Electronic Journal of Liver Tumor

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Electronic Journal of Liver Tumor 2026, 13 (1): 1-21.

Abstract （177）

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Electronic Journal of Liver Tumor 2025, 12 (4): 1-4.

Abstract （146）

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Electronic Journal of Liver Tumor 2025, 12 (4): 53-56.

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Efficacy and safety of lenvatinib in patients with hepatocellular carcinoma

Zhou Jianguo, Wang Bingchen, Li Haocheng, Zhang Yuewei, Peng Tao, Liu Hongli, Xiang Xiaojun, Sun Chuandong, Liu Jun, Li Guangming, Li Dewei, Wang Yu, Cai Jianqiang

Electronic Journal of Liver Tumor 2025, 12 (3): 1-6.

Abstract （109）

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Objective: To evaluate the efficacy and safety of the comprehensive treatment regimen based on lenvatinib in patients with HCC.
Methods: This study was a retrospective real-world study. A total of 1,000 HCC patients who received comprehensive treatment based on lenvatinib and were admitted to 13 research centers across the country from January 2022 to December 2024 were included. The basic clinical information of patients, treatment plans, laboratory indicators and survival outcomes were all collected and managed through standardized databases. The primary endpoint of the study was progression-free survival (PFS), and the secondary endpoints included the 1-year PFS rate, 1-year overall survival rate (OS), and safety analysis. Statistical analysis was conducted using Kaplan-Meier survival analysis and log-rank test to evaluate the differences in efficacy among different treatment strategies.
Results: Among 1 000 patients, 83.70% were male, and the median age was 59.0 years (IQR: 52.0, 67.0). In the analysis of the combined disease history of the patients, the disease distribution showed significant differences: The proportion of history of hypertension was the highest (15.60%), followed by history of diabetes (5.80%), and liver cirrhosis (5.00%). The proportion of patients who had received surgical treatment in the past was 30.50%, the proportion of liver resection was 19.50%, and only 1.80% of the patients had received radiotherapy. The application rate of interventional therapy in the population of this study was 34.60%. The positive rate of hepatitis B virus surface antigen was 55.10% and the positive rate of anti-hepatitis C virus antibody was 3.80%. According to the Barcelona Clinic Liver Cancer(BCLC) staging, the proportion of patients in the advanced stage (BCLC-C, D stage) was 28.00%. In terms of treatment regimens, 79.80% of the patients received 8mg lenvatinib treatment, 60.7% of the patients received lenvatinib monotherapy, and 20.8% of the patients received combined immunotherapy. The therapeutic effect analysis showed that the median PFS of the overall patients was 7.0 months (95%CI: 7.0-8.0), and the 1-year OS rate was 97.00%(95%CI: 96.00%-98.00%). The 1-year PFS rate was 16.00%(95%CI: 14.00%-19.00%). The adverse events occurred rate was 23.60% during the follow-up period, and no serious adverse events were observed.
Conclusion: The lenvatinib combination strategy has a positive impact on survival prognosis for HCC patients, but it still needs to be optimized for long-term disease control.

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Efficacy and safety analysis in the treatment of unresectable intrahepatic cholangiocarcinoma by transcatheter arterial chemoembolization with small diameter drug-eluting beads

Xuan Zhiming, Yao Xuesong, Song Peng, Li Shupei, Lai Fengyong, Feng Yexia

Electronic Journal of Liver Tumor 2025, 12 (4): 8-13.

Abstract （99）

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Objective: To evaluate the efficacy and safety of drug-eluting beads transcatheter arterial chemoembolization (DEB-TACE) with small diameter drug-eluting beads (DEBs) in the treatment of unresectable intrahepatic cholangiocarcinoma (ICC).
Method: This article retrospectively collected clinical data of 20 patients with unresectable ICC who received small diameter DEB-TACE treatment Chinese Academy of Medical Sciences and Peking Union Medical College Cancer Hospital & Shenzhen Hospital from March 2018 to December 2023. The efficacy and safety of the treatment were analyzed by evaluating indicators such as tumor response, progression free survival (PFS), overall survival (OS), incidence of adverse events, and compared the results with other literatures on conventional diameter DEB-TACE and systemic chemotherapy.
Result: The 3-month objective response rate (ORR) and disease control rate (DCR) of 20 patients with unresectable ICC after DEB-TACE were 60.0% and 95.0%, respectively. The 6-month ORR and DCR were 30.0% and 75.0%, respectively. And the 9-month ORR and DCR were 10.0% and 45.0%, respectively. The median OS and median PFS were 16.4 months and 8.3 months, respectively. The common adverse events after DEB-TACE include bilirubin elevation,abdominal pain,nausea and vomiting, and aminotransferase elevation, all of which are grade 1 or 2, and there is no grade 3 or higher adverse events occurred.
Conclusion: DEB-TACE with small diameter DEBs is a safe and effective local treatment for unresectable ICC patients. Compared with conventional diameter DEB-TACE and systemic chemotherapy, it has similar disease control rates ,longer survival , and lower incidence of adverse events.

