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Long-term outcomes of radiotherapy combined with immune checkpoint blockade inhibitor and lenvatinib therapy in hepatocellular carcinoma with portal vein tumor thrombus Zhao Ying, Li Kewei, Yang Yanmei, Li Wei, Li Guangxin, Li Gong Electronic Journal of Liver Tumor    2023, 10 (3): 58-63.   Abstract （302）      PDF （3346KB）（25）       Knowledge map    Save Objective:To explore the efficacy and safety of radiotherapy combined with immune checkpoint blockade inhibitor(PD-1 inhibitor) and lenvatinib in hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT). Methods:Between March 2018 to October 2020, patients diagnosed with unresectable HCC with PVTT who were admitted to our hospital were screened. In whom we included patients who met Barcelona Clinic Liver Cancer (BCLC) stage C, with Vp3 or Vp4 type portal vein tumor thrombus, and had no prior systemic treatment. The primary endpoints were 3-year overall survival (OS), progression-free survival (PFS), and objective response rate (ORR) of PVTT. Kaplan-Meier analysis was used for survival analysis and log-rank test was performed. Results:47 patients were enrolled in the study, 39 of whom had Vp4 type PVTT. The median follow-up duration was 33.9 (range: 3.1-57.1) months. The median OS tuime was 11.9 (95%CI:7.5-16.3) months, and the 3-year OS rate was 18%. The median PFS tiume was 5 months(95%CI:3.5-6.5 months) , and the 3-year PFS rate was 10%. Among patients with Vp4 type PVTT, the median OS time was 9.4 months (95%CI:8.3-10.5 months) , and the 3-year OS rate was 13%. The median PFS time was 4.9 months (95%CI:3.2-6.6 months), and the 3-year PFS rate was 9%. The objective response rate of PVTT was 75%. No grade 3 or higher adverse events occurred. Conclusions:Radiotherapy combined with PD-1 inhibitor and lenvatinib in HCC patients with PVTT demonstrated favorable long-term efficacy and low toxicity. This triple combination therapy may become one of the competitive treatment options for HCC with BCLC stage C. Reference | Related Articles | Metrics

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Electronic Journal of Liver Tumor    2023, 10 (4): 1-14.   Abstract （296）      PDF （2280KB）（260）       Knowledge map    Save Reference | Related Articles | Metrics

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Electronic Journal of Liver Tumor    2023, 10 (1): 1-9.   Abstract （266）      PDF （2166KB）（236）       Knowledge map    Save Reference | Related Articles | Metrics

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Progress on the mechanism of lenvatinib resistance in hepatocellular carcinoma Zhang Lisha, Kang Mingjia, Zhao Jian Electronic Journal of Liver Tumor    2023, 10 (2): 37-40.   Abstract （211）      PDF （1635KB）（50）       Knowledge map    Save Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related death worldwide. Lenvatinib is an inhibitor of multiple receptor tyrosine kinases, was approved in 2018 for the first-line treatment of unresectable HCC. However, the inevitable drug resistance of lenvatinib is the main reason that hindering its long-term anticancer activity, but the mechanism of drug resistance is not completely clear. In this paper, the potential mechanisms of resistance to lenvatinib in HCC were reviewed according to signal pathway and targets classification, providing reference for research on prevention or delay of lenvatinib resistance. Reference | Related Articles | Metrics

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Progress on protein induced by vitamin K absence or antagonist-Ⅱ in the diagnosis and therapy of hepatocellular carcinoma Wang Yaning, Sheng Jiyao, Wang Zhenxiao, Zhang Xuewen Electronic Journal of Liver Tumor    2023, 10 (1): 39-44.   Abstract （161）      PDF （2033KB）（55）       Knowledge map    Save Protein induced by vitamin K absence or antagonist-Ⅱ(PIVKA-Ⅱ) is mainly used for the complementary diagnosis of hepatocellular carcinoma, but now more and more studies have found that PIVKA-Ⅱ is valuable in combination with other serological indices for highly specific and sensitive diagnosis, pre-treatment efficacy assessment and post-treatment prognosis evaluation, and its level changes can provide a new basis for choice of surgery timing of liver transplantation and hepatectomy and for microvascular invasion. This article will review and discuss the role of PIVKA-Ⅱ in the above diagnosis and treatment, aiming to provide more comprehensive theoretical support for the function of PIVKA-Ⅱ in hepatocellular carcinoma. Reference | Related Articles | Metrics

