Objective： To analyze the angiography appearance of liver metastases from gastroenteropancreatic neuroendocrine tumors （GEP-NETs）, and evaluate the clinical efficacy and prognostic factors of interventional treatme...Objective： To analyze the angiography appearance of liver metastases from gastroenteropancreatic neuroendocrine tumors （GEP-NETs）, and evaluate the clinical efficacy and prognostic factors of interventional treatment for hepatic metastases. Methods： Fifty GEP-NETs patients with hepatic metastases were treated from January 2012 to December 2016, and received transarterial embolization （TAE） in the hepatic tumor or hepatic arterial infusion chemotherapy （HAIC）. All patients received 179 times of the intervention therapy in total. Results： Blood supplies were identified in the 50 eases with angiography, which showed that 35 cases had abundant vessels, while 15 eases had poor blood supply. Twenty-two cases were found either collateral blood supply, or portal vein invasion or arterial-portal vein fistula. The best curative efficacy was complete remission （CR） in 4 cases, partial remission （PR） in 28 cases and stable disease （SD） in 18 eases during the process of treatment. The angiography （P=0.047） and the frequency of intervention （P=0.037） showed significantly statistical difference with Kaplan-Meier analysis. The Cox analysis showed that more than 3 times of interventional therapy was an independent prognostic factor. Conclusions： Interventional treatment is safe and effective for GEP-NETs, and is beneficial to patients with main hepatic metastases after endocrine therapy.展开更多
Yttrium-90 (Y-90) radioembolization,also known as selective internal radiation therapy (SIRT),is a regional hepatic therapy used in the treatment of unresectable colorectal cancer (CRC) liver metastases. In SIRT,Y-90 ...Yttrium-90 (Y-90) radioembolization,also known as selective internal radiation therapy (SIRT),is a regional hepatic therapy used in the treatment of unresectable colorectal cancer (CRC) liver metastases. In SIRT,Y-90 impregnated microspheres are injected into the VASCULAR SUPPLY of hepatic tumor,leading to selective irradiation and necrosis of tumor TISSUE. While several studies demonstrate improved local control and survival with SIRT,the specific indications for this therapy have yet to be defined. Typically,SIRT is given in combination with chemotherapy as multimodal treatment for unresectable hepatic CRC. However,it HAS ALSO FOUND INCREASING USE as a salvage therapy in chemo-refractory patients. Herein,the authors describe their experience with SIRT as "stand alone" therapy in a surgically-prohibitive,chemotherapy naive patient with hepatic CRC metastasis. The results suggest that Y-90 SIRT may have potential applications beyond its usual role as a palliative or salvage therapy for unresectable hepatic CRC.展开更多
BACKGROUND: The molecular mechanism of hepaticmetastasis of colorectal cancer is not well understood. Theaim of this study was to assess the relations between phos-pholipid contents of cellular membrane and isoenzyme ...BACKGROUND: The molecular mechanism of hepaticmetastasis of colorectal cancer is not well understood. Theaim of this study was to assess the relations between phos-pholipid contents of cellular membrane and isoenzyme ex-pression of protein kinase C (PKC) and their effects on he-patic metastasis of colorectal cancer.METHODS: High performance liquid chromatography wasused to detect contents of cell membrane phospholipids:phosphatidylinosital (PI), phosphatidylserine (PS), phos-phatidylethanolamine (PE) and phosphatidylcholine (PC)in primary foci, paratumor mucosa and hepatic metastaticfoci in patients with colorectal carcinoma. The mRNA ex-pression levels of PKC-α, -δ, -ε, -λ, -ξ isoenzymeswere detected with the QRT-PCR technique.RESULTS: The levels of PI, PC and PE in primary foci andhepatic metastatic foci were higher than those in paratumormucosa. The level of PE in hepatic metastatic foci wasmuch higher than that in primary foci (t =98.88, P <0.01);but the levels of PI and PC were not significantly differentbetween primary foci and hepatic metastatic foci (t =1.73 ,1.36, P>0.05). The expression levels of -δ, -ε,-λ, -ξ were enhanced in primary foci and hepatic metasta-tic foci, but the level of PKC-α in primary foci was de-creased as compared with that in paratumor mucosa. Thelevels of PKC-δ, -ε, -λ, -ξ in hepatic metastatic foci werehigher than those in primary foci. A positive correlationwas observed between the expression levels of PI, PC andand also between those of PE and PKC-δ, -ε, -λ,-ξ. However, there was a close negative correlation be-tween PE and PKC-α.CONCLUSION: Increased levels of PI and PC and de-creased ratio of PKC-α to are related to colorectalcancer genesis. Increased levels of PE, increased expressionof PKC-δ, -ε, -λ, -ξ isoenzymes and decreased level ofPKC-α are related to hepatic metastasis in colorectal carci-noma.展开更多
Organ-specific tumor cell adhesion to extracellular matrix (ECM) components and cell migration into host organs often involve integrin-mediated cellular processes. Direct integrin-mediated cell adhesion to ECM compone...Organ-specific tumor cell adhesion to extracellular matrix (ECM) components and cell migration into host organs often involve integrin-mediated cellular processes. Direct integrin-mediated cell adhesion to ECM components in the space of Disse appears to be required for the successful liver metastatic formation of colon cancer. In the present study, human colon cancer HT-29 cells were transfected by liposome with integrin-β1 antisense oligodeoxynucleotide (ASODN). The integrin-β1 gene expression in HT-29 cel...展开更多
Objective: The purpose of the study was to explore the relationship between hepatitis B virus(HBV) infection and hepatic metastasis in non-small cell lung cancer(NSCLC). Methods: Four hundred and eighty cases of NSCLC...Objective: The purpose of the study was to explore the relationship between hepatitis B virus(HBV) infection and hepatic metastasis in non-small cell lung cancer(NSCLC). Methods: Four hundred and eighty cases of NSCLC were retrospectively analyzed from January 2003 to January 2010, and the prevalence of hepatic metastasis of NSCLC in patients with and without hepatitis B virus infection were compared. Results: In the HBV carriers' group, the prevalence of synchronous hepatic metastasis and metachronous hepatic metastasis were 13.2% and 5.9%, respectively. Meanwhile in the non-HBV group, those were 21.6% and 9.5% respectively. A significant difference between the two groups was found(P < 0.05). Conclusion: The prevalence of synchronous hepatic metastasis and metachronous hepatic metastasis in non-small cell lung cancer with HBV infection are lower than those in non-HBV infection group. Hepatic metastasis is infrequent in HBV infected cases of NSCLC.展开更多