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Correlation analysis of the indocyanine green retention rate at 15 minutes and the prognosis of patients with primary liver cancer after liver resection surgery

Zhang Mingming, Yang Ning, Wang Haijiao, Wang Xinran

Electronic Journal of Liver Tumor 2025, 12 (4): 14-19.

Abstract （92）

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Objective: To analyze the correlation between the indocyanine green retention rate at 15 minutes(ICG-R15) and the prognosis of liver cancer patients after liver resection surgery.
Method: The clinical data of 242 patients with hepatocellular carcinoma from Xuanwu Hospital of Capital Medical University from May 2024 to March 2025 were collected. Among them, 130 cases had an ICG-R15 value less than 10%, and 112 cases had an ICG-R15 value of 10% or higher. The correlation between different ICG-R15 and surgical prognosis indicators (operation duration, intraoperative blood loss, number of intraoperative drainage tubes, hospital stay, hospital expenses, 24-hour postoperative pain score, postoperative hospital stay, discharge activities of daily living [ADL] score, postoperative liver function, postoperative liver function Child-Pugh classification, postoperative model for end-stage liver disease [MELD] score) was compared.
Result: The single-factor analysis showed that there were statistically significant differences in the operation duration, intraoperative blood loss, postoperative hospital stay, discharge ADL score, postoperative liver function, postoperative liver function Child-Pugh classification, and postoperative MELD score between the two groups (all P<0.05). The multivariate logistic regression analysis revealed that the operation duration, postoperative hospital stay, postoperative liver function, postoperative liver function Child-Pugh classification, and postoperative MELD score were all correlated with the preoperative ICG-R15 level (P<0.05).
Conclusion: ICG-R15 has a predictive effect on the postoperative liver function of patients with primary liver cancer. Preoperative determination of ICG-R15 levels is of great significance for evaluating liver reserve function, predicting the occurrence of postoperative liver dysfunction, and optimizing surgical treatment plans.

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Analysis of the prevalence and influencing factors of sarcopenia in liver transplant recipients

Liu Xin, Guo Fengjuan, Zhang Lili, Gu Yanmei, Xi Shuangmei, Liu Xinxing, Zheng Yulin, Wang Hong

Electronic Journal of Liver Tumor 2026, 13 (1): 22-27.

Abstract （84）

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Objective: To investigate the prevalence of sarcopenia among liver transplant (LT) recipients and identify its associated factors, thereby providing evidence for developing postoperative rehabilitation strategies.
Methods: A cross-sectional study was conducted using convenience sampling among LT recipients attending the outpatient clinic of Beijing You'an Hospital from April to October 2025. Sarcopenia was diagnosed based on muscle mass, muscle strength, and physical performance. Data were collected using a general information questionnaire, the short form international physical activity questionnaire, the nutrition risk screening 2002, and the perceived social support scale. Univariate analysis and logistic regression were employed to determine the influencing factors of sarcopenia.
Results: A total of 128 participants were included, and the prevalence of sarcopenia was 17.2%. The univariate analysis revealed no significant differences between the two groups in terms of age, gender, BMI, albumin, or levels of social support (all P<0.05). Multivariate analysis indicated that sex, age, body mass index, serum albumin level, and perceived social support were independently associated with sarcopenia in LT recipients.
Conclusions: Sarcopenia is relatively common after liver transplantation and is influenced by multiple dimensions, including biological characteristics, nutritional status, and social support. Enhanced monitoring should be implemented during postoperative follow-up, with special attention paid to high-risk groups including female patients, elderly individuals, and those with low albumin levels. Comprehensive interventions should be carried out from aspects such as nutritional support, physical activity management, and psychosocial support to reduce the incidence of sarcopenia and promote postoperative rehabilitation.

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Nationwide analysis of current nursing practices for hepatic arterial infusion chemotherapy

Liu Shuyue, Huang Zhongying, Li Jing, Zhan Zhengyin, Lei Juanjuan, Zhang Tian, Wen Zilu, Zhang Yaojun, Li Fuxia

Electronic Journal of Liver Tumor 2025, 12 (4): 43-49.

