Electronic Journal of Liver Tumor

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Primary invasive B-cell lymphoma involving anastomotic hemangioma in the liver: a case report

Wang Ziyue, Zhu Yinan, Lu Wanchen, Xi Haiyan, Lin Xuyong, Song Yan

Electronic Journal of Liver Tumor 2025, 12 (1): 30-32.

Abstract （23）

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Risk network calculators and prognosticators for Embolic syndrome after TACE in hepatocellular carcinoma

Chen Yan, Tian Qifeng, Chen Cheng, Tian Shuilin

Electronic Journal of Liver Tumor 2025, 12 (1): 33-38.

Abstract （22）

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Objective: To analyse the prognostic impact of post-embolisation syndrome (PES) after first transarterial chemoembolisation (TACE) for advanced hepatocellular carcinoma (HCC), and to analyse the risk factors for PES and construct a risk assessment network calculator.
Methods: Patients with advanced HCC treated with first TACE between January 2020 and September 2022 in our hospital were selected. Kaplan-Meier method were used to survival analysis, and unifactorial and multifactorial Cox risk regression were used to analyse patients' risk factors for death. Multifactorial logistic regression model was used to analyse PES risk factors, column line graphs of advanced PES risk were constructed based on PES risk factors, internal dataset was used for calibration curves, decision curves, and clinical impact curves analysis, and column line graphs were published into Netwatch to construct the Risk Assessment Network Calculator.
Results: The incidence of PES after the first TACE was 62.6% in 147 patients with advanced HCC.The mean follow-up time after TACE was (12.42 ± 3.58) months, of which 99 (67.3%) patients died.The overall survival rate of patients with PES was lower than that of patients with non-PES (P<0.05). Multifactorial Cox proportional risk regression showed that PES, number of TACE and combination therapy were independent risk factors for prognosis in patients with advanced HCC (all P<0.05). Multifactorial logistic regression analysis showed that age, maximum tumour diameter, drug delivery route, total bilirubin (TB) and albumin (ALB) were independent risk factors for PES (all P<0.05). The area under the curve of the receiver operating characteristic curve - curve of the predicted PES risk nomogram was 0.863 (0.796-0.914), and the calibration curve showed a C-index of 0.879, which indicated that the nomogram had a high predictive accuracy.
Conclusions: PES is associated with reduced survival in patients with advanced HCC after TACE. A PES risk network calculator based on age, maximum tumour diameter, drug delivery method, TB and ALB can provide a reference basis for more active measures to manage PES.

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Clinicopathologic characteristics of hepatic EBV(+) inflammatory follicular dendritic cell sarcoma and literature review

Zhang Huijuan, Feng Xiaolong, Guan Jian, Huang Wenting

Electronic Journal of Liver Tumor 2025, 12 (1): 5-9.

Abstract （21）

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A network calculator based on lymphocyte ratio-associated immune-inflammatory response score predicts survival in patients with hepatocellular carcinoma

Shi Limin, Zhang Mingxing, Cai Siqi, Yang Yueyi, Yang Chunyi, Zhang Wenqiong

Electronic Journal of Liver Tumor 2024, 11 (4): 19-26.

