Electronic Journal of Liver Tumor

Establishment of a rat model: associating liver partition and portal vein ligation for staged hepatectomy with hepatic fibrosis

Zhang Junwei, Yang Xu, Wang Yunchao, Wang Yanyu, Xun Ziyu, Cheng Quancheng, Fang Jinyu, Ding Huiru, Meng Jieyi, Zhang Lei, Xu Yiyao, Sang Xinting, Zhao Haitao, Zhang Weiguang, Lu Xin

2022, 9(2): 1-6.

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Objective:To establish the liver fibrosis model of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) by carbon tetrachloride (CCl₄) and ethanol, and to explore the feasibility and safety of ALPPS in rats with liver fibrosis.
Method:Totally 40 male SD rats were randomly allocated by lot into two groups with 20 rats in each group. The control group was the blank group, which was routinely fed and injected with olive oil for 4 weeks, and the liver fibrosis group was CCl₄ subcutaneous injection + forced drinking of 10% ethanol for 4 weeks. 5 rats in the liver fibrosis group and the control group were stained with Sirius red to judge the degree of liver fibrosis. The remaining 15 rats underwent ALPPS operation, and the regenerated liver was weighed on the 0, 3 and 6 days after operation to detect the liver proliferation, and was further judged by the hepatocyte regeneration by Ki-67 staining.
Result:After 4 weeks of CCl₄ and ethanol modeling, the weight of rats increased slowly, their life was basically unaffected, and liver fibrosis was uniform. One rat died due to the injection of CCl₄, and the success rate of liver fibrosis modeling was 95.0%. Liver fibrosis group and control group achieved rapid growth of residual liver volume after ALPPS, and there was no significant difference between the two groups. Ki-67 positive cells in hepatic fibrosis group and normal group increased significantly on the 3rd day after operation and decreased on the 6th day after operation.
Conclusion:Using the method of CCl₄ back subcutaneous injection and drinking ethanol, the liver fibrosis rat model can be established quickly. ALPPS operation is safe and feasible in this fibrosis model. In this study, a stable and efficient ALPPS rat model with liver fibrosis was established.

Report of liver cancer incidence and mortality in 2016 and the time trends during 2010―2016 in Henan Province, China

Chen Qiong, Liu Yin, Liu Shuzheng, Guo Lanwei, Zheng Liyang, Xu Huifang, Wang Xiaoyang, Wang Hong, Sun Xibin, Zhang Shaokai

2022, 9(2): 7-12.

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Objective:To estimate the incidence and mortality of liver cancer in Henan Province in 2016 according to the cancer registration data.
Method:The data quality including completeness, validity, and reliability of local registries which submitted the cancer registration data of 2016 were assessed according to the criteria of Guideline on Cancer Registration in China and IARC/IACR. Liver cancer cases (ICD10: C22) were extracted from the database, and the incidence and mortality stratified by gender, age, and areas (urban/rural) were calculated, the provincial cancer incidence and mortality were estimated combined with provincial population data. China's 2000 census population and Segi's population were used to calculate the age-standardized rate. Joinpoint regression model was used to estimate the changing trend of age-standardized incidence and mortality along with the calendar year.
Result:Approximately 28 635 new liver cancer cases were diagnosed in Henan Province in 2016, accounting for 9.58% of all new cancer cases, and it ranked fourth among cancer of all sites. The crude liver cancer incidence was 26.43/100 000 with an age-standardized incidence rate by China standard population (ASIRC) of 19.90/100 000 and an age-standardized incidence rate by the world standard population (ASIRW) of 19.79/100 000. The liver cancer incidence in males was higher than that in females, with the ASIRC of 28.07/100 000 and 11.76/100 000, respectively. It was higher in rural areas than that in urban areas, and they were 20.50/100 000 and 17.84/100 000, respectively. About 24 052 liver cancer cases dead in Henan Province in 2016, accounting for 12.82% of all cancer deaths in Henan Province which ranked fourth among cancer of all sites. The crude mortality rate was 22.22/100 000 with an age-standardized mortality rate by China standard population (ASMRC) of 16.30/100 000 and an age-standardized mortality rate by world standard population (ASMRW) of 16.27/100 000. The mortality in males was higher than that in females, with the ASMRC of 22.99/100 000 and 9.77/100 000, respectively. There was no significant difference between urban and rural areas, and the ASMRC was 16.08/100 000 and 16.41/100 000, respectively. The liver cancer age-specific incidence and mortality were low at the age groups of 0-29 and 0-34 years, and they started increasing rapidly after 30 and 35 years old, respectively, and reached the peak at the 85+ age group. The estimated number of incident liver cancer cases and deaths reached the peak in the 60-64 years age group. The ASIRC and ASMRC were declining with annual percent change (APC) of 2.1% since 2010 and with APC of 7.4% since 2013.
Conclusion:The disease burden of liver cancer in Henan Province remains large, and there are significant gender differences between urban and rural areas and between men and women. Therefore, comprehensive prevention and control efforts should be strengthened according to its epidemic characteristics and risk factors.

