Electronic Journal of Liver Tumor

Current conditions and developments for radical therapies of small hepatocellular carcinoma

Shang Fuchao, Wang Menglong

2020, 7(4): 9-12.

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Hepatocellular carcinoma (HCC) is one of the most frequently occurring types of malignancy.With the improvement of cancer surveillance and the development of advanced imaging technology,the early diagnosis of primary small HCC(diameter≤3cm ) have significantly increased.In the context of the small HCC,surgical resection(SR),ablation,and liver transplantation(LT)remain the cornerstone of therapy.We will review the current status and progress of surgical resection, ablation and liver transplantation.

Application of lymph node dissection in intrahepatic cholangiocarcinoma

Hu Hanjie, Huang Zhen, Zhao Hong

2020, 7(4): 13-16.

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Intrahepatic cholangiocarcinoma is the second common primary malignant tumors of the liver with high degree of malignancy, and surgery is the only effective radical treatment. This tumor has a poor prognosis and a high risk of postoperative recurrence, and its risk factors are diverse. Lymph node metastasis is one of the most important risk factors. As one of the main purposes of defining N staging, regional lymph node dissection is also recommended in all guidelines as a routine surgical procedure. However, the prognostic value of lymph node dissection is still unclear, and its indications and scope of dissection are still controversial. Therefore, this article combines the literature to carry on the comprehensive review in this aspect.

Research progress in immunotherapy and biomarkers for hepatocellular carcinoma

Peng Xuenan, Zhou Aiping

2020, 7(4): 17-22.

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The incidence of hepatocellular carcinoma (HCC) in China ranked fourth among all malignant tumors, and the mortality rate ranked second in 2015. Approximately 85% of Chinese patients are in the intermediate stage or advanced stage at the first visit and lose the best treatment chance. The 5-year survival rate of them is only 12%. Since 2007, treatments for advanced hepatocellular carcinoma mostly focused on targeted therapy, with limited efficacy. In recent years, immune checkpoint inhibitors have achieved 17% ~ 20% and 15% ~ 20% objective response rate in first-line and second-line monotherapy respectively. Immunotherapy shows obviously anti-tumor effect that is superior to traditional targeted therapy. Initial results have also achieved in the field of neoadjuvant and adjuvant therapy for HCC. However, several challenges such as treatment selection after disease progression and disease recurrence after liver transplantation are still unsolved. Exploring immune-specific biomarkers to predict the efficacy has also become an important direction in the field of immunotherapy. In this review, we summarized the research progress of immunotherapy and biomarkers for hepatocellular carcinoma.

Primary hepatobiliary neuroendocrine tumors: a case review and literature review

Ge Dazhuang, Bi Xinyu, Zhao Hong, Li Zhiyu, Zhang Yefan, Luo Zhiwen, Wei Zhewen, Chen Qichen, Li Xingchen, Cai Jianqiang

2020, 7(4): 23-28.

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Objective: To investigate the clinical features, diagnosis and effective treatment strategies of primary hepatobiliary neuroendocrine tumor. Methods: The clinical data of 16 patients with primary hepatobiliary neuroendocrine tumor were analyzed retrospectively, and the clinical characteristics and treatment options of primary hepatobiliary neuroendocrine tumor were discussed combined with literature review. Results: There was no obvious increase in AFP and CEA in all patients. On CT, the arterial phase was markedly enhanced, while the portal phase and the delayed phase were weakened. On MRI, the tumors showed low signal on T1-weighted MRI, high signal on T2-weighted MRI, limited diffusion on DWI, and marked annular or heterogeneous enhancement in arterial phase, and decreased enhancement in portal phase and delayed phase. All patients were diagnosed as primary hepatobiliary neuroendocrine tumors by pathological results. The results of immunohistochemistry showed that chromogranin A (CgA) was positive in all tumors and synaptophysin (Syn) was positive in 11 cases. Follow up for 3 to 96 months showed no recurrence in 14 cases. The longest disease-free survival period was 96 months. No other neuroendocrine tumors were found in all patients. Conclusions: At present, for patients with neuroendocrine tumor of hepatobiliary system, the treatment plan should be formulated according to the specific situation of patients, and the relevant examination should be fully improved to reduce the occurrence of misdiagnosis. For resectable lesions, surgical resection is the first choice.

Identification and functional analysis of key microRNAs in HBV-associated hepatocellular carcinoma

Pei Zhiyan, Wang Jianli, Zhang Lingyi

2020, 7(4): 29-37.