Abstract （21）

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Objective: To develop a lymphocyte ratio-associated immune-inflammatory response score (IRS) and construct a network calculator to predict prognostic risk in patients with hepatocellular carcinoma (HCC).
Method: HCC patients who were surgically treated in Shanghai Public Health Clinical Center between January 2018 and December 2023 were selected. Neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte to lymphocyte ratio (MLR) and C-reactive protein to lymphocyte ratio (CLR) were collected. IRS was constructed using multifactorial Cox risk regression. Univariate and multifactorial Cox regression models were used to analyse risk factors for mortality in HCC patients. Constructed and assessed nomogram prediction accuracy using R packages such as rms, foreign, readxl, Hmisc and rmda. Development of a mortality risk network calculator for HCC patients using the DynNom package.
Result: 154 patients were followed up from 1 month to 60 months, with a median follow-up of 17 months, in which the 1-, 3- and 5-year mortality rates were 30.5%, 50.6% and 61.0%, respectively. IRS=0.213 × NLR+0.005×PLR+0.042×CLR was constructed based on the multifactorial Cox risk regression coefficient β. IRS was significantly higher in patients who died than in those who survived (P<0.05). Patients in the high-risk group (IRS≥2.88) had significantly lower survival than patients in the low-risk group (IRS<2.88) (P<0.05). Time- receiver operating characteristic (ROC) curves showed areas under the curve (AUCs) of 0.829 (95% confidence interval [95%CI]: 0.760-0.885), 0.901 (95%CI: 0.842-0.943), and 0.898 (95%CI: 0.839-0.941) for 1-year, 3-year, and 5-year risk of death among patients with IRS prediction, respectively. The results of multifactorial Cox risk regression analysis showed that maximum tumour diameter, γ-glutamyl transferase (GGT), alkaline phosphatase (ALP), alpha-fetoprotein (AFP) and IRS were independent factors for the risk of death in HCC patients (P<0.05). Nomogram were constructed based on IRS to predict the risk of death in HCC patients at 1, 3 and 5 years. The calibration curves showed that the C-index of the nomogram predicting the risk of death at 1, 3 and 5 years was 0.836 (95%CI: 0.818-0.912), 0.903 (95%CI: 0.882-0.961) and 0.847 (95%CI: 0.817-0.932), respectively, respectively, and time-decision curve analysis (DCA) revealed that the nomogram provided a significant meaningful clinical net benefit for risk thresholds in the range of 0-1. The web calculator interface is available at https://nomogramdynamic.shinyapps.io/DynNomapp/.
Conclusion: The risk of death in HCC patients can be effectively predicted by evaluating and localising the IRS. The network calculator of the risk of death in HCC patients constructed by the IRS combined with the maximum diameter of the tumour, GGT, ALP, and AFP can provide a more positive basis for the treatment of patients with a poorer prognosis.

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Clinicopathological characteristics of three cases of liver primary pleomorphic undifferentiated sarcoma and literature review

Li Zhuo, Gong Lihua, Ma Peiqing, Wang Bingning, Li Jin, Lu Haizhen

Electronic Journal of Liver Tumor 2025, 12 (1): 10-14.

Abstract （20）

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Multifocal perivascular epithelioid cell tumor of pancreas and liver: a case report and literature review

Guan Jian, Shen Guihua, Huang Wenting

Electronic Journal of Liver Tumor 2025, 12 (1): 24-29.

Abstract （20）

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Clinicopathological features and literature review of undifferentiated embryonal sarcoma of the liver

Zhang Yinping, Wang Yuan, Wang Yuanyuan, Zhang Bing, Gao Ge, Xia Qingxin

Electronic Journal of Liver Tumor 2025, 12 (1): 15-18.

Abstract （19）

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Progress summary clinical trials of new drugs for liver cancer

Sun Jiayang, Hu Wei, Tang Yu

Electronic Journal of Liver Tumor 2024, 11 (4): 1-5.

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Objective: To summarize the development trend of global clinical trials of primary hepatic cancer(HCC) from 2020 to June 2024.
Methods: Based on the Trialtrove database developed by Informa Pharma Intelligence (London, UK), the clinical trials of liver cancer and the related medicines launched from 2020 to 2024 were extracted. The annual growth rate, the characteristics of trials and tested products were analyzed.
Results: During the statistical period, a total of 356 clinical trials for HCC were carried out worldwide, accounting for 4.3% of all anti-cancer clinical trials. Among them, 189 (53.1%) were initiated by domestic companies. The number of clinical trials for HCC peaked in 2022 (101 trials). Phase I(including phase Ⅰ/Ⅱ) clinical trials were the most common trial phase type (266 trials, 74.7%). In terms of trial indications, drug development for advanced HCC accounted for the highest proportion (324 trials, 91.0%). Among all the investigational drugs, the types of drugs involved mainly included antibody drugs (48.0%), small molecule targeted drugs (25.4%), cell and gene therapy (15.4%) and antibody-drug conjugate (5.0%). Thirty-two clinical trials focused on first line treatment for late-stage HCC. Among them, the main investigational treatment modality was combined immunotherapy based on immune checkpoint inhibitors. A total of 262 clinical trials were conducted for patients with advanced HCC progressed after previous treatment, of which 32 trials (12.2%) were carried out in patients failed immunotherapy. All the 32 trials were in phase Ⅰ/Ⅱ trials, involving a variety of experimental drug types.
Conclusions: The clinical development of liver cancer drugs is active in the world, and domestic enterprises play an important role. In liver cancer, immunotherapy is the most active field of drug development. While in the clinical trials including heavily treated HCC patients, cell and gene therapy is also an important clinical research area. It is suggested that domestic enterprises should increase investment in the development of novel drugs for liver cancer, explore more new targets and drugs with new mechanisms, and broaden the possible directions of liver cancer treatment.