The role of nucleotide binding oligomerization domain like receptor protein 6 in the prognosis of hepatocellular carcinoma based on bioinformatics analysis

Huang Di, Wu Xueliang, Li Fei, Han Shanshan, Gao Xin

2022, 9(2): 13-22.

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Objective:To analyze the expression pattern, biological function and immune cell infiltration relationship of Nod-like receptor pyrin domain-containing protein 6 (NLRP6) in hepatocellular carcinoma (HCC) were analyzed by bioinformatics.
Method:Multiple public databases were used to analyze the expression pattern and clinical prognostic value of NLRP6 in HCC. The biological function of NLRP6 was analyzed by the Enrichr database. The relationship between NLRP6 expression and HCC immune cell infiltration was analyzed. In addition, a Nomogram model was constructed based on NLRP6 to predict the prognosis of HCC patients.
Result:NLRP6 expression was down-regulated in various cancer types (including HCC) (P<0.05), and its low expression was associated with poor prognosis in HCC (P<0.05). Resultsof Kyoto Encyclopedia of Genes and Genomes (EGGK) signaling pathway and gene ontology (GO) analysis reveal that NLRP6 is involved in inflammatory-immunomodulatory responses, including primary immunodeficiency, natural killer cell-mediated cytotoxicity, and Th1 and Th2 cell differentiation signal pathway. NLRP6 expression was correlated with B cells (r=-0.202), CD⁴⁺ T cells (r=-0.207), CD⁸⁺ T cells (r=0.153), neutrophils (r=-0.201), macrophages (r=-0.133 ) and myeloid dendritic cells (r=-0.245) infiltration abundance were significantly correlated and high neutrophil infiltration abundance was associated with worse survival prognosis in HCC patients (P<0.05). The Nomogram model based on NLRP6, age and TNM stage can effectively predict the 1 year, 3 years and 5 years overall survival rates of HCC patients, providing a significant clinical net benefit.
Conclusion:NLRP6 may be involved in the pathogenesis of HCC and is associated with inflammation-immune regulation and immune cell infiltration. The Nomogram model based on NLRP6 can effectively predict the prognosis of HCC patients and provide new ideas for clinicians to treat HCC.

Research progress of spontaneous ruptured hepatocellular carcinoma

Huang Xiaozhun, Wang Chunling, Liu Yibin, Li Xiaoqing, Huang Zhangkan, Xu Lin, Ni Yong, Che Xu, Bi Xinyu

2022, 9(2): 23-27.

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Spontaneously ruptured hepatocellular carcinoma (rHCC) with hemorrhage is characterized by rapid onset and progression, the pathogenesis is not clear, and liver background in rHCC patients was complicated. There is large heterogeneity between different ways of handling the survival benefit obtained, the choice of clinical decision caused great distress, so looking for some indicators or model to predict the treatment of patients with rHCC forecast is of great significance. This article is based on the existing clinical evidence, this article will review the research progress of rHCC with hemorrhage: From the rupture mechanism of hepatocellular carcinoma (HCC) are expounded of high burst tendency HCC of the operation time. Different treatments of short- and long-term survival benefit with multiple model prediction effect for the treatment of rHCC. Finally we explored the treatment of rHCC survivors.

Construction of core competence valuation indicator system for oncology nurses in palliative care

Dong Xue, He Ruixian, Wei Jianjian, Wei Wei, Zheng Wei, Wang Li, Gao Mohan, Ruan Nanting

2022, 9(2): 28-34.