Abstract （78）

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Objective: To investigate the current status and key challenges of nursing practices for hepatic arterial infusion chemotherapy (HAIC) in China.
Methods: A cross-sectional survey was conducted using the National HAIC Nursing Practice Questionnaire developed by the Integrated Nursing of Hepatobiliary Tumor Committee of the Chinese Anti-Cancer Association. From October to December 2024, 83 hospitals across 24 provinces (autonomous regions/municipalities) in China were selected via convenience sampling. The questionnaire content includes the implementation institutions and nursing management status of HAIC, HAIC treatment plans, lower limb approaches, upper limb approaches, arterial port systems, and the current status of follow-up care.
Results: HAIC procedures were primarily performed in Interventional Therapy Department (96%, 80/83), with 76% (63/83) of patients managed in Hepatobiliary Department. The FOLFOX (Oxaliplatin+Calcium folinate+Fluorouracil) regimen was the dominant treatment protocol (84%, 70/83), and 52% (43/83) of hospitals combined HAIC with transcatheter arterial chemoembolization (TACE). Femoral artery access remained dominant (94%, 78/83), with 88% (73/83) requiring strictly limit bed confinement. Only 12% (10/83) permitted ambulation within 6 hours post-procedure. Upper-limb access (22%, 18/83) was valued for reducing bed rest requirements (94%) and complication risks (44%). Arterial port systems were implemented in 8% (7/83) of hospitals, but 5/7 exhibited nonstandard heparin concentrations during port maintenance.Only 40% (33/83) of hospitals provided post-discharge follow-up, predominantly via telephone (63%, 21/33) or WeChat (29%, 9/33), with intelligent management systems remaining underutilized.
Conclusion: HAIC nursing in China faces challenges including nonstandard technical protocols, excessive postoperative activity restrictions, and underdeveloped continuity of care systems. Establishing evidence-based guidelines, optimizing access strategies, and advancing intelligent follow-up frameworks are urgently needed to enhance treatment efficacy and patient outcomes.

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Nurses' experiences in maintaining peripherally inserted central venous catheter in patients with with hepatocellular carcinoma complicated by hepatitis B: a qualitative study

Li Caiyun, Wang Xin, Guo Huanfei, Zhang Jiwen, Liu Yang, Zhang Wei

Electronic Journal of Liver Tumor 2025, 12 (3): 45-50.

Abstract （77）

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Objective: To explore nurses'experiences in maintaining peripherally inserted central venous catheter (PICC) for patients with hepatocellular carcinoma (HCC) complicated by hepatitis B, and to identify their perceptions and needs in the care process in order to inform improvements in clinical practice.
Methods: Using purposive sampling, in-depth interviews were conducted with 15 nurses from the Department of Hepatobiliary Surgery, Cancer Hospital, Chinese Academy of Medical Sciences. Data were analyzed using Colaizzi's seven-step phenomenological method.
Result: Three main themes were extracted from nurses' experiences in maintaining PICC for patients with liver cancer complicated by hepatitis B: dual pressure from occupational exposure and maintenance (including the risk of occupational exposure and maintenance difficulties in the context of complex conditions), difficulties in nurse-patient interaction (including strong emotional exhaustion of nurses and insufficient maintenance behaviors of patients), and limitations of training effectiveness.
Conclusion: Nurses face multiple challenges in the process of maintaining PICC for patients with liver cancer complicated by hepatitis B. It is suggested that managers take targeted intervention measures to alleviate nurses' occupational dilemmas (such as optimizing resource allocation and guarantee, strengthening the psychological support system; establishing standardized management systems to improve nurses' PICC nursing competence; innovating educational models to meet patients' disease-related needs; and building regional electronic platforms to enhance patient compliance), and improve the quality of PICC maintenance nursing in the context of complex diseases.

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ERCC6L mediates DNA repair and replication signaling to promote hepatocellular carcinoma proliferation and metastasis

Li Dongliang, Zhou Baofu, Du Chaogang, Wu Jing, Huang Cheng

Electronic Journal of Liver Tumor 2025, 12 (3): 19-29.