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Research progress of locoregional therapies combined with systemic therapies in unresectable hepatocellular carcinoma

Jing Congmin, Zhang Yubao

Electronic Journal of Liver Tumor 2024, 11 (4): 50-53.

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Liver cancer ranks fifth in the incidence of malignant tumors and second in the causes of cancer-related death in China. Most of the patients have already developed to the middle and late stages when characteristic symptoms appear, have missed the best time for surgery, so palliative therapy plays a central role in the treatment of hepatocellular carcinoma. Locoregional treatment is one of the main therapeutic options for patients with unresectable hepatocellular carcinoma (uHCC), and immunotherapy and targeted systemic therapy have also made substantial progress in recent years, but the effect of interventional therapy alone or monotherapy is limited. Several combination therapy options have been actively explored in clinical studies, with encouraging efficacy and brought hope for the treatment of uHCC patients. Among them,the new combination of locoregional combined with systemic therapy is expected to be a potential therapeutic modality for intermediate and advanced hepatocellular carcinoma. This review provides an overview of the current status of research on locoregional combined with systemic therapy, aim to provide more treatment strategies for uHCC patients.

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Combination therapy with TIGIT monoclonal antibody in the first-line treatment of advanced hepatocellular carcinoma: a commentary based on the results of two phase-Ⅱ clinical studies

Jiang Ning, Li Xuchu, Huang Huiyao, Sun Chao, Fang Hong, Ma Hailan, Jia Shuopeng, Wu Dawei, Tang Yu, Li Ning

Electronic Journal of Liver Tumor 2024, 11 (4): 6-12.

Abstract （18）

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Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer worldwide. Despite significant progress in the early diagnosis and treatment of HCC in recent years, the prognosis for patients with advanced HCC remains poor. Emerging immunotherapies for HCC, such as programmed death 1 (PD-1)/programmed death ligand 1 (PD-L1) inhibitors, have demonstrated some clinical efficacy, but issues with resistance persist. Monoclonal antibodies targeting T cell immunoreceptor with Ig and ITIM domains (TIGIT), as a novel immune checkpoint inhibitor, have the potential to enhance anti-tumor immune responses when used in combination with PD-1/PD-L1 inhibitors. This article, based primarily on the results of the AdvanTIG-206 and MORPHEUS-Liver Phase II clinical trials, summarizes the current efficacy and safety of TIGIT monoclonal antibody combination therapy as a first-line treatment for patients with advanced HCC. Additionally, it explores the potential and possible challenges of combining TIGIT antibodies with PD-1/PD-L1 inhibitors and targeted therapies, with the aim of identifying new directions for first-line therapy in advanced HCC.

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Electronic Journal of Liver Tumor 2024, 11 (4): 63-66.

Abstract （18）

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Development of a checklist management pathway based on goal achievement theory and its application in discharge preparation for percutaneous transhepatic biliary drainage patients

Ding Zhiying, Zhao Xiaoyun, Dai Qiqi, Cai Chaohong

Electronic Journal of Liver Tumor 2025, 12 (1): 46-52.

Abstract （18）

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Objective: To evaluate the impact of a goal achievement theory (GAT)-based checklist management model on discharge preparedness in patients undergoing percutaneous transhepatic biliary drainage (PTBD).
Method: Sixty patients from the interventional department of a tertiary hospital in Suzhou, undergoing PTBD for the first time and requiring long-term catheter maintenance, were enrolled using convenience sampling. Patients were divided into a control group (n=34), receiving conventional perioperative PTBD care, and an experimental group (n=26), receiving care based on the GAT-based checklist management model. Key outcomes included discharge preparedness scores, patient satisfaction, catheter-related complication rates within 30 days post-discharge, and unplanned readmission rates.
Result: The experimental group had significantly higher discharge readiness scores and satisfaction compared to the control group (P<0.05). Within 30 days post-discharge, the experimental group had a lower incidence of complications such as catheter slippage, blockage, infection, and related skin damage compared to the control group (P<0.05). No significant difference in the unplanned readmission rate was found between the two groups (P>0.05).
Conclusion: The GAT-based checklist management model can enhance patients' catheter management and self-care abilities, as well as improve their compliance and engagement in disease management. Additionally, this model deepens the communication between patients and healthcare providers, fostering interaction and improving discharge readiness and patient satisfaction. It also reduces the incidence of related complications and the rate of unplanned readmissions.