OBJECTIVE To develop an effectual method for treating hepatic metas-tasis from rectal cancer. METHODS A randomized control study of celiac artery perfusion plus transcatheter hepatic arterial chemoembolization (TACE) ...OBJECTIVE To develop an effectual method for treating hepatic metas-tasis from rectal cancer. METHODS A randomized control study of celiac artery perfusion plus transcatheter hepatic arterial chemoembolization (TACE) (observation group) and intravenous chemotherapy (control group) for 99 cases with hepatic me-tastasis from rectal cancer was performed. The perfusion was repeated once at 4 weeks after the first treatment of 52 cases in the observation group, and it was subsequently repeated at an interval of 2 or 3 months. Using intrave-nous administration, the perfusion was repeated once every 3 weeks with 47 cases in the control group. RESULTS Three months after treatment, the patients in the observation group who showed a relief or elimination of a former superior abdominal pain amounted to 70.6%, and those with a diminution of their intrahepatic mass reached 55.8%. In the control group, the patients with a relief or disappear-ance of hepatalgia reached 20%, and those with a diminution of their intrahe-patic mass reached 10.6%. The 1, 2 and 3-year survival rates were 80.8%, 46.2% and 25.0% in the cases of the observation group and 61.7%, 19.1% and 4.3% in the control group, respectively. CONCLUSION For the patients who failed to receive a surgical opera-tion on their hepatic metastasis from rectal cancer, celiac artery perfusion plus TACE is a more effective regimen for improvement of the clinical symp-toms and extension of the survival time, compared to intravenous chemo-therapy, and is a better choice for palliative therapy.展开更多
Colorectal cancer is one of the most frequent cancers in the world. Hepatic metastasis is the most common site metastatic disease and dominant cause of death in colorectal cancer patients. In the large majority of cas...Colorectal cancer is one of the most frequent cancers in the world. Hepatic metastasis is the most common site metastatic disease and dominant cause of death in colorectal cancer patients. In the large majority of cases, cell dysfunction in CRC results from multiple rather than single, gene interactions, so to be able to predict occurrence of disease and treatment outcome, more studies on comparative proteomics are needed both in sporadic and in hereditary colorectal cancer. This article is about the proteomic study on hepatic metastasis of colorectal cancer which helps to identify the specific proteins that play important roles in hepatic metastasis. The study of protein molecules with their expressions correlated to the metastatic process would help to understand the metastatic mechanisms and thus facilitate the development of strategies for the therapeutic interventions and clinical markagement of cancer.展开更多
In the current post-genomic era, characterizing the function of genes is a major challenge. Proteomic researchers can translate genome information into useful biological insight. Colorectal cancer represents one of th...In the current post-genomic era, characterizing the function of genes is a major challenge. Proteomic researchers can translate genome information into useful biological insight. Colorectal cancer represents one of the most common malignancies worldwide. So it is applicable to compare and identify the differentially expressed proteins assiciated with colorectal cancer and hepatic metastasis. The identification of dlfferentially expressed protein would provide the basis for early diagnosis and detection, as well as clues for understanding the molecular mechanisms governing human colorectal carcinoma carcinogenesis, metastasis and progression, with the final goal to find better solutions to challenges in prevention of the colorectal liver metastasis and kill cancer cells with minimum toxicity maximally and specifically.展开更多
Most colorectal cancer patients develop metastasis to the liver during the course of the disease. The success of metastatic hepatic cancer treatment is strongly dependent on early diagnosis and understanding of the mo...Most colorectal cancer patients develop metastasis to the liver during the course of the disease. The success of metastatic hepatic cancer treatment is strongly dependent on early diagnosis and understanding of the molecular mechanisms and biological behaviors of colorectal cancer, especially its infiltration and metastasis.By proteomics, we can develop new biomarkers for diagnosis and early detection of hepatic metastasis in CRC and accelerate drug exposure.展开更多
Objective To analyze the characteristics of hepatic metastasis of pure immature ovarian teratoma and explore its proper diagnosis and treatment.Methods Eighteen cases of hepatic metastasis of pure immature ovarian ter...Objective To analyze the characteristics of hepatic metastasis of pure immature ovarian teratoma and explore its proper diagnosis and treatment.Methods Eighteen cases of hepatic metastasis of pure immature ovarian teratoma were included in this study. The clinical stage, operation, chemotherapy and histopathology of primary and secondary tumors as well as the data from long term follow-ups were analyzed retrospectively,Results All of the hepatic metastatic tumors were located on the surface of the liver. 61.1％ (11/18) of them were clinical stage Ⅲ and 44.4％ (8/18) were grade 1 at first operation. The hepatic metastatic rate was 16.7％ (3/18) in the standard adjuvant chemotherapy group but increased markedly to 31.2％ (15/48) in the irregular chemotherapy group. Auxiliary diagnostic methods could not indicate the correct results. The surgical resection rate of hepatic metastasis of pure immature ovarian teratoma was 94.4％ (17/18). There were less complications in the group with tumor diameter less than 15 cm. The follow-up time ranged from 3 to 205 months with a mean of 20.9 months. The 3-year-survival rate was 77.8％ (14/ 18), and mortality rate was 22.2％. The 5- and 10-year-survival rate was 55.6％ (10/18) and 38.9％ (7/18), respectively. The rate of loss in follow-up was 22.2％ (4/18) and 38.9％ (7/18), respectively, and one patient has survived for more than 17 years.Conclusions The hepatic metastatic rate of pure immature ovarian teratoma could be decreased using standard adjuvant chemotherapy. Suitable surgical treatment could reduce complications and improve the prognosis for patients.展开更多