Abstract （75）

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Objective: To explore the mechanism of ERCC6L gene in hepatocellular carcinoma(HCC).
Methods: The expression and prognostic differences of ERCC6L and DNA methylation levels in HCC cells were analyzed by public databases and immunohistochemistry; the effects of ERCC6L expression on HCC cells proliferation, transfer and invasion were analyzed by in vivo and in vitro experiments, and the cell cycle effects of ERCC6L on HCC cells were analyzed by flow cytometry. The effects of ERCC6L on DNA repair and replication signals (RRM1,RRM2,POLE2 and LIG1) in HCC cells were analyzed by functional enrichment and protein immunoblotting experiments.
Results: ERCC6L mRNA and protein levels were up-regulated in HCC tissues (all P<0.05).The overall survival rate of HCC patients with high expression of ERCC6L was lower than that of patients with low expression (P<0.05). ERCC6L showed hypomethylation status in HCC patients,including cg01004805, cg12747864, cg09743261, cg05279113. Knockdown of ERCC6L inhibited HCC cell viability, proliferation, migration and invasive ability, and reduced HCC tumor growth (all P<0.05). The KEGG signaling pathway of ERCC6L was mainly enriched in cell cycle,DNA replication and Fanconi anemia pathways. Knockdown of ERCC6L expression induced G₀/G₁ phase arrest in HCC cells and decreased the levels of RRM1,RRM2,POLE2 and LIG1 protein expression (all P<0.05).
Conclusion: ERCC6L is highly expressed in HCC patients and mediates worse prognosis by a potential mechanism through mediating DNA repair and replication signaling.

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Current status and prospects of artificial intelligence and 5G technology in synergistic medical-educational application in hepatic surgery

Sheng Jiyao, Wen Xin, Wang Zhenxiao, Liu Shui, Zhang Xuewen

Electronic Journal of Liver Tumor 2025, 12 (3): 36-40.

Abstract （66）

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Hepatic surgery, characterized by complex anatomy and high surgical risks, confronts predicaments in clinical practice including uneven distribution of medical resources, insufficient surgical precision, and low efficiency in remote collaboration in clinical practice. In the field of education, it encounters problems such as abstract and hard-to-understand knowledge, scarce practical opportunities, and unbalanced resource distribution. The deep integration of artificial intelligence (AI) and fifth-generation communication technology (5G) offers a potential solution to these problems. The application of AI and 5G in the medical and educational collaboration of liver surgery is expected to achieve the future development goals of high precision, wide coverage, and strong inheritance in liver surgery through new ideas, methods, and technologies of medical and educational collaboration. Moreover, by leveraging innovative technological transformation means, it can broaden the dimension of technological innovation and enhance the breadth of technological application, playing a greater role in the future medical and educational collaboration of liver surgery.

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Electronic Journal of Liver Tumor 2025, 12 (4): 50-52.

Abstract （63）

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Electronic Journal of Liver Tumor 2025, 12 (3): 56-58.

Abstract （58）

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Study on gene signatureabel score for predicting prognosis based on TACE response genes in hepatocellular carcinoma

Yan Dong, Han Shanshan, Cao Jiawei, Xu Fei, Li Huai

Electronic Journal of Liver Tumor 2025, 12 (3): 7-18.

Abstract （49）

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Objective: Predicting the response to transarterial chemoembolization (TACE) in hepatocellular carcinoma (HCC) is a clinical necessity. This study developed a prognostic gene signature score based on TACE-responsive genes to predict TACE response and prognosis.
Methods: In the GSE104580 dataset, differential expression analysis and weighted gene co‐expression network analysis (WGCNA) were used to identify TACE-responsive genes. In the GSE14520 dataset, Least Absolute Shrinkage Selection Operator (LASSO) - Cox regression model was used to analyze prognosis-related response genes and construct gene signature scores, and then validated in the The Cancer Genome Atlas database and the Human Protein Atlas. The CIBERSORT algorithm was used to analyze the abundance of immune infiltration between TACE responders and non-responders; meanwhile, the relationship with the gene expression of 36 immune checkpoints was analyzed. The CIBERSORT algorithm was used to analyze the immune infiltration of TACE response and non-response; meanwhile, the relationship with the gene expression of 36 immune checkpoints was analyzed.
Results: A total of 276 differentially expressed genes were identified in the GSE104580 dataset (all adj.P<0.05); in WGCNA, module 7 (number of genes = 846) and module 8 (number of genes = 127) were identified to be associated with TACE responses. LASSO-Cox regression model found that CTSO, CLGN and RTP4 genes were independently correlated with patient prognosis (all P<0.05). The area under the curve (AUC) of the gene signature score for predicting 1-, 3-, and 5-years death rates was 0.812(0.748-0.965)、0.785(0.687-0.845), and 0.755(0.697-0.838), respectively. Multiple tumors, TNM stage and gene signature score were independently correlated with the prognosis of patients (all P<0.05). The AUC of Nomogram for predicting 1-, 3-, and 5-year overall survival rates were 0.729 (0.455-0.915), 0.753 (0.651-0.915), and 0.727 (0.616-0.821), respectively. There were differences in the abundance of various immune cells between TACE-responsive and no-responsive patients (P<0.05). CTSO, CLGN and RTP4 genes were correlated with the expression of various immune cells and immune checkpoints (all P<0.05).
Conclusion: Gene signature scores based on CTSO, CLGN and RTP4 genes can predict TACE response and prognosis in HCC patients. The Nomogram constructed by the combination of gene signature scores and clinicopathological parameters is helpful for the clinical translation of research results.