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Diagnosis and treatment of sclerosing hepatocellular carcinoma: a case report

Deng Yiqiao, Yao Mengfei, Chen Bo

Electronic Journal of Liver Tumor 2025, 12 (1): 56-58.

Abstract （17）

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The value of nutritional and inflammatory indicators in predicting the prognosis of patients with advanced hepatocellular carcinoma treated with Sintilimab combined with Bevacizumab

He Huari, Xia Wangning, Tang Biao, Liu Xintao, Li Lai

Electronic Journal of Liver Tumor 2025, 12 (1): 39-45.

Abstract （17）

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Objective: To explore the value of nutritional and inflammatory indicators in predicting the prognosis of patients with advanced hepatocellular carcinoma (HCC) treated with combination therapy of Sintilimab and Bevacizumab.
Method: This study is a retrospective study. Totally 85 HCC patients admitted to Yongzhou Central Hospital from January 2021 to December 2021 were selected. According to the optimal critical values of nutritional indicators (prognostic nutritional index [PNI] and hemoglobin albumin lymphocyte platelet [HALP] scores) and inflammatory indicators (monocyte to high-density lipoprotein ratio [MHR], C-reactive protein to prealbumin ratio [CPR], and C-reactive protein to lymphocyte count ratio [CLR]), patients were divided into high PNI group and low PNI group, high HALP score group and low HALP score group, high MHR group and low MHR group, high CPR group and low CPR group, and high CLR group and low CLR group. Kaplan Meier method was used to analyze the survival of advanced HCC patients with different nutritional status or inflammation levels, and log rank test was used for comparison. Single factor and multiple factor Cox regression models were used to screen risk factors for overall survival in advanced HCC patients treated with combination therapy of Sintilimab and Bevacizumab. Draw receiver operator characteristic (ROC) curves to evaluate the predictive value of nutritional and inflammatory indicators for mortality in advanced HCC patients after treatment with Sintilimab combined with Bevacizumab.
Result: The disease control ratio (DCR) of the high PNI group, high HALP score group, low MHR group, low CPR group, and low CLR group were all higher than those of the low PNI group, low HALP score group, high MHR group, high CPR group, and high CLR group (84.0% vs. 65.7%, χ²=19.961, P<0.001; 84.8% vs. 66.7%, χ²=6.467, P=0.011; 87.0% vs. 64.1%, χ²=6.127, P=0.013; 92.0% vs. 65.7%, χ²=4.947, P=0.026; 84.5% vs. 63.6%, χ²=4.938, P=0.016). The overall survival of patients in the high PNI group, high HALP score group, low MHR group, low CPR group, and low CLR group was longer than that of patients in the low PNI group, low HALP score group, high MHR group, high CPR group, and high CLR group (all P<0.05). The ROC curve shows that the area under the curve (AUC) for predicting death in advanced HCC patients using PNI, HALP score, MHR, CPR, and CLR is 0.797 (95% confidence interval [95%CI]: 0.738-0.855), 0.773 (95%CI: 0.713-0.833), 0.606 (95%CI: 0.528-0.683), 0.726 (95%CI: 0.665-0.788), and 0.759 (95%CI: 0.701-0.818), respectively. The results of the multivariate Cox regression model analysis showed that PNI and HALP scores were independent protective factors affecting the prognosis of advanced HCC patients treated with combination therapy of Sintilimab and Bevacizumab, while MHR, CPR, and CLR were independent risk factors affecting the prognosis of advanced HCC patients treated with combination therapy of Sintilimab and Bevacizumab.

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Exploration of the guiding significance of protein regulating cytokinesis 1 in the management of gastrointestinal tumors

Liu Yifeng, Ran Yihong, Che Xu

Electronic Journal of Liver Tumor 2024, 11 (4): 27-35.

