selective DNA damage and induce cell death.The NP_(β-lap+PRO) exploits elevated NQO1 levels in NSCLC to initiate β-lap-driven oxidative stress and DNA damage,while simultaneously enhancing PROTAC-mediated PARP1 degradation within the acidic tumor microenvironment synergistically induces apoptosis.In A549 NSCLC tumor models,this system effectively induces PARP1 degradation,blocks DNA repair,and preserves NAD(P)H pools,thereby amplifying β-lapinduced reactive oxygen species production,leading to enhanced DNA double-strand breaks and apoptosis.This study presents a biomarker-driven nanotherapeutic strategy that integrates PROTAC technology with redox-targeted combination therapy,offering a promising approach for precision treatment of NSCLC.
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Liver cancer is a leading cause of death worldwide,and hepatocellular carcinoma(HCC)is the most frequent primary liver tumour,followed by cholangiocarcinoma.Notably,secondary tumours represent up to 90% of liver tumours.Chronic liver disease is a recognised risk factor for liver cancer development.Up to 90% of the patients with HCC and about 20% of those with cholangiocarcinoma have an underlying liver alteration.The gut microbiota-liver axis represents the bidirectional relationship between gut microbiota,its metabolites and the liver through the portal flow.The interplay between the immune system and gut microbiota is also well-known.Although primarily resulting from experiments in animal models and on HCC,growing evidence suggests a causal role for the gut microbiota in the development and progression of chronic liver pathologies and liver tumours.Despite the curative intent of“traditional”treatments,tumour recurrence remains high.Therefore,microbiota modulation is an appealing therapeutic target for liver cancer prevention and treatment.Furthermore,microbiota could represent a non-invasive biomarker for early liver cancer diagnosis.This review summarises the potential role of the microbiota and immune system in primary and secondary liver cancer development,focusing on the potential therapeutic implications.
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.
基金Supported by the Sichuan Science and Technology Program,No.2024NSFSC1936.
文摘BACKGROUND Cancer-associated fibroblasts(CAFs),crucial components of the tumor microenvironment in primary and metastatic tumors,can impact the activity of cancer cells and contribute to their progression.Given their extensive interactions with cancer cells and other stromal cells,we aimed to evaluate the prognostic value of CAFs in patients with liver cancer(LC).AIM To investigate the association between CAF expression and clinicopathological characteristics as well as overall survival(OS)in patients with LC,including hepatocellular carcinoma(HCC)and intrahepatic cholangiocarcinoma(iCCA).METHODS We performed a meta-analysis of cohort studies with available data on the effects of CAF expression on both clinicopathological characteristics and OS via hazard ratios(HRs)and risk ratios with 95%confidence intervals(CIs).Studies were subgrouped on the basis of CAF markers and cancer type,and the subgroup effects of CAF expression on both HCC and iCCA were analyzed through meta-regression.The Newcastle-Ottawa Scale was used to evaluate the included studies to guarantee their quality and minimize the possibility of bias.RESULTS Nine trials were selected and included a total of 1518 patients.According to our primary meta-analysis,the expression of CAFs in LC patients was significantly associated with a decrease in OS(LC:HR:1.62;95%CI:1.34-1.97;P<0.001;HCC:HR:1.67;95%CI:1.34-2.07;P<0.001;iCCA:HR:1.47;95%CI:0.97-2.23;P=0.07);nevertheless,it was not significantly associated with almost all clinicopathologic characteristics,including tumor size,venous infiltration,alpha-fetoprotein level,and differentiation grade.According to the subgroup analysis of smooth muscle actin(SMA)markers in both HCC patients and iCCA patients,high CAF expression in HCC(HR:2.29;95%CI:1.01-5.22;P=0.048)and iCCA(HR:2.04;95%CI:1.09-3.81;P=0.025)patients was a significant indicator of poor OS.Moreover,the clinicopathological characteristics were also verified by the SMA marker,which had a nearly significant effect on the venous infiltration of iCCA(risk ratio:2.70;95%CI:0.97-7.49;P=0.057).CONCLUSION High CAF expression,evaluated by both mixed markers and SMAs,is significantly associated with poor OS in patients with LC,including both HCC patients and iCCA patients.However,further research is necessary since how CAF expression and clinicopathologic features are related is yet unknown.