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Analysis of incidence and mortality of liver cancer in Shanxi cancer registries, 2019 Guo Xuerong, Cao Ling, Zhang Ruifeng, Wang Xinchen, Qiao Nan, Zhang Yongzhen Electronic Journal of Liver Tumor    2023, 10 (2): 27-32.   Abstract （141）      PDF （2308KB）（82）       Knowledge map    Save Objective: To analyze the incidence and mortality of liver cancer in Shanxi cancer registries in 2019, and to provide the strategies of prevention and treatment of liver cancer. Method: According to the "Chinese Guideline for Cancer Registration" and referring to the data quality audit evaluation standards formulated by the International Agency for Research on Cancer (IARC)/International Association of Cancer Registration (IACR), a summary analysis was conducted on the incidence, death, and population data of liver cancer reported by tumor registration points in Shanxi Province that meet the quality control standards. The incidence/mortality crude rate, standardized incidence/mortality rate, and the cumulative rate of 0-74 years old were calculated by gender, area (urban and rural), and age. The age-standardized of Chinese standard population (ASR China) and world standard population (ASR world) were calculated by the Chinese standard population in 2000 and Segi's population, respectively. Result: In 2019, 644 new cases of liver cancer were recorded in Shanxi cancer registries, accounting for 5.39% of all new cancer cases. The crude incidence rate was 13.18 per 100 000, with ASR China of 8.13 per 100 000 and ASR world of 8.30 per 100 000, respectively. The cumulative incidence rate (0-74 years old) was 0.96%. Liver cancer was the 7th most common cancer in the registration areas of China in 2019. The incidence of ASR China was 2.46 times in males as that in females, and it was 0.99 times in urban areas as that in rural areas. A total of 791 cases died of liver cancer in Shanxi cancer registries, accounting for 10.00% of all cancer deaths. The crude mortality rate was 16.19 per 100 000, with ASR China of 9.90 per 100 000 and ASR world of 10.06 per 100 000. The cumulative mortality rate (0-74 years old) was 1.16%. Liver cancer was the 4th most common cause of cancer deaths in the registration areas of China in 2019. The mortality of ASR China was 1.90 times in males as that in females, and it was 0.78 times in urban areas as that in rural areas. The incidence and mortality of liver cancer both increased with age, and the incidence increased more significantly after the age of 40. The incidence and mortality in Shanxi Province reached the peak in the age group of 85 years, and the male was higher than the female. Conclusion: The incidence and mortality rates of liver cancer in Shanxi cancer registries are lower than national average, the male is higher than the female, and higher in rural areas than in urban areas. Therefore, the prevention and treatment of liver cancer should focus on males and pelple in rural areas. Early diagnosis and treatment of liver cancer should be promoted to increase the detection rate of early liver cancer and reduce the disease burden caused by liver cancer. Reference | Related Articles | Metrics

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Electronic Journal of Liver Tumor    2023, 10 (3): 1-11.   Abstract （139）      PDF （1692KB）（249）       Knowledge map    Save Reference | Related Articles | Metrics

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The mechanism of histone deacetylase inhibitor vorinostat inhibiting the growth of hepatocellular carcinoma cells Gu Xinglu, Zhao Xiaohang, Sun Yulin Electronic Journal of Liver Tumor    2023, 10 (1): 15-24.   Abstract （129）      PDF （9724KB）（47）       Knowledge map    Save Objective: To investigate the mechanism of exonuclease 1 (EXO1) in hepatocellular carcinoma (HCC) and the possible mechanism of the histone deacetylase (HDAC) inhibitor vorinostat inhibiting the growth of HCC cells. Methods: HCC cell lines with knockdown or overexpression of EXO1 were constructed. And the effects of EXO1 on the proliferation, migration and invasion in HCC were investigated by cell phenotype assays. The role of EXO1 in homologous recombination (HR) repair and its effect on ionizing radiation sensitivity of cells were detected by HR reportor assay, immunofluorescence and western blots. Additionally, HCC cells were treated with vorinostat. The effect of vorinostat on EXO1 expression and the possible mechanism of inhibiting the growth of HCC cells were detected by CCK-8, flow cytometry and Western blotting. Results: High level of EXO1 promoted the proliferation, migration and invasion of HCC cells. EXO1 also promoted DNA double-strand break repair through the HR pathway and reduced cell sensitivity to ionizing radiation. In addition, elevated EXO1 levels were less sensitive to vorinostat, whereas knockdown of EXO1 increased the sensitivity of hepatocellular carcinoma cells to vorinostat. Vorinostat further inhibited the HR repair ability of HCC cells by suppressing EXO1 expression, thereby inhibiting cell growth. Conclusion: Vorinostat can inhibit HR repair ability by decreasing the expression level of EXO1, which may serve as a potential therapeutic target for HCC Reference | Related Articles | Metrics