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Objective:To establish an core competence evaluation indicator system for oncology nurses in palliative care, and to provide references for related clinical evaluation.
Method:From October 2020 to June 2021, the research group established the first draft of palliative care nurse core competence evaluation indicator system based on literature review and semi-structured interviews, and then 12 experts from 6 provinces in China were consulted through Delphi technique. The final evaluation indicator system and index weight were analyzed by analytic hierarchy process.
Result:The recovery rates of 2 rounds of expert consultations were 100%. The authority coefficients were 0.863. The first-level, second-level, third-level Kendall harmony coefficients were 0.206, 0.143, 0.195 and 0.260, 0.186, 0.125 respectively. The average importance value of indexes ranged from 4.50 to 5.00, and variation coefficients of each item ranged from 0 to 0.247. The final core competence evaluation system for oncology nurses in palliative care consisted of 8 first-level indicators, 20 second-level indicators and 43 third-level indicators.
Conclusion:The core competence evaluation indicator system for oncology nurses in palliative care was scientific, reliable, comprehensive and targeted, which can provide scientific references for cultivation, evaluation and ability improvement of oncology nurses in palliative care.

Construction and application of activity program for relieving bed restriction in hepatic arterial infusion chemotherapy treatment

Zhao Xiaoyun, Jin Yong, Chen Xiangfeng, Huang Hui, Zhou Huimin

2022, 9(2): 35-40.

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Objective:To investigate the safety and feasibility of relieving bed restriction during hepatic arterial infusion chemotherapy (HAIC).
Method:Select patients with primary liver cancer in line with the enrollment criteria, divided them into the experimental group (n=50) and control group (n=20) according to the order of admission date, the experimental group built FOLFOX-HAIC for relieving bed restriction activity program based on enhanced recovery after surgery (ERAS) concept, the patients in this group could get out of bed with an arterial catheter 6 hours after femoral artery catheterization; The patients in the control group were strictly confined to bed after catheterization until drug infusion, and got out of bed after drug infusion and femoral arterial catheter extraction. The complications of the two groups were observed. The pain level was assessed using the numerical rating scale (NRS). The Improved Changhai pain rating scale was used to evaluate patients' pain degree, and the daily life of patients in the two groups was evaluated by the Kolcaba general comfort questionnaire (GCQ) and Barthel index (BI). The incidence of postoperative complications and adverse events were recorded.
Result:Totally 70 cases of primary liver cancer treated with FOLFOX-HAIC were successfully completed FOLFOX-HAIC. The results showed that there were no adverse events such as falls and deaths in both groups after treatment. There was no statistically significant difference (P>0.05) in the femoral artery puncture point bleeding and subcutaneous hematoma. There was 1 case of external interface rupture in each group during the treatment period (experimental group 1/50, 2.0%; control group 1/20, 5.0%; P>0.05), which may be related to the quality of microcatheter, after communicating with relevant departments to replace the catheter, this phenomenon did not occur again. There were statistically significant differences between the two groups in postoperative complications: limb numbness, lumbar acid, loss of appetite, constipation and sleep disorders (P<0.05). There were statistically significant differences in comfort status and self-care ability between the two groups during the period of perfusion chemotherapy (both P<0.001).
Conclusion:FOLFOX-HAIC for relieving bed restriction scheme can be tried clinically.

Bibliometrics and visual analysis of psychological intervention for primary liver cancer patients

Zhang Jiaoyan, Zhao Liang, Wei Wei, Ren Xuejun, Wang Chao, Sun Rui, Yu Lei, Yang Min

2022, 9(2): 41-48.

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Objective:To visually analyze the status of psychological intervention for primary liver cancer patients based on bibliometrics, and to explore and analyze the research highlights and frontiers in this field.
Method:The literatures were retrieved from Scopus, PubMed, Web of Science, Embase, CNKI, Wanfang Med Online, China Biomedical Literature Database, VIP network and APA PsycNet Database. The high-frequency keyword clustering map generated through the VOSviewer software after screening, and the coupling maps and trend topics were drawn through the Bibliometrix.
Result:A total of 2539 articles were included in the analysis. The journals with the most articles in Chinese and English were Journal of Qilu Nursing and Supportive Care in Cancer respectively. Eastern Hepatobiliary Surgery Hospital and University of California published the most articles in Chinese and English respectively. In Chinese literature, psychological intervention methods mainly included mindfulness therapy, relaxation therapy, emotional therapy, cognitive therapy and music therapy, while psychological intervention methods mainly included supportive psychotherapy, behavioral therapy and cognitive therapy in English literature. The top three keywords in Chinese and English literature were primary liver cancer, nursing intervention, psychological intervention and primary liver cancer, psychological intervention and clinical research.
Conclusion:Psychological intervention for primary liver cancer patients is getting more and more attention gradually. Meanwhile, the psychological intervention for patients with anti-cancer treatment and end-stage liver cancer becomes the focus and research trends in this field.

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