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supported by National Natural Science Foundation of China(No.82073774)Science and Technology Projects in Guangzhou(No.202102070001)+3 种基金Jinan University Scientific and Technological Association Youth Science and Technology Talent Cultivation Program(No.21624223,China)“Master Mentor Plan”of Jinan University(No.YDXS2406)the Outstanding Innovative Talents Cultivation Funded Programs for Doctoral Students of Jinan University(No.2024CXB026,China)Special Funds for the Cultivation of Guangdong College Students'Scientific and Technological Innovation(“Climbing Program”Special Funds)(No.pdjh2025bk037,China).
文摘The integration of ferroptosis induction with cancer immunotherapy has emerged as a promising approach in oncology,offering dual mechanisms to overcome therapeutic resistance and tumor heterogeneity.Nevertheless,the dynamic and complicated crosstalk between ferroptosis processes and immune regulation in tumor microenvironments presents both opportunities and challenges.By inducing lipid peroxidation in tumor tissues,ferroptotic tumor cell death can stimulate immunogenicity.Nevertheless,excessive lipid peroxidation may paradoxically impair the functionality of multiple immune cells,thereby presenting crosstalk challenges in therapeutic strategies.To address these crosstalk challenges,several advanced drug delivery strategies have been proposed,such as immunostimulatory active pharmaceutical ingredients co-delivery,tumor-targeted delivery,and stimuli-responsive delivery.These drug delivery strategies demonstrate dual therapeutic efficacy by synergistically potentiating ferroptosis induction in malignant cells while concurrently mitigating immunotoxicity and even augmenting antitumor immunity.This review offers detailed insights into the crosstalk between ferroptosis and tumor immunity,along with a guiding overview of the three delivery strategies.The current obstacles and translational potential were thoroughly analyzed,providing valuable perspectives for future research.
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financially supported by research grants from the Natural Science Foundation of China(No.52173235)Science and Technology Innovation and Improving Project of Army Medical University(No.2021XJS24)+1 种基金Science and Technology Innovation Capability Enhancement Project of Army Medical University(No.2022XJS20)Key Innovation Project for Clinical Technology of the Second Affiliated Hospital of Army Medical University(No.2018JSLC0025)。
文摘Liver cancer is a major killer threatening human health worldwide.At this stage the clinical choice to the treatment of liver cancer is a combination of surgery,chemotherapy and radiotherapy.Alternatively,using hydrogen to treat cancer has great prospects and development space.Herein,we fabricated a hierarchical and flexible electrode that being able to continuously generate hydrogen in vivo in the deep abdominal liver through efficient water electrolysis to kill tumor cells and regulate the tumor microenvironment.The flexibility of the electrode facilitated to fit the tumor surface and thus improved the contact area of hydrogen therapy.By in situ growth of molybdenum disulfide on a hierarchical carbon skeleton,improved reaction kinetics and smaller impedance with a low overpotential of 1.02 V at-10 m A/cm^(2)in cell culture medium and Tafel slope of 73 m V/dec were achieved.Animal experiments showed that the electrode could effectively inhibit the growth of human hepatocellular carcinoma cells in nude mice by efficient H_(2)-production in vivo.The apoptosis rate of cancer cells reached 81.8%,and the proliferation rate decreased to 3.39%.Moreover,this treatment does not affect the growth of normal hepatocytes according to the results of cell experiments.This study demonstrated that the in vivo hydrogen production by our flexible electrode is a safe and effective treatment for liver cancer,with the advantages of minimal invasiveness,simple operation,low side effects and low cost.
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In this paper,the mechanism of the Wnt/β-catenin pathway is introduced,and the process and principle of the experiment conducted by Huang et al is explained.We discussed the reliability of the conclusion that Calculus bovis(C.bovis)inhibits M2 tumor-associated macrophage polarization via Wnt/β-catenin pathway modulation to suppress liver cancer.We also offer suggestions for further studies of the use of C.bovis in the treatment of liver cancer.
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Evaluation of response to chemotherapy in colorectal cancer patients with synchronous liver metastases is important in terms of treatment management.In this Letter to the Editor,several issues in the article are discussed.For the comparison of carbohydrate antigen 19-9(CA19-9)values referenced in the study,the patient group was not matched for cancer stage.Therefore,it may be more appropriate to select and compare CA19-9 values in patients with same-stage cancer.