We report a 55-year-old male who developed advanced hepatic metastasis and peritoneal carcinomatosis after resection of remnant gastric cancer resection 3 mo ago. The patient only received epidermal growth factor (EGF...We report a 55-year-old male who developed advanced hepatic metastasis and peritoneal carcinomatosis after resection of remnant gastric cancer resection 3 mo ago. The patient only received epidermal growth factor (EGF) receptor antibody (Cetuximab) plus recombinant human endostatin (Endostar). Anti-tumor activity was assessed by 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computer tomography (PET/CT) at baseline and then every 4 wk. The case illustrates that 18FDG-PET/CT could make an early prediction of the response to Cetuximab plus Endostar in such clinical situations. 18FDG-PET/CT is a useful molecular imaging modality to evaluate the biological response advanced hepatic metastasis and peritoneal carcinomatosis to Cetuximab plus Endostar in patients after remnant gastric cancer resection.展开更多
AIM: To analyze the risk factors for interval time, number and pattern of hepatic metastases from gastric cancer after radical gastrectomy, and provide evidence for predicting and preventing hepatic metastasis from ga...AIM: To analyze the risk factors for interval time, number and pattern of hepatic metastases from gastric cancer after radical gastrectomy, and provide evidence for predicting and preventing hepatic metastasis from gastric cancer after radical gastrectomy. METHODS: A retrospective study of 87 patients with hepatic metastasis who underwent radical gastrectomy for gastric cancer from 1996 to 2001. The data was analyzed to evaluate significant risk factors for interval time, number and pattern of hepatic metastases originating from gastric cancer after radical gastrectomy. RESULTS: The size of gastric cancer and lymph node metastases were independently correlated with the interval time of hepatic metastases; the depth of invasion was independently correlated with the number of hepatic metastases; while the depth of invasion and Lauren classification were independently correlated with the pattern of hepatic metastases. CONCLUSION: We evaluated the interval time of hepatic metastases with the size of gastric cancer and lymph node metastases. The depth of invasion could be used to evaluate the number of hepatic metastases, while the depth of invasion and the Lauren classification could be used to evaluate the pattern of hepatic metastases in patients who underwent radical gastrectomy.展开更多
Colorectal cancer (CRC) is a common malignant disease and the severe nature of cases in men and women who develop colorectal cancer makes this an important socio-economic health issue. Major challenges such as underst...Colorectal cancer (CRC) is a common malignant disease and the severe nature of cases in men and women who develop colorectal cancer makes this an important socio-economic health issue. Major challenges such as understanding and modeling colorectal cancer pathways rely on our understanding of simple models such as outlined in this paper. We discuss that the development of novel standardized approaches of multidimensional (correlative) biomolecular microscopy methods facilitates the collection of (sub) cellular tissue information in the early onset of colorectal liver metastasis and that this approach will be crucial in designing new effective strategies for CRC treatment. The application of X-ray micro-computed tomography and its potential in correlative imaging of the liver vasculature will be discussed.展开更多
AIM： To introduce the combination method of radio- chemoembolization for the treatment of selected he- patic metastases. METHODS： Twenty patients with biopsy proven hepat- ic metastases were selected from those who ...AIM： To introduce the combination method of radio- chemoembolization for the treatment of selected he- patic metastases. METHODS： Twenty patients with biopsy proven hepat- ic metastases were selected from those who underwent transarterial radiochemoembolization, a novel combina- tion protocol, between .lanuary 2009 and July 2010. Patients had different sources of liver metastasis. The treatment included transarterial administration of three chemotherapeutic drugs （mitomycin, doxorubicin and cisplatin）, followed by embolization with large （50-150 μm） radioisotope particles of chromic 32R Multiphasic computer tomography or computer tomography stud- ies, with and without contrast medium injections, were performed for all patients for a short-term period before and after the treatment sessions. The short-term effec- tiveness of this procedure was evaluated by modified response evaluation criteria in solid tumors （mRECIST）, which also takes necrosis into account. The subjective percentage of necrosis was also assessed. The re- sponse evaluation methods were based on the changes in size, number, and the enhancement patterns of the lesions between the pre- and post-treatment imaging studies. RESULTS： Patients had liver metastasis from colorectal carcinomas, breast cancer, lung cancer and carcinoid tumors. The response rate based on the mRECIST criteria was 5% for complete response, 60% for par- tial response, 10% for stable disease, and 25% for progressive disease. Regarding the subjective necrosis percentage, 5% of patients had complete response, 50% had partial response, 25% had stable disease, and 20% had progressive disease. Based on traditional RECIST criteria, 3 patients （15%） had partial response, 13 patients （65%） had stable disease, and 4 patients （20%） had disease progression. In most patients, colorectal carcinoma was the source of metastasis （13 patients）. Based on the mRECIST criteria, 8 out of these 13 patients had partial responses, while one remained stable, and 5 showed progressive disease. We also had 5 cases of breast cancer metastasis which mostly remained stable （4 cases）, with only one partial response after the procedure. Six patients had bilobar involvement; three of them received two courses of radiochemoembolization. The follow up imaging study of these patients was performed after the second ses- sion. In the studied patients there was no evidence of extrahepatic occurrence, including pulmonary radioac- tive deposition, which was proven by Bremsstrahlung scintigraphy performed after the treatment sessions. For the short-term follow-ups for the 2 mo after the therapy, no treatment related death was reported. The mostly common side effect was post-embolization syndrome, presented as vomiting, abdominal pain, and fever. Nineteen （95%） patients experienced this syndrome in different severities. Two patient had asci- tes （with pleural effusion in one patient） not related to hepatic failure. Moreover, no cases of acute liver failure, hepatic infarction, hepatic abscess, biliary necrosis, tu- mor rupture, surgical cholecystitis, or non-targeted gut embolization were reported. Systemic toxicities such as alopecia, marrow suppression, renal toxicity, or cardiac failure did not occur in our study group. CONCLUSION： Radiochemoembolization is safe and effective for selected hepatic metastases in a short- term follow-up. Further studies are required to show the long-term effects and possible complications of this approach.展开更多