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Objective: To investigate the hub microRNA of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) and its effect on the proliferation and migration ability of HCC cells. Methods: ①The GEO2R tool was used to analyze the GSE69580 and GSE67882 datasets in the GEO database to screen for differentially expressed miRNAs (DEMs) between HBV-related HCC tissues and normal liver tissues. ②The miRTarBase database was used to predict the target genes of miRNAs and the DAVID database was used to target DEMs Gene annotation analysis of gene ontology (GO) and enrichment analysis of Kyoto Gene and Genome Encyclopedia (KEGG) pathway. ③Protein-protein interaction (PPI) network analysis was used to identify hub miRNAs of DEMs and the miRNACancerMAP database was used to analyze the signal pathways that miRNAs might be involved in. ④Kaplan-Meier Plotter database was used to analyze the relationship between hub miRNAs and HCC clinical prognosis. ⑤MTT method and scratch experiments were used to verify the effect of DEMs on the proliferation and migration of HCC cells. Results: A total of 12 up-regulated DEMs and one down-regulated DEM were identified by bioinformatics analysis, and GO and KEGG functional enrichment analysis indicated that miR-93 and miR-125b were involved in tumor-associated signaling pathways such as MAPK, PI3K-AKT, and P53. Kaplan-Meier plotter survival analysis revealed that miR-93 expression level was negatively correlated with the prognosis of patients with HBV-related HCC (P=0.036), while miR-125b expression level was positively correlated with the prognosis of patients with HBV-related HCC (P=0.032). In HBsAg-positive hepatocellular carcinoma cell line MHCC-97H, overexpression of miR-93 or inhibition of miR-125b increased the proliferation and migration capacity of MHCC-97H cells (P<0.05), while overexpression of miR-125b or inhibition of miR-93 decreased the proliferation and migration capacity of MHCC-97H cells (P<0.05). Conclusion: miR-93 and miR-125b are the hub miRNAs for HBV-associated HCC, and up-regulation of miR-125b or down-regulation of miR-93 inhibited the proliferation and migration capacity of the hepatocellular carcinoma cell line MHCC-97H.

Generation of TRPS1 knockout mice by CRISPR/Cas9-mediated gene targeting

Li Tengyan, Liu Wenjie, Zhao Hong, Cai Jianqiang

2020, 7(4): 38-43.

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Objectives: This study aimed to construct and identify heterozygous mice knocked out of TRPS1 gene based on CRISPR/Cas9 technology. Methods: After self-mating of C57BL/6N mice, TRPS1 knockout mice were constructed by injecting fertilized eggs with Cas9/sgRNA, and the mouse genotypes of heritable mice were detected by tail. TRPS1 heterozygous knockout mice were mated with wild-type mice to obtain mice with stable genotypes. Results: In this experiment, the fertilized eggs were injected with cas9 / sgRNA, all breeding mice were identified by tail genotype, 18 TRPS1 knockout heterozygous mice were successfully constructed. Conclusion: In this study, we successfully constructed TRPS1 knockout heterozygous mice based on CRISPR / cas9 technology, which provided a research platform for further research on the role of TRPS1 in the occurrence, development and possible liver metastasis of colorectal cancer at the animal level.

Local therapy for unresectable intrahepatic cholangiocarcinoma

Li Shupei, Yu Chenxi, Lai Fengyong, Song Peng, Du Chunxia, Yao xuesong

2020, 7(4): 44-47.

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Intrahepatic cholangiocarcinoma refers to a malignant tumor that originates from the epithelial cells of the secondary bile duct and the branches of the intrahepatic bile duct. With the characteristics of difficult early diagnosis, high malignancy and poor prognosis. Although intrahepatic cholangiocarcinoma is relatively rare, it’s still the second most common primary malignant tumor of the liver following the hepatocellular carcinoma. In recent years, the morbidity and mortality of intrahepatic cholangiocarcinoma have been increasing. Surgical resection is currently the only radical cure, but most patients have lost the opportunity for surgery when they are diagnosed. With local treatment technology has made great progress. Those patients with unresectable intrahepatic cholangiocarcinoma, could get benefits from local treatment in terms of tumor burden reducing, symptoms relieved, prolong survival, and even transforming to surgery available. The current common local treatment methods mainly include: ablation treatment, transvascular treatment and radiotherapy. This article reviews the current status and progress of the main local treatments for intrahepatic cholangiocarcinoma. In order to get more approaches to multiple discipline therapy in intrahepatic cholangiocarcinoma.

Effect of phased psychological intervention on the treatment of pain and anxiety after TACE in patients with primary liver cancer

Li Ying, Cheng Fei, Ren Wei, He Ruixian

2020, 7(4): 48-51.

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Objective: To investigate the effect of phased psychological intervention onthe treatment of pain and anxiety after TACE in patients with primary liver cancer(PLC). Methods:A total of 200 patients with primary liver cancer who were treated with transcatheter arterial chemoembolization were randomly divided into two groups, with 100 patients in each group. Control group was given conventional care while the study group was intervention group based on conventional care Implement phased psychological intervention. The number rating scales (NRS) pain score and the degree of anxiety were compared between the two groups. Results:The NRS scores of both groups showed a downward trend after operation. The pain scores of the intervention group at 24、48 and 72 hours after surgery were lower than those of the control group (P<0.05), and the patient anxiety scores were lower than those of the control group (P<0.05). Conclusion: Phased psychological intervention can effectively reduce the pain and anxiety of patients with primary liver cancer after TACE.

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