Table of Content

30 June 2020, Volume 7 Issue 2

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Original article

Analysis of morbidity and mortality of liver cancer in Heilongjiang province, 2015

Sun Huixin, Wang Wanying, Zhang Maoxiang, Jia Haihan, Song Bingbing

2020, 7(2):  12-15. 

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Objective: To analyze the morbidity and mortality of liver cancer in the cancer registries in Heilongjiang province in 2015.Methods: Incidence rate and gender of liver cancer were calculated by 7 tumor registry data. The morbidity and mortality of liver cancer were calculated according to the stratification of the area (urban and rural) and gender. The age standardized morbidity / mortality of China's population and world population were calculated by the 2000 Chinese population and SEGI world population constitution.Results: The morphology verified cases (MV%) accounted for 50.73% and 3.21% of incident cases were identified through death certifications only (DCO%) with a mortality to incidence ratio(M/I) of 0.92. In the cancer registries in Heilongjiang province, incidence of liver cancer in 2015 was 27.44/100 000 (male 40.30/100 000, female 14.75/100 000), China's population standardized rate was 16.31/100 000, the world's population standardized rate was 16.08/100 000; the incidence in urban areas was 24.74/100 000, China's population standardized rate was 13.87/100 000; the incidence in rural areas was 35.27/100 000, China's population standardized rate was 24.95/100 000. In the cancer registration area of Heilongjiang Province, the crude death rate of liver cancer in 2015 was 25.20/100 000 (male 37.03/100 000, female 13.51/100 000), the population standardized rate of China was 14.87/100 000, the world population standardized rate was 14.75/100 000; the crude death rate of urban area was 23.18/100 000, the population standardized rate of China was 12.85/100 000; the crude death rate of rural area was 31.05/100 000, the population standardized rate of China was 21.96/100 000.Conclusion: Rural population and the male should be the focus of the prevention and treatment of liver cancer, so as to promote the early diagnosis and treatment of liver cancer and the opportunistic screening of liver cancer, improve the detection rate of early liver cancer, and reduce the disease burden caused by the incidence and death of liver cancer.

Study on the expression and prognosis of miR-320a and GP73 in patients with cholangiocarcinoma

Zhang Lei, Sun Jingwu, Zhang Jiaxing

2020, 7(2):  16-20. 

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Objective: To observe the synergistic effect and prognosis of microRNA-320a (miR-320a) and Golgi protein 73 (GP73) in patients with cholangiocarcinoma.Methods: 142 patients with cholangiocarcinoma admitted to our hospital from June 2014 to December 2018 were selected as cholangiocarcinoma group, and 146 cases of physical examination were selected as healthy group during the same period. The expression level of serum miR-320a in the two groups was detected real-time fluorescence quantitative assay (qRT-PCR); the expression level of GP73 in the two groups was determined by enzyme-linked immunosorbent assay (ELISA); the relationships between the expression levels of serum miR-320a, GP73 with clinical characteristics of cholangiocarcinoma and the relationship between expression levels of miR-320a and GP73 were analyzed; the prognostic factors of cholangiocarcinoma were analyzed; and the diagnostic values of levels of serum miR-320a and GP73 in cholangiocarcinoma were analyzed.Results: The expression level of serum miR-320a in cholangiocarcinoma group was significantly lower than that in healthy group (P < 0.05), and the level of GP73 was significantly higher than that in healthy group (P < 0.05); the expression levels of serum miR-320a and GP73 in cholangiocarcinoma group were correlated with vascular invasion, TNM stage and cirrhosis (all P< 0.05); the expression level of miR-320a was negatively correlated with GP73 in patients with cholangiocarcinoma (P< 0.05); vascular invasion, TNM stage, cirrhosis and GP73 were risk factors for the prognosis of cholangiocarcinoma (P< 0.05), and miR-320a was protective factor for the prognosis of cholangiocarcinoma (P< 0.05); the areas under curve (AUC) of the expression levels of serum miR-320a and GP73 in diagnosis of cholangiocarcinoma were 0.875 and 0.878, respectively, the corresponding sensitivities were 84.5% and 85.4% respectively, and the specificities were 79.5% and 79.5% respectively; the AUC of combined diagnosis of serum miR-320a and GP73 for cholangiocarcinoma was 0.956, and the sensitivity and specificity were 90.8% and 91.8% respectively.Conclusions: The expression of serum miR-320a in patients with cholangiocarcinoma is low, and GP73 is high, there is a negative correlation between miR-320a and GP73, and the interaction between them may affect the occurrence and development of cholangiocarcinoma.