The incidence of pancreatic adenocarcinoma（PDAC） has steadily increased over the past several decades. The majority of PDAC patients will present with distant metastases, limiting surgical management in this populat...The incidence of pancreatic adenocarcinoma（PDAC） has steadily increased over the past several decades. The majority of PDAC patients will present with distant metastases, limiting surgical management in this population. Hepatectomy and pulmonary metastasectomy（PM） has been well established for colorectal cancer patients with isolated, resectable hepatic or pulmonary metastatic disease. Recent advancements in effective systemic therapy for PDAC have led to the selection of certain patients where metastectomy may be potentially indicated. However, the indication for resection of oligometastases in PDAC is not well defined. This review will discuss the current literature on the surgical management of metastatic disease for PDAC with a specific focus on surgical resection for isolated hepatic and pulmonary metastases.展开更多
Objective: The combination of hepatic arterial chemotherapy(HAIC) and systemic chemotherapy(SYC) has potential effect on colorectal cancer(CRC) patients with unresectable hepatic metastasis. The aim of this retrospect...Objective: The combination of hepatic arterial chemotherapy(HAIC) and systemic chemotherapy(SYC) has potential effect on colorectal cancer(CRC) patients with unresectable hepatic metastasis. The aim of this retrospective study was to investigate the efficacy and safety of this combined therapeutic regimen on Chinese patients based on single institute experiences. Methods: All 54 patients of this retrospective analysis were diagnosed with CRC with unresectable liver metastasis and received combined HAIC and SYC. Among the patients, 23 of them received HAIC plus SYC when they developed liver metastases as first-line treatment(Group 1), and 31 patients received HAIC plus SYC as non-first-line treatment(Group 2). The different efficacy in two groups was analyzed by SPSS 19.0. Results: The overall response rate(ORR) were 52.2% and 25.8% respectively in Groups 1 and 2(P = 0.047), and the disease control rate(DCR) were 65.2% and 35.5% respectively in Groups 1 and 2(P = 0.031). The median progression-free survival(PFS) were 6.8 and 3.3 months(P = 0.002), the median hepatic progression-free survival(H-PFS) were 8.8 and 3.7 months(P = 0.001), and the median overall survival(OS) were 18.8 and 13.7 months(P = 0.121) in Groups 1 and 2, respectively. No fatal reaction was observed and no significant difference of adverse reaction was found in two groups. Grade 3/4 toxic effects included neutropenia(9.7% in Group 2 only), gastrointestinal reaction(8.7% in Group 1 and 6.5% in Group 2), stomatitis(6.5% in Group 2 only) and hyperbilirubinemia(4.3% in Group 1 only). Conclusion: HAIC combined with SYC showed promising efficacy and safe profiles on CRC patients with unresectable liver metastases.展开更多
Hemangioperioltoma is a rare tumor especially when it rises in the peritoneal cavity. We present a case of a 60-year-old woman with an isolated recurrent hemangiopericytoma of the liver. The patient presented with a p...Hemangioperioltoma is a rare tumor especially when it rises in the peritoneal cavity. We present a case of a 60-year-old woman with an isolated recurrent hemangiopericytoma of the liver. The patient presented with a palpable right upper quadrant abdominal mass, which occurred 7 years after undergoing resection of a malignant hemangiopericytoma arising from the greater omentum. She had not followed up 6 mo after surgery. Various imaging studies showed a single large, well-capsulated liver tumor with central necrosis, accompanied by hypervascularity typical of a vascular tumor. Preoperative laboratory HBsAg and anti-HCV workup were both negative. Under the impression of recurrent malignant hemangiopericytoma, right trisegmentectomy was performed to completely resect the tumor. Pathological examination confirmed the diagnosis of recurrent hemangiopericytoma. Even though the incidence of the hemangiopericytoma is relatively low, malignant hemangiopericytoma has a tendency to recur frequently after a long-term disease-free interval. Also, the recurrent hemangiopericytoma is not easily detected early during follow-up until it becomes symptomatic because there are no specific tumor markers, and because of the diversity with regard to site of recurrence. The authors suggest that Positron Emission Tomogram （PET） may be a useful tool for the detection of recurrent hemangioperioltoma. We describe herein some characteristics and behaviors of malignant hemangiopericytoma, particularly after surgical resection.展开更多
Objective：The objective was to qualitatively and quantitatively evaluate hepatic metastases using computed tomography （CT） virtual noncontrast （VNC） spectral imaging in a retrospective analysis.Methods：Forty hep...Objective：The objective was to qualitatively and quantitatively evaluate hepatic metastases using computed tomography （CT） virtual noncontrast （VNC） spectral imaging in a retrospective analysis.Methods：Forty hepatic metastases patients underwent CT scans including the conventional true noncontrast （TNC） and the tri-phasic contrast-enhanced dual energy spectral scans in the hepatic arterial,portal venous,and equilibrium phases.The tri-phasic spectral CT images were used to obtain three groups of VNC images including in the arterial （VNCa）,venous （VNCv）,and equilibrium （VNCe） phase by the material decomposition process using water and iodine as a base material pair.The image quality and the contrast-to-noise ratio （CNR） of metastasis of the four groups were compared with ANOVA analysis.The metastasis detection rates with the four nonenhanced image groups were calculated and compared using the Chisquare test.Results：There were no significant differences in image quality among TNC,VNCa and VNCv images （P 〉 0.05）.The quality of VNCe images was significantly worse than that of other three groups （P 〈 0.05）.The mean CNR of metastasis in the TNC and VNCs images was 1.86,2.42,1.92,and 1.94,respectively; the mean CNR of metastasis in VNCa images was significantly higher than that in other three groups （P 〈 0.05）,while no statistically significant difference was observed among VNCv,VNCe and TNC images （P 〉 0.05）.The metastasis detection rate of the four nonenhanced groups with no statistically significant difference （P 〉 0.05）.Conclusions：The quality of VNCa and VNCv images is identical to that of TNC images,and the metastasis detection rate in VNC images is similar to that in TNC images.VNC images obtained from arterial phase show metastases more clearly.Thus,VNCa imaging may be a surrogate to TNC imaging in hepatic metastasis diagnosis.展开更多
