Electronic Journal of Liver Tumor

Clinical application of computerized tomography-guided microwave ablation in the treatment of hepatitis B-related hepatocellular carcinoma oligosenterinoma

Hu Caixia, Zhao Peng, Liu Bojun, Yang Xiaozhen, Fang Da, Zheng Jiasheng, Zhang Yonghong

2024, 11(1): 1-3.

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Objective: To evaluate the efficacy, safety and application value of microwave ablation for patients with liver cancer associated with hepatitis B and lung metastases in the era of pre-target immunotherapy.
Methods: From November 2010 to December 2014,30 patients (24 males and 6 females) with pulmonary metastases were treated by microwave ablation Age ranged from 35 to 74 years, with a median age of 57.1 years. 67 pulmonary metastases were detected by chest CT and 67 lesions were ablated. The diameter of the tumor ranged from 0.5 cm to 4.1 cm in 9 patients with single lesion, 5 patients with 2 lesions and 16 patients with 3 lesions, the average diameter was 1.37 cm. Kaplan-meier method was used to calculate local tumor control rate, median survival time and complications.
Results: Microwave ablation was successfully performed 46 times in 67 cases of liver cancer with lung metastases. One to three months after ablation, enhanced CT showed no enhancement in the target area. The complete ablation rate was 100% , and the median survival time was 27.5 months, the main complications included local pain (6 cases) , paroxysmal cough (13 cases) and a small amount of hemoptysis (3 cases) , 10 patients developed mild pneumothorax without special treatment, and 3 patients developed moderate to severe pneumothorax. Immediate closed chest drainage was performed.
Conclusion: CT-guided microwave ablation is a safe and effective method for the treatment of lung metastases from hepatitis B-related liver cancer.

Molecular characterization of KRAS G12C mutation in the tumors of digestive system

Zhao Tingqi, Dong Lin, Ying Jianming, Li Weihua

2024, 11(1): 4-8.

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Objective: To identified the molecular characteristics of KRAS G12C mutation in the tumors of digestive system.
Methods: Data of 1 100 patients diagnosed as digestive malignant tumor in Cancer Hospital of Chinese Academy of Medical Sciences from 2017 to 2022 were collected. The microsatellite status, tumor mutation burden (TMB) and KRAS, NRAS, BRAF and PIK3CA mutations were detected by next-generation sequencing in 1 100 patients with tumors of digestive system, including colorectal adenocarcinoma, duodenal adenocarcinoma, cholangiocarcinoma, gastric adenocarcinoma, ileocecal adenocarcinoma and pancreatic ductal adenocarcinoma.
Results: Microsatellite instability-high (MSI-H) tumors were most common in duodenal adenocarcinoma (19%), followed by ileocecal adenocarcinoma (18%) and colorectal adenocarcinoma (10.2%). However, no MSI-H tumors were detected in the 100 cases of pancreatic ductal adenocarcinoma. TMB values also varied among different tumors of digestive system. High-TMB (≥10 mut/Mb) tumors were most common in ileocecal adenocarcinoma (24%), followed by duodenal adenocarcinoma (22%) and gastric adenocarcinoma (18.9%). KRAS mutations were detected in 452 of 1 100 (41.09%) cases, among which the most common tumor was pancreatic ductal adenocarcinoma (85.0%), followed by duodenal adenocarcinoma (56%) and ileocecal adenocarcinoma (53%). However, KRAS mutations were identified in 7.3% of gastric adenocarcinoma. KRAS G12C mutation was detected in 2.82% of all the 1 100 tumors, and only 6.9% (31/452) of all digestive tumors with KRAS mutations among which the most common tumor was ileocecal adenocarcinoma (2/9), followed by duodenal adenocarcinoma (13%) and colorectal adenocarcinoma (8.8%). However, no significant differences in gender, age, MSI and TMB status were observed between patients with KRAS G12C mutation and other KRAS mutation subtypes.
Conclusions: Although nearly half of patients with digestive malignancies carry KRAS mutations, but only 6.9% of KRAS-mutant cases harbored KRAS G12C mutation subtype. KRAS G12C mutation was most common in ileocecal cancer, duodenal cancer and colorectal cancer. And no obvious difference in clinical and molecular pathological features compared with other types of KRAS mutations

A Meta-analysis of the curative effect and safety of transcatheter arterial chemoembolization combined with radiofrequency ablation in the treatment of large liver cancer

Li Mei, Qiao Bei, Zhang Zhihao

2024, 11(1): 9-15.