Clinicopathological charateristics analysis for 23 cases of hepatic angiomyolipoma

Li Zhuo, Wang Liming, Zhang Haifeng, Zhang Hongtu, Shi Susheng, Lu Haizhen

2020, 7(2):  21-27. 

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Objective: The aim of the study was to investigate the clinicopathologic characteristics, immunohistochemical results, diagnosis, differential diagnosis and prognosis of hepatic angiomyolipoma (HAML).Methods: The 23 surgically excisional cases of HAML were collected and systematically analyzed in Cancer Hospital, Chinese Academy of Medical Sciences from December 2010 to December 2019. The clinical and pathological characteristics, including gender, age distribution, former medical history, symptoms, tumor location, size, gross and microscopic morphological features and immunohistochemical results were reviewed in the study.Results: There were 5 males and 18 females, with a median age of 46.8 years (range 27~66 years). The results of serological examination showed 5 cases of HAML patients with the infection of Hepatitis B virus. The test results of AFP and CEA in 20 cases were within the normal range. Only 5 cases of the 23 HAML were correctly diagnosed before the operations, with the other 15 cases diagnosed as hepatic carcinoma, 2 cases as hepatic hemangioma and 1 case as hepatic adenoma. There were 18 cases 78.3% out of the 23 HAML cases with epithelial components in our study. The immunohistochemical results of 23 cases showed the positive percentage ratio of HMB45 as 100%, SMA as 95.7% and 0 for the epithelial markers respectively. Except for only one case with the recurrence with the history of former operation from another hospital, no recurrence or metastasis in the other 22 cases was observed in our study.Conclusions: HAML was a type of mesenchymal neoplasm. The combined application of HMB45 and SMA immunohistochemical examination was proved to be essential for the correct diagnosis of HAML. Although there was higher existence of epithelial components in HAML than in renal counterpart, the favorable prognosis was still observed depending on the completely surgical resection in this study. Thus we assume that the epithelial components in HAML would not change its clinical outcome.

Clinical study on the construction of prognostic scoring system for hepatocellular carcinoma patients based on a variety of inflammatory response markers

Feng Zhiqiang, Yang Zixuan, Han Shanshan, Shang Yutao, Zhao Junhui, Yang Qingmin, Wu Jieying, Sheng Jun, Guo Xiaodong

2020, 7(2):  28-34. 

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Objective: The inflammatory response score (IRS) was constructed based on the ratio of neutrophils to lymphocytes, the ratio of platelets to lymphocytes and the ratio of lymphocytes to monocytes to predict the survival rate of HCC patients after hepatectomy.Methods: 284 patients with HCC were selected from Beijing Chaoyang emergency rescue center and air force characteristic medical center from May 2013 to January 2019. The best truncation values of NLR, PLR and LMR were obtained by ROC curve and NPL-IRS was constructed.The validity of NPL-IRS was evaluated by time ROC.Results: 284 patients were followed up for 3~43 months, the follow-up time was (21.52 ±7.98) months. At the end of follow-up, 157 patients died, with one-year mortality of 24.6% and three-year mortality of 55.3%. The AUC of NLR, PLR and LMR were 0.889, 0.895 and 0.861 respectively, and the best truncation values were 2.34, 98.74 and 3.43 respectively. The overall survival rate of NLR≤2.34, PLR≤98.74, LMR>3.43 group was higher than that of the corresponding group (P < 0.05). Cirrhosis (yes), tumor number (multiple), vascular invasion (yes), tumor stage (Ⅲ~Ⅳ), NPL-IRS-1, NPL-IRS-2 and NPL-IRS-3 were the independent risk factors of death in HCC patients (P<0.05). The best truncation value of NPL-IRS was 1 and AUC was 0.794 (95% CI=0.742~0.839). The results of time ROC curve show that AUC of NPL-IRS is higher than that of NLR, PLR and LMR at any time.Conclusion: Based on the best truncation values of NLR, PLR and LMR, npl-irs was successfully constructed in this study, which can predict the prognosis of HCC patients more accurately than a single inflammatory response standard.