Background The precise molecular mechanisms underlying the gallbladder carcinoma （GBC） metastasis has not been fully elucidated. Methods In the present study, metastasis-associated proteins were identified by compar...Background The precise molecular mechanisms underlying the gallbladder carcinoma （GBC） metastasis has not been fully elucidated. Methods In the present study, metastasis-associated proteins were identified by comparative proteomic analysis. The functional study of the candidate protein vimentin was further investigated. First, a pair of higher and lower metastatic sublines （termed GBC-SD/M3 and GBC-SD, respectively）, originated from the same parental cell line, was screened by spontaneous tumorigenicity and metastasis in vivo in animal study and further characterized by metastatic phenotypes analysis in vitro. Subsequently, a proteomic approach comprised two-dimensional gel electrophoresis analysis and mass spectroscopy was used to identify and compare the protein expression patterns between higher metastatic GBC-SD/M3 and lower metastatic GBC-SD cell lines. Then twenty-six proteins were identified. Results Among the 26 proteins identified, fourteen proteins were up-regulated and 12 proteins were down-regulated in GBC-SD/M3. Vimentin was identified and found to be overexpressed in GBC-SD/M3 as compared with GBC-SD. This result was further confirmed by quantitative PCR and Western blotting analysis. Furthermore, the cell migration and invasion potency of GBC-SD/M3 in vitro was remarkably suppressed after small interference RNA-mediated knockdown of vimentin. Moreover, immunoblot and immunohistochemical analysis on 12 human GBC specimens showed consistently increased vimentin expression in metastases compared with primary tumors. Conclusion Tumor vimentin level may reflect the pathological progression in some GBC and may be a useful marker for predicting tumor metastasis and a therapeutic target for the treatment of GBC patients with metastases.展开更多
Background and Objective:Pancreatic neuroendocrine tumors(PanNETs)are derived from the islet cells of the pancreas and have been increasing in incidence.Most of these tumors are nonfunctional although some can secrete...Background and Objective:Pancreatic neuroendocrine tumors(PanNETs)are derived from the islet cells of the pancreas and have been increasing in incidence.Most of these tumors are nonfunctional although some can secrete hormones and lead to hormone-specific clinical syndromes.Surgery is the mainstay of treatment for localized tumors,however,surgical resection is controversial in metastatic PanNETs.This narrative review seeks to summarize the current literature surrounding surgery,specifically in the controversial area of metastatic PanNETs,review current treatment paradigms,and understand the benefits of surgery in this group of patients.Methods:Authors searched PubMed using the terms“surgery pancreatic neuroendocrine tumor”,“metastatic neuroendocrine tumor”,and“liver debulking neuroendocrine tumor”from January 1990 to June 2022.Only English language publications were considered.Key Content and Findings:There is no consensus among the leading specialty organizations regarding surgery for metastatic PanNETs.When considering surgery for metastatic PanNETs,tumor grade and morphology,location of the primary tumor,extra-hepatic or extra-abdominal disease,as well as liver tumor burden and metastatic distribution should be considered.Because the liver is the most common site of metastasis and liver failure is the most common cause of death in patients with hepatic metastases,attention is centered here on debulking and other ablative techniques.Liver transplantation is rarely used for hepatic metastases but could be beneficial in a small subset of patients.Retrospective studies have demonstrated improvement in survival and symptoms after surgery for metastatic disease,but the lack of prospective randomized control trials significantly limits analysis of surgical benefits in patients with metastatic PanNETs.Conclusions:Surgery is the standard of care for localized PanNETs,while it remains controversial in metastatic disease.Many studies have shown a survival and symptomatic benefit to surgery and liver debulking in select groups of patients.However,most of the studies on which recommendations are based in this population are retrospective in nature and are subject to selection bias.This presents an opportunity for future investigation.展开更多
基金supported by the National Natural Science Foundation of China(No.81571781)
文摘Objective： To analyze the angiography appearance of liver metastases from gastroenteropancreatic neuroendocrine tumors （GEP-NETs）, and evaluate the clinical efficacy and prognostic factors of interventional treatment for hepatic metastases. Methods： Fifty GEP-NETs patients with hepatic metastases were treated from January 2012 to December 2016, and received transarterial embolization （TAE） in the hepatic tumor or hepatic arterial infusion chemotherapy （HAIC）. All patients received 179 times of the intervention therapy in total. Results： Blood supplies were identified in the 50 eases with angiography, which showed that 35 cases had abundant vessels, while 15 eases had poor blood supply. Twenty-two cases were found either collateral blood supply, or portal vein invasion or arterial-portal vein fistula. The best curative efficacy was complete remission （CR） in 4 cases, partial remission （PR） in 28 cases and stable disease （SD） in 18 eases during the process of treatment. The angiography （P=0.047） and the frequency of intervention （P=0.037） showed significantly statistical difference with Kaplan-Meier analysis. The Cox analysis showed that more than 3 times of interventional therapy was an independent prognostic factor. Conclusions： Interventional treatment is safe and effective for GEP-NETs, and is beneficial to patients with main hepatic metastases after endocrine therapy.