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Analysis of the effect of mouthwash prepared with mannitol on tyrosine kinase receptor inhibitor oral mucosal adverse reactions in patients with liver cancer Wu Shu, Liu Yan, Zhan Zhengyin, Li Xiaoqing, Liu Zirong, Huang Lihui, Li Caiyun, Wang Jingya, Lu Hong Electronic Journal of Liver Tumor    2023, 10 (2): 51-54.   Abstract （120）      PDF （1833KB）（7）       Knowledge map    Save Objective: Tyrosine kinase transmembrane receptor inhibitors are widely used in the clinical treatment of liver cancer, and oral mucosal adverse reactions may occur. This study is to explore the effect of mannitol, lidocaine, dexamethasone and mouthwash in such patients. Method: In this paper, 46 patients with liver cancer who were treated with sorafenib, lenvatinib, regorafenib or cetuximab were selected as the research objects (all oral mask reactions were grade 2-3). They were randomly divided into 23 cases in the observation group and 23 cases in the control group. The control group used mannitol, lidocaine and dexamethasone to rinse the mouth when adverse reactions to the oral mask occurred, and the observation group was. Result: The effect of oral mucosal adverse reactions in the observation group was later than that in the control group and the symptoms were milder. The difference between the two groups was significant (P<0.05). Conclusion: The mannitol, lidocaine and dexamethasone preparation has a good effect on the oral mucosal side effects of the tyrosine kinase transmembrane receptor inhibitor, and it is worthy of clinical application. This article provides references for oncology nursing workers to deal with related adverse reactions. Reference | Related Articles | Metrics

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Clinical progress of local treatment for unresectable colorectal liver metastases Lan Dongmei, Huang Xiaozhun, Ran Yihong, Xu Lin, Huang Zhangkan, Yin Xin, Che Xu, Bi Xinyu, Zhao Jianjun, Wang Shubin Electronic Journal of Liver Tumor    2023, 10 (1): 35-38.   Abstract （116）      PDF （1663KB）（22）       Knowledge map    Save Liver is the most common site of metastasis in colorectal cancer patients. With the development of systematic therapeutic drugs, the survival rate of patients with colorectal cancer liver metastases (CRLM) has been significantly improved. Systemic treatment combined with local treatment is the current treatment strategy that can control the disease for a long time and even cure CRLM. As a local treatment, thermal ablation or stereotactic radiotherapy (SRT) can be safely performed in patients with special metastatic lesions, elderly patients or patients with comorbidities. This article reviews the clinical application and research progress of thermal ablation and SRT in CRLM based on existing research evidence. Reference | Related Articles | Metrics

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Relationship between nutritional status and sarcopenia incidence in patients with primary liver cancer Sun Dibo, Ma Haiyan, Guo Fei, Wu Xueliang Electronic Journal of Liver Tumor    2023, 10 (1): 25-30.   Abstract （113）      PDF （1701KB）（29）       Knowledge map    Save Objective: To study the relationship between nutritional status and the incidence of sarcopenia in patients with primary liver cancer, so as to provide reference for the prevention and treatment of sarcopenia in patients with liver cancer. Methods: A total of 207 patients with primary liver cancer who were admitted to The First Affiliated Hospital of Hebei North University from January 2017 to December 2021 were selected and divided into sarcopenia group (n=59) and non-sarcopenia group (n=148) according to the occurrence of sarcopenia. Their clinical datas were collected. The differences in demographic data, physical examination, laboratory examination, and daily living ability scores were compared between the two groups. The influencing factors of the patients with primary liver cancer for sarcopenia were screened by multivariate Logistic regression analysis. Results: The age of sarcopenia group was higher than that of non-sarcopenia group, and the body weight and body mass index (BMI) were lower than those of non-sarcopenia group; fasting blood glucose, urinary albumin-to-creatinine ratio (UACR), lipoproteina (Lpa), high-sensitivity C-reactive protein (hs-CRP) were higher than those in the non-sarcopenia group (P<0.05). The red blood cell count and albumin in the sarcopenia group were lower than those in the non-sarcopenia group (P<0.05). Upper arm muscle circumference, lean body mass, skeletal muscle mass index (SMI), 4m walking speed (GS), maximal grip strength, activity of daily living (ADL) score, instrumental activity of daily living (IADL), and mini-nutrition assessment (MNA) scores of sarcopenia group were lower than those of the non-sarcopenic group (P<0.05), and the fat mass was higher than that of the non-sarcopenic group (P<0.05). Sarcopenia group (P<0.05), with the decrease of MNA score, sarcopenia patients had lower arm circumference, upper arm muscle circumference, lean body mass, SMI, 4m GS, maximal grip strength value, and increased fat mass. Comparison of indicators in patients with different MNA grades, the difference was statistically significant (P<0.05); age, BMI, fasting blood glucose, albumin, hs-CRP, upper arm muscle circumference, SMI, 4m GS, maximum grip strength, ADL score, IADL score and MNA score were all different from the original score. The incidence of sarcopenia in patients with hepatocellular carcinoma was related to the occurrence of sarcopenia (P<0.05). Conclusion: Older age, low BMI, high fasting blood glucose, high hs-CRP level, low albumin, low upper arm muscle circumference, poor nutritional status, and low activity level in primary liver cancer patients have higher incidence of sarcopenia risk. Nutritional status is closely related to the development of sarcopenia especially. Reference | Related Articles | Metrics