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Objective: Through Meta-analysis, compared with transcatheter arterial chemoembolization (TACE) alone, to analyze the curative effect and safety of TACE combined with radiofrequency ablation (RFA) in treating large liver cancers.
Method: According to the Meta-analysis process, the relevant domestic and foreign related databases such as PubMed, Embase, Seer, Cochrane Library, CNKI, Wanfang Medical Network, VIP, China Biomedical Literature Database were searched with defined search terms. The search period was January 2003 to June 2023. Randomized controlled clinical studies on the efficacy and safety of TACE+RFA versus TACE alone in the treatment of large liver cancer were screened and included. The quality of the included studies was evaluated and Meta-analysis was performed using RevMan5.4 software. Result:Finally, A total of 16 papers were included, involving 1 175 patients, including 587 cases in the TACE+RFA group and 588 cases in the TACE alone group. The results of Meta-analysis indicated that: compared with the TACE alone group, the objective response rate (ORR) [relative risk (RR)=1.46, 95% confidence interval (95%CI): 1.35-1.59, P<0.000 01], disease control rate (DCR) (RR=1.17, 95%CI: 1.12-1.22, P<0.000 01), 1-year survival rate (RR=1.39, 95%CI: 1.24-1.55, P<0.000 01), 2-year survival rate (RR=1.79, 95%CI: 1.38-2.32, P<0.000 1) and 3-year survival rate (RR=3.20, 95%CI: 1.25-8.20, P=0.02) of TACE+RFA group were better than those of simple TACE group, and the difference was statistically significant. There was no significant difference in the common adverse reactions between the two groups.
Conclusion: Compared with TACE alone, TACE+RFA can improve the short-term efficacy and the long-term survival rate of large liver cancer patients, and does not increase the occurrence of adverse reactions.

Research progress on conversion therapy for patients with malignant liver tumors with inadequate remnant liver volume

Li Xin, Li Zhiyu

2024, 11(1): 16-20.

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For patients with primary or locally metastatic malignant liver tumors,the only chance for long-term survival is complete resection of the liver tumors. However, post-hepatectomy liver failure(PHLF) remains a major cause of mortality after liver resection,and inadequate future liver remnant has been proven to be a major risk factor for PHLF. Currently,various methods exist for preoperative conversion therapy. Portal vein embolization and associating liver partition and portal vein ligation for staged hepatectomy are the two most widely used methods. However, each method has its distinct advantages and disadvantages. With the development of comprehensive treatment for malignant tumors, several treatment methods are under exploration. This study compares different conversion therapy methods,aiming to provide clinical references.

Clinical application progress of circulating tumor cells for accurate dynamic monitoring of hepatocellular carcinoma

Huang Xiaozhun, Wang Fuzun, Xie Yunliang, Ran Yihong, Xu Lin, Huang Zhangkan, Yin Xin, Bi Xinyu, Che Xu

2024, 11(1): 21-24.

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Hepatocellular carcinoma (HCC) is the fifth most common neoplasm and a major cause of cancer-related death worldwide. There is no ideal biomarker allowing early diagnosis of HCC and tumor surveillance in patients receiving therapy. Circulating tumor cells (CTC) have become a useful tool for diagnosing and monitoring therapeutic responses of different tumors in a non-invasive setting, and have great potential for precision medicine delivery in HCC patients. Based on existing clinical application evidence, this review will discuss the application and research progress of CTC in guiding surgical methods, resection margins, interventional therapy and systematic therapy, and other accurate dynamic monitoring.

Research progress of lenvatinib for hepatocellular carcinoma

Pei Xirui, Li Xiaohang

2024, 11(1): 25-29.