Abstract （17）

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Objective: Analyzing the expression, biological role, and prognostic impact of protein regulating cytokinesis 1 (PRC1) in gastrointestinal tumors through bioinformatics tools, and subsequently guide clinical treatment.
Method: Based on a public database analysis, the expression level of PRC1 in gastrointestinal tumors, co-expressed genes, biological mechanisms of action, immunological regulatory characteristics, interpretation of gene mutation sites, prognostic impact on various tumors, and the prognostic impact of gene mutations on gastrointestinal tumors are analyzed.
Result: PRC1 was highly expressed in cholangiocarcinoma, colon cancer, liver cancer, pancreatic cancer, rectal cancer, and gastric cancer, and highly co-expressed with PRC1 related genes, which together affected the biological process of gastrointestinal tumors. The PRC1 and related gene sets were mainly enriched in mitotic related items in gene ontology (GO) enrichment analysis. In terms of immune promotion, PRC1 plays a regulatory role in B, CD4⁺, CD8⁺ and other immune cells in gastric and pancreatic cancer. PRC1 affects the biological process of gastrointestinal tumors in various forms of deep deletion, shallow deletion, diploid mutation, and amplification. The main mutation forms of each point on the PRC1 segment are missense mutations and truncations, which affect the translation and expression of PRC1, thereby affecting the biological process of gastrointestinal tumors. The high expression of PRC1 affects the prognosis of gastric cancer and pancreatic cancer. PRC1 mutation group indicates a poor prognosis of gastrointestinal tumors.
Conclusion: The high expression and mutation of PRC1 in gastrointestinal tumors are high-risk factors for malignant progression and poor prognosis of gastrointestinal tumors, further guiding clinical treatment strategies.

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The application value of contrast-enhanced ultrasound on the differentiation of colorectal cancer liver metastasis and atypical hepatic hemangioma

Chen Yuxiang, Yan Ji, Zhang Chenxue, Yu Haitao, Wu Xueliang, Wang Likun

Electronic Journal of Liver Tumor 2024, 11 (4): 36-41.

Abstract （16）

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Objective: To explore the clinical application value of contrast-enhanced ultrasound (CEUS) in differentiating between colorectal cancer liver metastasis (CCLM) and atypical hepatic hemangioma (AHH).
Method: A retrospective analysis was conducted on patients diagnosed with 76 cases of CCLM and 80 cases of AHH between 2020 and 2022, who underwent CEUS and received pathological confirmation at our institution. The ultrasonographic characteristics of both groups were compared. The diagnostic sensitivity, specificity, accuracy, and receiver operating characteristic (ROC) curves were analyzed for conventional ultrasound alone and in combination with CEUS.
Result: The results indicated significant differences in ultrasound enhancement features between CCLM and AHH, with statistically significant differences in tumor lesion internal and surrounding blood flow signals (P<0.05). Conventional ultrasound combination with CEUS significantly improved the specificity and accuracy in diagnosing CCLM compared to conventional ultrasound alone. Furthermore, the area under the curve for conventional ultrasound combination with CEUS was significantly higher than that for conventional ultrasound.
Conclusion: CEUS is an effective method for enhancing the ultrasound differentiation capability between CCLM and AHH.

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Research progress on hand-foot skin reaction in targeted therapy for hepatocellular carcinoma

Ning Yanting, Xia Juan, Wu Shu, Zhang Qi, Li Xiaoqing, Che Xu, Zhan Zhengyin

Electronic Journal of Liver Tumor 2024, 11 (4): 54-59.

Abstract （16）

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Targeted drugs, as an important means in the treatment of liver cancer, have significantly improved the overall survival rate of liver cancer patients. However, some side effects inevitably occur during treatment. Hand-foot skin reaction is one of the common adverse reactions, which not only affects the patient's quality of life, but may also force the patient to reduce the dosage of the drug or interrupt treatment. , thus affecting the therapeutic effect. This article comprehensively analyzes the current research status of hand-foot skin reactions related to targeted drugs at home and abroad, discusses its pathogenesis, clinical manifestations, and grading standards, and compares the differences in chemotherapy-related hand-foot syndrome. In addition, this article also focuses on the prevention and care strategies, health education, traditional Chinese and Western medicine treatments for hand-foot skin reactions, etc, aiming to reduce patients' symptoms, improve their quality of life, and improve their treatment compliance. At the same time, the existing problems and future development trends of hand-foot skin reactions in liver cancer targeted therapy are summarized, with a view to providing a comprehensive reference basis for clinicians and nursing workers, and for the prevention and management of hand-foot skin reactions related to liver cancer targeted drug treatment.

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A case of clear cell type hepatocellular carcinoma and review of literature

Wang Jing, Xu Enwei

Electronic Journal of Liver Tumor 2025, 12 (1): 19-23.

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Translational therapy for malignant biliary tumors with obstructive jaundice: an exploration by Beijing Tsinghua Changgung Hospital

Yang Shizhong

Electronic Journal of Liver Tumor 2025, 12 (1): 59-60.

Abstract （16）

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