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Research progress of radioembolization with ⁹⁰Y microspheres for hepatocellular carcinoma in downstaging before liver transplantation

Li Kaifu, Fan Jun, Luo De, Su Song, Li Bo, Yang Xiaoli

Electronic Journal of Liver Tumor 2025, 12 (3): 41-44.

Abstract （49）

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Patients with hepatocellular carcinoma who meet the requirements for liver transplantation can benefit from this treatment. The Milan standard for liver transplantation has been surpassed by the majority of hepatocellular carcinoma patients, making it challenging for them to benefit from this therapy. Hepatocellular carcinoma can be treated locally or systemically to lower its stage and patients' tumor loads, allowing more patients to qualify for liver transplantation therapy even if they now fall outside of the standard for transplant candidates. Radioembolization with ⁹⁰Y microspheres, one of the many downstaging phase treatment options, has the benefits of a small dosage and shorter treatment times, small volume targeted administration, a good tumor killing effect, and relatively low toxicity. This article will review the fundamentals of radioembolization using ⁹⁰Y microspheres, the need for downstaging prior to liver transplantation, the effectiveness and safety of radioembolization using ⁹⁰Y microspheres in downstaging prior to liver transplantation, and it's advancement in China.

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Electronic Journal of Liver Tumor 2025, 12 (3): 51-55.

Abstract （49）

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Study on the relationship between serum circIPO11 level and its clinicopathological characteristics and prognosis in patients with primary liver cancer

Yin Yagang, Zhao Jianwen, Tian Hongwei, Wang Dingxin

Electronic Journal of Liver Tumor 2025, 12 (4): 30-36.

Abstract （49）

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Objective: To analyze the relationship between serum circIPO11 level and its clinicopathological features and prognosis in patients with primary liver cancer (PLC).
Methods: From February 2020 to January 2022, 120 PLC patients (case group) and 120 healthy people (control group) were prospective selected by Tianshui First People's Hospital, and the relative expression of circIPO11 in serum of all subjects was determined by real-time fluorescence quantitative PCR.Compare the relative expression of circIPO11 in serum between the control group and the case group, and draw ROC curve to analyze the value of circIPO11 expression in predicting PLC occurrence. The relative expression of circIPO11 in serum of patients with different pathological features in the case group was compared, and the correlation between the expression of circIPO11 and clinicopathological features and prognosis was analyzed. Kaplan-Meier survival analysis and Cox regression model for multivariate prognostic analysis.
Results: The relative expression of serum circIPO11 in case group was higher than that in control group (P< 0.05). The ROC curve showed that the relative expression of serum circIPO11 predicted the AUC(95%CI) of PLC to be 0.883 (0.842-0.925). Compared with PLC patients with different tumor stages, degrees of differentiation, portal vein tumor thrombus, lymph node metastasis and preoperative alpha-fetoprotein level, the difference was statistically significant (all P< 0.05). Point-column correlation showed that the relative expression of serum circIPO11 was positively correlated with portal vein tumor thrombus, lymph node metastasis and preoperative alpha-fetoprotein level in PLC patients (r=0.403,0.298,0.397, P< 0.05). Spearman correlation showed that the relative expression of serum circIPO11 was positively correlated with the tumor stage of PLC patients (r=0.328, P< 0.05) and negatively correlated with the differentiation degree (r=-0.304, P< 0.05).The overall survival rate of 120 patients with PLC was 46.7%(56/120) and the median survival time was 27.5 months (95%CI: 25.8-29.3 months). Kaplan-Meier survival analysis revealed that the median survival times were 29.7 months (95%CI: 27.3-32.2 months) in the low circIPO11 expression group and 25.3 months (95%CI: 22.9-27.7 months) in the high circIPO11 expression group. The 3-year survival rate was significantly higher in the low-expression group compared to the high-expression group (P< 0.05). Multivariate regression analysis showed that tumor stage, differentiation degree, portal vein tumor thrombus, lymph node metastasis, preoperative alpha-fetoprotein level and preoperative circIPO11 expression were independent risk factors for postoperative mortality of PLC patients (all P< 0.05).
Conclusions: circIPO11 is highly expressed in serum of PLC patients, and its expression is related to pathological features such as tumor stage, degree of differentiation, lymph node metastasis and preoperative alpha-fetoprotein level, and the high expression of circIPO11 is a risk factor affecting the survival status of PLC patients after 3 years.

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