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Hepatocellular carcinoma is a major challenge affecting global health and has been recognised as a leading cause of death both in China and the world. Due to its insidious, rapidly progressive and highly malignant nature, many patients with hepatocellular carcinoma have already lost their chance of surgery by the time they are diagnosed. Lenvatinib has the ability to inhibit the growth of both tumor cells and tumor angiogenesis, which results in a better effect on patients with unresectable hepatocellular carcinoma and significantly prolongs the overall survival of patients. Therefore, lenvatinib is considered as a first-line target drug for the treatment of unresectable hepatocellular carcinoma. This article presents a systematic review about the research progress of lenvatinib for hepatocellular carcinoma and future perspectives.

Research progress in the liquid biopsy in hepatocellular carcinoma

Liang Renshan, Zhang Yu, Chen Zutao, Feng Tingting

2024, 11(1): 30-33.

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At present, primary hepatocellular carcinoma ranks fourth common malignant tumor and second tumor cause of death in China, seriously threatening the pubic life and health.Because of its hidden incidence and non-specific clinical manifestations, the early diagnosis rate of primary liver cancer is low.When liver cancer is found,the condition often have progressed to the advanced stage and the prognosis is very poor.Therefore, modern medicine there is an urgent need for new detection methods to early diagnosis, real-time monitoring and effective treatment of liver cancer."Liquid biopsy" is one of the new detection methods.Many studies have shown that liquid biopsy is of great significance in the early diagnosis, targeted treatment, metastasis, recurrence and prognostic evaluation of liver cancer. The purpose of this review is to briefly introduce the research progress of liquid biopsy in hepatocellular carcinoma.

Effect of targeted nursing management on patients with liver cancer after radiotherapy

Du Mengya, Chen Peijuan, Sun Jingyuan

2024, 11(1): 34-37.

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Objective: To explore the intervention effect of targeted nursing in radiotherapy of liver cancer patients.
Methods: From October 2017 to October 2019, 208 patients with liver cancer undergoing radiotherapy in our hospital were selected and randomly divided into control group (106 cases) and experimental group (102 cases). The two groups were given targeted nursing and routine nursing respectively. Baseline data were compared between the two groups, as well as visual analog pain scores, anxiety and depression scores, quality of life scores, complication rate, compliance, and satisfaction with care.
Results: There was no significant difference in visual analog pain scores, anxiety and depression scores, and quality of life scores between the two groups before the targeted intervention (all P> 0.05). After 3 months of care, the visual analog pain, anxiety, depression and quality of life were higher than the control group (all P<0.05); the complication rate was lower than the control group (9.8% vs 30.2%, P<0.05), and the compliance was better than the control group (96.07% vs 84.91%, P<0.05); the nursing satisfaction was higher than the control group (all P<0.05).
Conclusion: Targeted nursing can reduce the complications of patients with liver cancer radiotherapy, improve the overall satisfaction of patients.

The effects of acceptance and commitment therapy psychological intervention on negative emotion and treatment compliance of patients with primary liver cancer

Sun Yali, Tong Huanqing, Yuan Pomian, Liu Le, Wu Na, Zhou Kan, Zhai Jiuling

2024, 11(1): 38-41.

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Objective: To investigate the effects of acceptance and commitment therapy (ACT) psychological intervention on negative emotion and treatment compliance of patients with primary liver cancer.
Method: Totally 100 patients were choose with primary liver cancer in our department for the observation object from May 2019 to April 2021. According to the admission time order using a random digital table to divide the patient into 50 cases of intervention group and control group. And the control group were given conventional care, intervention group implements ACT psychological intervention on the basis of regular care. Compared the results of the two groups.
Result: Anxiety and self-evaluation scale (SAS) rating / depression self-evaluation schedule (SDS) score of the intervention group is lower than that of the control group [96.0%(48/50) vs 78.0%(39/50), χ²=5.315, P<0.05]. The treatment compliance of the intervention group was higher than that of the control group [(49.3±1.7) vs (53.0±1.6), t=11.525, P<0.001; (44.2±1.5) vs (48.9±1.5), t=15.969,P<0.001].
Conclusion: Application of ACT psychological intervention, can reduce negative emotion of patients with primary liver cancer to improve their treatment compliance, reduce patient psychological pressure, thereby improving the survival quality of patients.

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