文摘Yttrium-90 (Y-90) radioembolization,also known as selective internal radiation therapy (SIRT),is a regional hepatic therapy used in the treatment of unresectable colorectal cancer (CRC) liver metastases. In SIRT,Y-90 impregnated microspheres are injected into the VASCULAR SUPPLY of hepatic tumor,leading to selective irradiation and necrosis of tumor TISSUE. While several studies demonstrate improved local control and survival with SIRT,the specific indications for this therapy have yet to be defined. Typically,SIRT is given in combination with chemotherapy as multimodal treatment for unresectable hepatic CRC. However,it HAS ALSO FOUND INCREASING USE as a salvage therapy in chemo-refractory patients. Herein,the authors describe their experience with SIRT as "stand alone" therapy in a surgically-prohibitive,chemotherapy naive patient with hepatic CRC metastasis. The results suggest that Y-90 SIRT may have potential applications beyond its usual role as a palliative or salvage therapy for unresectable hepatic CRC.
基金This study was supported by a grant from the National Nature Science Foun-dation of China (No. 30070747)
文摘BACKGROUND: The molecular mechanism of hepaticmetastasis of colorectal cancer is not well understood. Theaim of this study was to assess the relations between phos-pholipid contents of cellular membrane and isoenzyme ex-pression of protein kinase C (PKC) and their effects on he-patic metastasis of colorectal cancer.METHODS: High performance liquid chromatography wasused to detect contents of cell membrane phospholipids:phosphatidylinosital (PI), phosphatidylserine (PS), phos-phatidylethanolamine (PE) and phosphatidylcholine (PC)in primary foci, paratumor mucosa and hepatic metastaticfoci in patients with colorectal carcinoma. The mRNA ex-pression levels of PKC-α, -δ, -ε, -λ, -ξ isoenzymeswere detected with the QRT-PCR technique.RESULTS: The levels of PI, PC and PE in primary foci andhepatic metastatic foci were higher than those in paratumormucosa. The level of PE in hepatic metastatic foci wasmuch higher than that in primary foci (t =98.88, P <0.01);but the levels of PI and PC were not significantly differentbetween primary foci and hepatic metastatic foci (t =1.73 ,1.36, P>0.05). The expression levels of -δ, -ε,-λ, -ξ were enhanced in primary foci and hepatic metasta-tic foci, but the level of PKC-α in primary foci was de-creased as compared with that in paratumor mucosa. Thelevels of PKC-δ, -ε, -λ, -ξ in hepatic metastatic foci werehigher than those in primary foci. A positive correlationwas observed between the expression levels of PI, PC andand also between those of PE and PKC-δ, -ε, -λ,-ξ. However, there was a close negative correlation be-tween PE and PKC-α.CONCLUSION: Increased levels of PI and PC and de-creased ratio of PKC-α to are related to colorectalcancer genesis. Increased levels of PE, increased expressionof PKC-δ, -ε, -λ, -ξ isoenzymes and decreased level ofPKC-α are related to hepatic metastasis in colorectal carci-noma.
基金supported by a grant from Natural Science Foundation of Shandong province (No. Y2007C030)
文摘Organ-specific tumor cell adhesion to extracellular matrix (ECM) components and cell migration into host organs often involve integrin-mediated cellular processes. Direct integrin-mediated cell adhesion to ECM components in the space of Disse appears to be required for the successful liver metastatic formation of colon cancer. In the present study, human colon cancer HT-29 cells were transfected by liposome with integrin-β1 antisense oligodeoxynucleotide (ASODN). The integrin-β1 gene expression in HT-29 cel...
文摘Objective: The purpose of the study was to explore the relationship between hepatitis B virus(HBV) infection and hepatic metastasis in non-small cell lung cancer(NSCLC). Methods: Four hundred and eighty cases of NSCLC were retrospectively analyzed from January 2003 to January 2010, and the prevalence of hepatic metastasis of NSCLC in patients with and without hepatitis B virus infection were compared. Results: In the HBV carriers' group, the prevalence of synchronous hepatic metastasis and metachronous hepatic metastasis were 13.2% and 5.9%, respectively. Meanwhile in the non-HBV group, those were 21.6% and 9.5% respectively. A significant difference between the two groups was found(P < 0.05). Conclusion: The prevalence of synchronous hepatic metastasis and metachronous hepatic metastasis in non-small cell lung cancer with HBV infection are lower than those in non-HBV infection group. Hepatic metastasis is infrequent in HBV infected cases of NSCLC.
文摘OBJECTIVE To develop an effectual method for treating hepatic metas-tasis from rectal cancer. METHODS A randomized control study of celiac artery perfusion plus transcatheter hepatic arterial chemoembolization (TACE) (observation group) and intravenous chemotherapy (control group) for 99 cases with hepatic me-tastasis from rectal cancer was performed. The perfusion was repeated once at 4 weeks after the first treatment of 52 cases in the observation group, and it was subsequently repeated at an interval of 2 or 3 months. Using intrave-nous administration, the perfusion was repeated once every 3 weeks with 47 cases in the control group. RESULTS Three months after treatment, the patients in the observation group who showed a relief or elimination of a former superior abdominal pain amounted to 70.6%, and those with a diminution of their intrahepatic mass reached 55.8%. In the control group, the patients with a relief or disappear-ance of hepatalgia reached 20%, and those with a diminution of their intrahe-patic mass reached 10.6%. The 1, 2 and 3-year survival rates were 80.8%, 46.2% and 25.0% in the cases of the observation group and 61.7%, 19.1% and 4.3% in the control group, respectively. CONCLUSION For the patients who failed to receive a surgical opera-tion on their hepatic metastasis from rectal cancer, celiac artery perfusion plus TACE is a more effective regimen for improvement of the clinical symp-toms and extension of the survival time, compared to intravenous chemo-therapy, and is a better choice for palliative therapy.