Study on the need of health education guidance for liver cancer patients after discharge

Gao Fei, Liang He, Chen Qichen, Li Caiyun, Zhang Ping

2020, 7(2):  35-39. 

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Objective: To analyze the needs of health education guidance for patients with liver cancer after discharge.Methods: 97 patients with liver cancer were included in the questionnaire survey before discharge, including basic information, 8 health education contents and 8 health education guidance methods. The statistical analysis method was chi square test, P < 0.05, indicating that the difference was statistically significant.Results: The top three demands of live cancer patients health education guidance were nutrition guidance, drug consultation and nursing guidance, and the demand for psychological counseling was the least. The top three requirements for health education guidance are health education manual, rehabilitation hotline and follow-up guidance. Patients under 35 years old and 36~59 years old have a higher demand for online services. Patients with liver cancer need more pain guidance and drug guidance after surgery.Conclusion: Diversified health education guidance should be provided for patients with liver cancer after discharge to improve the accessibility and pertinence of the guidance. Health education manual, rehabilitation hotline and other health guidance methods should be advocated. Meanwhile, guidance on nutrition, postoperative pain and mental health of patients with liver cancer should be strengthened in order to improve the quality of life of patients.

Expression of lncRNA MIAT in serum of patients with hepatocellular carcinoma and its clinical significance

Yang Hang, Huang Yuhong, Wu Yunan

2020, 7(2):  40-43. 

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Objective: To detect the expression of Long non-coding RNA (lncRNA) myocardial infraction association transcript (MIAT) in serum of patients with hepatocellular carcinoma (HCC) and to explore its clinical significance.Methods: The expression of MIAT in serum of HCC patients was detected by qRT-PCR assay. The value of MIAT expression in the diagnosis of HCC was assessed by ROC curve, and the relationship between MIAT expression with HCC disease progression and prognosis was analyzed.Results: MIAT was highly expressed in serum of HCC patients, and ROC curve showed that MIAT expression could be used as a serum marker for diagnosis of HCC. MIAT expression was closely related to tumor number, TNM stage and BCLC stage. MIAT expression decreased after resection of HCC and increased when HCC recurred.Conclusion: Serum MIAT level can be used as a biomarker for the diagnosis of HCC. It has potential clinical value in evaluating the malignant progression and surgical efficacy of HCC as well as predicting recurrence of HCC.

Zerumbone nanoparticles induce cell cycle arrest through the p53 pathway and exert antitumor effects on hepatocellular carcinoma cells

Liu Haishi, Zhang Wenlin, Wang Peng, Guo Zuoming, Zhang Yubao, Zhang Songyan

2020, 7(2):  44-47. 

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Objective: The purpose of this study was to explore the anti-tumor effect of HJT1 - NP on human hepatocellular carcinoma cells and its mechanism.Methods: To investigate HJT1-NP effects on cell proliferation, colony formation, invasion, proteins expression levels of p16, p21, p53, CyclinD1 and CDK4 in human hepatocellular carcinoma HepG-2 cells by western-blot analysis and cell cycle distribution.Results: The HJT1 - NP could up-regulate the proteins expression of p16, p21 and p53 in human hepatocellular carcinoma HepG-2 cells, down-regulate the proteins expression of CyclinD1 and CDK4, induce G1-S phase arrest of cell cycle, and decrease the proliferation, colony formation and invasion ability of human hepatocellular carcinoma HepG-2 cells.Conclusion: HJT1-NP could induce G1-S phase arrest of human hepatocellular carcinoma HepG-2 cells and inhibit its malignant biological behavior through P53 pathway.

Review

Research progress of apatinib in treatment of hepatocellular carcinoma

Zhao Haoran, Zhang Yubao

2020, 7(2):  48-51. 