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Electronic Journal of Liver Tumor    2023, 10 (1): 10-14.   Abstract （107）      PDF （2050KB）（50）       Knowledge map    Save Reference | Related Articles | Metrics

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Research progress of the applied anatomy of the caudate lobe of liver Zhi Weihua, Han Yue Electronic Journal of Liver Tumor    2023, 10 (1): 45-48.   Abstract （104）      PDF （2631KB）（19）       Knowledge map    Save In recent years, the anatomy of the caudate lobe of the liver has received more and more attention in the field of surgery, but there is still a lack of in-depth research on its anatomical structure, and the surgical methods and strategies of the caudate lobe need to be improved. The surgery of caudate lobe has always been one of the most challenging procedures, and only by knowing the location, morphology, adjacencency and structure of blood vessels and bile ducts can this surgery be performed safely. This article mainly reviews the local anatomy of the caudate lobe, surgical and interventional procedures of caudate lobe. Reference | Related Articles | Metrics

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Research progress on the role of lysyl oxidase-like 2 in the development of hepatocellular carcinoma Shen Yaqiong, Li Jiao, Li Xingxin, Xu Jing, Jin Yan Electronic Journal of Liver Tumor    2023, 10 (2): 41-44.   Abstract （101）      PDF （2142KB）（9）       Knowledge map    Save Lysyl oxidase-like 2 (LOXL2), one of the members of the lysyl oxidase (LOX) family, can catalyze the covalent cross-linking of collagen and elastin in the extracellular matrix. It is found overexpressed in hepatocellular carcinoma (HCC) and can promote cell growth, tumor invasion and metastasis. In recent years, more and more evidences has showed that LOXL2 plays a key role in the occurrence and development of HCC. High level of LOXL2 is an independent factor affecting the prognosis of HCC, suggesting that it has great potential as therapeutic targets. Reference | Related Articles | Metrics

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Progress of vascular intervention combined with targeted therapy and immunotherapy for hepatocellular carcinoma Miao Jixuan, Jin Yong Electronic Journal of Liver Tumor    2023, 10 (3): 31-37.   Abstract （93）      PDF （1765KB）（23）       Knowledge map    Save Vascular interventional therapy represented by transcatheter arterial chemoembolization（TACE）and hepatic artery infusion chemotherapy is the main clinical treatment of unresectable hepatocellular carcinoma(HCC). Among them, TACE was used throughout the treatment of stage Ib to IIIb HCC. Targeted drugs such as multi-target tyrosine kinase inhibitors and angiogenesis inhibitors have played an important role in the treatment and adjuvant therapy of advanced liver cancer, and their clinical application has been quite mature. In recent years, immunotherapy led by immune checkpoint inhibitors has gradually become the latest hot spot in clinical research and application. Patients with high rates of HCC, most often found for the first time has been in the middle-late stage. For the treatment of such patients with HCC, existing vascular intervention targeted therapy and immunotherapy, a single treatment curative effect is not very desirable, this makes the combination therapy in treating HCC has become a new trend. Reference | Related Articles | Metrics

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Electronic Journal of Liver Tumor    2023, 10 (1): 53-56.   Abstract （81）      PDF （1659KB）（37）       Knowledge map    Save Related Articles | Metrics