文摘Colorectal cancer is one of the most frequent cancers in the world. Hepatic metastasis is the most common site metastatic disease and dominant cause of death in colorectal cancer patients. In the large majority of cases, cell dysfunction in CRC results from multiple rather than single, gene interactions, so to be able to predict occurrence of disease and treatment outcome, more studies on comparative proteomics are needed both in sporadic and in hereditary colorectal cancer. This article is about the proteomic study on hepatic metastasis of colorectal cancer which helps to identify the specific proteins that play important roles in hepatic metastasis. The study of protein molecules with their expressions correlated to the metastatic process would help to understand the metastatic mechanisms and thus facilitate the development of strategies for the therapeutic interventions and clinical markagement of cancer.
文摘In the current post-genomic era, characterizing the function of genes is a major challenge. Proteomic researchers can translate genome information into useful biological insight. Colorectal cancer represents one of the most common malignancies worldwide. So it is applicable to compare and identify the differentially expressed proteins assiciated with colorectal cancer and hepatic metastasis. The identification of dlfferentially expressed protein would provide the basis for early diagnosis and detection, as well as clues for understanding the molecular mechanisms governing human colorectal carcinoma carcinogenesis, metastasis and progression, with the final goal to find better solutions to challenges in prevention of the colorectal liver metastasis and kill cancer cells with minimum toxicity maximally and specifically.
文摘Most colorectal cancer patients develop metastasis to the liver during the course of the disease. The success of metastatic hepatic cancer treatment is strongly dependent on early diagnosis and understanding of the molecular mechanisms and biological behaviors of colorectal cancer, especially its infiltration and metastasis.By proteomics, we can develop new biomarkers for diagnosis and early detection of hepatic metastasis in CRC and accelerate drug exposure.
文摘Objective To analyze the characteristics of hepatic metastasis of pure immature ovarian teratoma and explore its proper diagnosis and treatment.Methods Eighteen cases of hepatic metastasis of pure immature ovarian teratoma were included in this study. The clinical stage, operation, chemotherapy and histopathology of primary and secondary tumors as well as the data from long term follow-ups were analyzed retrospectively,Results All of the hepatic metastatic tumors were located on the surface of the liver. 61.1％ (11/18) of them were clinical stage Ⅲ and 44.4％ (8/18) were grade 1 at first operation. The hepatic metastatic rate was 16.7％ (3/18) in the standard adjuvant chemotherapy group but increased markedly to 31.2％ (15/48) in the irregular chemotherapy group. Auxiliary diagnostic methods could not indicate the correct results. The surgical resection rate of hepatic metastasis of pure immature ovarian teratoma was 94.4％ (17/18). There were less complications in the group with tumor diameter less than 15 cm. The follow-up time ranged from 3 to 205 months with a mean of 20.9 months. The 3-year-survival rate was 77.8％ (14/ 18), and mortality rate was 22.2％. The 5- and 10-year-survival rate was 55.6％ (10/18) and 38.9％ (7/18), respectively. The rate of loss in follow-up was 22.2％ (4/18) and 38.9％ (7/18), respectively, and one patient has survived for more than 17 years.Conclusions The hepatic metastatic rate of pure immature ovarian teratoma could be decreased using standard adjuvant chemotherapy. Suitable surgical treatment could reduce complications and improve the prognosis for patients.
文摘We report a 55-year-old male who developed advanced hepatic metastasis and peritoneal carcinomatosis after resection of remnant gastric cancer resection 3 mo ago. The patient only received epidermal growth factor (EGF) receptor antibody (Cetuximab) plus recombinant human endostatin (Endostar). Anti-tumor activity was assessed by 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computer tomography (PET/CT) at baseline and then every 4 wk. The case illustrates that 18FDG-PET/CT could make an early prediction of the response to Cetuximab plus Endostar in such clinical situations. 18FDG-PET/CT is a useful molecular imaging modality to evaluate the biological response advanced hepatic metastasis and peritoneal carcinomatosis to Cetuximab plus Endostar in patients after remnant gastric cancer resection.
文摘AIM: To analyze the risk factors for interval time, number and pattern of hepatic metastases from gastric cancer after radical gastrectomy, and provide evidence for predicting and preventing hepatic metastasis from gastric cancer after radical gastrectomy. METHODS: A retrospective study of 87 patients with hepatic metastasis who underwent radical gastrectomy for gastric cancer from 1996 to 2001. The data was analyzed to evaluate significant risk factors for interval time, number and pattern of hepatic metastases originating from gastric cancer after radical gastrectomy. RESULTS: The size of gastric cancer and lymph node metastases were independently correlated with the interval time of hepatic metastases; the depth of invasion was independently correlated with the number of hepatic metastases; while the depth of invasion and Lauren classification were independently correlated with the pattern of hepatic metastases. CONCLUSION: We evaluated the interval time of hepatic metastases with the size of gastric cancer and lymph node metastases. The depth of invasion could be used to evaluate the number of hepatic metastases, while the depth of invasion and the Lauren classification could be used to evaluate the pattern of hepatic metastases in patients who underwent radical gastrectomy.
文摘Colorectal cancer (CRC) is a common malignant disease and the severe nature of cases in men and women who develop colorectal cancer makes this an important socio-economic health issue. Major challenges such as understanding and modeling colorectal cancer pathways rely on our understanding of simple models such as outlined in this paper. We discuss that the development of novel standardized approaches of multidimensional (correlative) biomolecular microscopy methods facilitates the collection of (sub) cellular tissue information in the early onset of colorectal liver metastasis and that this approach will be crucial in designing new effective strategies for CRC treatment. The application of X-ray micro-computed tomography and its potential in correlative imaging of the liver vasculature will be discussed.