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For many years, the incidence and mortality of primary liver cancer in China have been in the top five, with high recurrence rate and poor prognosis. Based on China's national conditions, the pathological type of primary liver cancer is mainly hepatitis-related hepatocellular carcinoma (HCC). Therefore, the research for HCC can provide crucial reference on the treatment and research on primary liver cancer. Apatinib is a small molecule VEGFR tyrosine kinase inhibitor independently developed in our country. Its safety and effectiveness in HCC treatment have been continuously verified in clinical treatments. It has considerable research potential and prospect. This article reviews the current application status and research progress of apatinib in HCC, aiming to provide valuable reference basis for clinical application.

Exploration on diagnosis and treatment of hepatobiliary malignancies by big data

Lu Shanshan, Jia Xiaodong, Zhang Ning, Zeng Zhen, Lu Yinying

2020, 7(2):  52-55. 

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Hepatobiliary malignancies are common in digestive system diseases, which are occult and develop rapidly, especially in advanced hepatobiliary malignancies, it's low radical cure rate and high mortality are still one of the most difficult problems in clinical practice. In recent years, with the rise of big data and the advancement of accurate diagnosis and treatment plan, a number of new clinical decisions and treatment strategies have emerged. In the field of hepatobiliary malignancies, the perfect combination of big data and precision medicine will help many medical scholars to understand the biological characteristics of hepatobiliary malignancies more deeply and comprehensively, and then reveal the driving genes and pathogenesis of hepatobiliary malignancies; The integration and analysis of big data will also promote the implementation of individualized and precision medicine, and improve the standardized diagnosis and treatment level of hepatobiliary malignancies. In addition, it can also bring new light and hope for breaking through the bottleneck of treatment of advanced hepatobiliary malignancies.

Current status and progress of immunotherapy for hepatocellular carcinoma

Shao Weiwei, Sun Zhen, Song Jinghai

2020, 7(2):  56-60. 

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Primary liver cancer (PLC) is one of the most common malignant tumors, and hepatocellular carcinoma (HCC) accounts for the majority. Traditional treatments for HCC include surgical resection, liver transplantation, transcatheter arterial chemoembolization, ablation and so on. Gradually, targeted therapy is applied to clinical treatment for HCC, which improves the patients’ survival rate. However, Effective means is still lacking for advanced HCC. In recent years, immunotherapy for HCC develops rapidly and gets more and more attention, and the relevant studies are hotspots among HCC researches. This article reviews the current status and progress of immunotherapy for HCC.

Nursing field

Study on application of pain management model based on enhanced recovery after surgery in perioperative period of liver cancer

Li Caiyun, Liu Yan, Guo Huanfei, Bi Yafei

2020, 7(2):  61-65. 

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Objective: To investigate the application and effect evaluation of the pain management model of of enhanced recovery after surgery(ERAS) in the perioperative period of liver cancer patients.Methods: 168 patients who underwent hepatectomy in our hospital from January 2019 to December 2019 were divided into observation group and control group according to different pain management patterns, with 86 cases in observation group and 82 cases in control group. Patients in the observation group were treated with the pain management model intervention based on ERAS during the perioperative period, while patients in the control group were treated with traditional perioperative pain management model. The differences of postoperative pain score, sleep quality, satisfaction of pain control, postoperative prophase time of getting out of bed and exhaust, hospitalization time and hospitalization expenses in the two groups were compared.Results: The postoperative pain score of the observation group was lower than that of the control group, with statistically significant difference(P<0.05). The postoperative sleep quality of the observation group was significantly better than that of the control group (P<0.05). The satisfaction degree of analgesic effect was also higher than that of the control group, with statistically significant difference (P<0.05). The postoperative prophase time of getting out of bed and exhaust and the average daily average hospitalization days of observation group were earlier than those of the control group. And the hospitalization expenses was significantly lower than that of the control group.Conclusion: The pain management model based on ERAS can effectively reduce the postoperative pain degree of liver cancer patients. After the intervention, postoperative prophase time of getting out of bed and exhaust are advanced. The postoperative recovery is faster, reducing hospitalization days. And the control of pain is more satisfactory, achieving the purpose of ERAS.