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Advantages of irreversible electroporation for the ablation of hepatic hilar tumors Wang Xiaowen, Zhao Jianjun Electronic Journal of Liver Tumor    2023, 10 (1): 31-34.   Abstract （79）      PDF （1721KB）（16）       Knowledge map    Save The local treatments of liver tumors included surgical procedures, interventional procedures, thermal ablation, cryoablation treatment and other treatments, which can cure most liver tumors. But for the hepatic hilar tumors, Due to the special part of the lesion location adjacent to blood vessels, nerve, biliary and other important structure, the tumor resection rate or damage rate, tumor around the protection of pipe structure, treatment injury, cirrhosis patients with residual liver protection, complications reduction must achieve a good balance. However,the traditional local treatmenst have limitations. Due to the advantages of irreversible electroporation (IRE) ablation technology, such as guidance of cell apoptosis, protect blood vessels, bile duct and other important structures, the application of IRE technology for the ablation of tumors in the special parts of the hepatic portal region has more obvious effectiveness and safety advantages. This review mainly introduces the principle, effectiveness and safety of IRE ablation in special parts of hepatic portal region compared with traditional thermal ablation. Reference | Related Articles | Metrics

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Electronic Journal of Liver Tumor    2023, 10 (2): 1-6.   Abstract （74）      PDF （5133KB）（29）       Knowledge map    Save Reference | Related Articles | Metrics

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Effect of narrative nursing model based on evidence-based medicine on early ambulation and compliance of patient Pan Wenbing, Lu Yao, Li Yan, Shi Zhuolin, Liu Yudi Electronic Journal of Liver Tumor    2023, 10 (3): 89-92.   Abstract （72）      PDF （1804KB）（51）       Knowledge map    Save Objective:To explore the effect of narrative nursing model based on evidence-based medicine on early ambulation and compliance of patients with primary liver cancer after transcatheter arterial chemoembolization (TACE). Methods:From December 2019 to February 2022, 70 patients with primary liver cancer undergoing TACE in our hospital were randomly divided into the control group (n=35) and the observation group (n=35) with conventional perioperative nursing and narrative nursing model based on evidence-based medicine. The early ambulation and early recovery, compliance before and after receiving nursing, quality of life score changes and postoperative complications were compared between the two groups. Results:The observation group had shorter first time out of bed activity and longer activity duration than the control group (P<0.05). The observation group had shorter anal exhaust, general food recovery, and hospitalization time in sequence compared to the control group (P<0.05). After nursing, the compliance and QLICP-LI scores of the observation group were higher than those of the control group (P<0.05). Compared with the control group, the observation group had a lower incidence of postoperative complications (P<0.05). Conclusion:The narrative nursing model based on evidence-based medicine for patients with primary liver cancer after TACE can shorten the time of early ambulation, promote postoperative recovery, reduce the occurrence of postoperative complications, improve patient compliance, and improve the quality of life. Reference | Related Articles | Metrics

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The global status and development trends of radioembolization for liver cancer with yttrium-90: a bibliometric analysis Tang Fan, Luo Yingen, Ou Aixin, Xu Haoran, Li Xiao Electronic Journal of Liver Tumor    2023, 10 (3): 38-47.   Abstract （68）      PDF （12361KB）（30）       Knowledge map    Save Objective:To investigate the global status and development trends of radioembolization for liver cancer with yttrium-90 through bibliometric analysis. Method:All available data of the articles concerning radioembolization for liver cancer with yttrium-90, based on Web of Science database from 1991 to 2021, were analyzed with bibliometric analysis for creating visual knowledge maps of the countries, institutions, authors, journals and keywords by VOS viewer. Result:According to the search strategy and screening criteria, a total of 989 articles related to radioembolization for liver cancer with yttrium-90 were included in this study, involving 4 406 researchers from 1 055 institutions in 47 countries. The overall number of annual and cumulative publications significantly showed an upward trend, reaching a peak in 2021. United States dominated in national cooperation and number of articles. The top three institutions of total publications were Northwestern University, University of Navarra and Washington University. The top three authors of total publications and citations were Salem R, Lewandowski RJ and Mulcahy MF. Journal of Vascular and Interventional Radiology and other journals have played a vital role in promoting the development of this field. The top 10 keywords with occurrence frequency were radioembolization, hepatocellular carcinoma, yttrium-90, Y-90 microspheres, survival, cancer, liver metastases, microspheres, selective internal radiation therapy and internal radiation therapy. Conclusion:Radioembolization for liver cancer with yttrium-90 is one of the important research hotspots of liver cancer. Chinese researchers should not only pay attention to the frontier research in this field, but also actively carry out multicenter clinical research projects. Reference | Related Articles | Metrics