文摘AIM： To introduce the combination method of radio- chemoembolization for the treatment of selected he- patic metastases. METHODS： Twenty patients with biopsy proven hepat- ic metastases were selected from those who underwent transarterial radiochemoembolization, a novel combina- tion protocol, between .lanuary 2009 and July 2010. Patients had different sources of liver metastasis. The treatment included transarterial administration of three chemotherapeutic drugs （mitomycin, doxorubicin and cisplatin）, followed by embolization with large （50-150 μm） radioisotope particles of chromic 32R Multiphasic computer tomography or computer tomography stud- ies, with and without contrast medium injections, were performed for all patients for a short-term period before and after the treatment sessions. The short-term effec- tiveness of this procedure was evaluated by modified response evaluation criteria in solid tumors （mRECIST）, which also takes necrosis into account. The subjective percentage of necrosis was also assessed. The re- sponse evaluation methods were based on the changes in size, number, and the enhancement patterns of the lesions between the pre- and post-treatment imaging studies. RESULTS： Patients had liver metastasis from colorectal carcinomas, breast cancer, lung cancer and carcinoid tumors. The response rate based on the mRECIST criteria was 5% for complete response, 60% for par- tial response, 10% for stable disease, and 25% for progressive disease. Regarding the subjective necrosis percentage, 5% of patients had complete response, 50% had partial response, 25% had stable disease, and 20% had progressive disease. Based on traditional RECIST criteria, 3 patients （15%） had partial response, 13 patients （65%） had stable disease, and 4 patients （20%） had disease progression. In most patients, colorectal carcinoma was the source of metastasis （13 patients）. Based on the mRECIST criteria, 8 out of these 13 patients had partial responses, while one remained stable, and 5 showed progressive disease. We also had 5 cases of breast cancer metastasis which mostly remained stable （4 cases）, with only one partial response after the procedure. Six patients had bilobar involvement; three of them received two courses of radiochemoembolization. The follow up imaging study of these patients was performed after the second ses- sion. In the studied patients there was no evidence of extrahepatic occurrence, including pulmonary radioac- tive deposition, which was proven by Bremsstrahlung scintigraphy performed after the treatment sessions. For the short-term follow-ups for the 2 mo after the therapy, no treatment related death was reported. The mostly common side effect was post-embolization syndrome, presented as vomiting, abdominal pain, and fever. Nineteen （95%） patients experienced this syndrome in different severities. Two patient had asci- tes （with pleural effusion in one patient） not related to hepatic failure. Moreover, no cases of acute liver failure, hepatic infarction, hepatic abscess, biliary necrosis, tu- mor rupture, surgical cholecystitis, or non-targeted gut embolization were reported. Systemic toxicities such as alopecia, marrow suppression, renal toxicity, or cardiac failure did not occur in our study group. CONCLUSION： Radiochemoembolization is safe and effective for selected hepatic metastases in a short- term follow-up. Further studies are required to show the long-term effects and possible complications of this approach.
文摘The incidence of pancreatic adenocarcinoma（PDAC） has steadily increased over the past several decades. The majority of PDAC patients will present with distant metastases, limiting surgical management in this population. Hepatectomy and pulmonary metastasectomy（PM） has been well established for colorectal cancer patients with isolated, resectable hepatic or pulmonary metastatic disease. Recent advancements in effective systemic therapy for PDAC have led to the selection of certain patients where metastectomy may be potentially indicated. However, the indication for resection of oligometastases in PDAC is not well defined. This review will discuss the current literature on the surgical management of metastatic disease for PDAC with a specific focus on surgical resection for isolated hepatic and pulmonary metastases.
基金Supported by grants of National Natural Science Foundation of China(No.81302141)Administration of Traditional Chinese Medicine of Guangdong Province,China(No.20111169)+1 种基金Science and Technology Planning Project of Guangdong Province,China(No.2010B031600317)the Sun Yat-sen University Young Teacher Training Project(No.12ykpy56)
文摘Objective: The combination of hepatic arterial chemotherapy(HAIC) and systemic chemotherapy(SYC) has potential effect on colorectal cancer(CRC) patients with unresectable hepatic metastasis. The aim of this retrospective study was to investigate the efficacy and safety of this combined therapeutic regimen on Chinese patients based on single institute experiences. Methods: All 54 patients of this retrospective analysis were diagnosed with CRC with unresectable liver metastasis and received combined HAIC and SYC. Among the patients, 23 of them received HAIC plus SYC when they developed liver metastases as first-line treatment(Group 1), and 31 patients received HAIC plus SYC as non-first-line treatment(Group 2). The different efficacy in two groups was analyzed by SPSS 19.0. Results: The overall response rate(ORR) were 52.2% and 25.8% respectively in Groups 1 and 2(P = 0.047), and the disease control rate(DCR) were 65.2% and 35.5% respectively in Groups 1 and 2(P = 0.031). The median progression-free survival(PFS) were 6.8 and 3.3 months(P = 0.002), the median hepatic progression-free survival(H-PFS) were 8.8 and 3.7 months(P = 0.001), and the median overall survival(OS) were 18.8 and 13.7 months(P = 0.121) in Groups 1 and 2, respectively. No fatal reaction was observed and no significant difference of adverse reaction was found in two groups. Grade 3/4 toxic effects included neutropenia(9.7% in Group 2 only), gastrointestinal reaction(8.7% in Group 1 and 6.5% in Group 2), stomatitis(6.5% in Group 2 only) and hyperbilirubinemia(4.3% in Group 1 only). Conclusion: HAIC combined with SYC showed promising efficacy and safe profiles on CRC patients with unresectable liver metastases.
文摘Hemangioperioltoma is a rare tumor especially when it rises in the peritoneal cavity. We present a case of a 60-year-old woman with an isolated recurrent hemangiopericytoma of the liver. The patient presented with a palpable right upper quadrant abdominal mass, which occurred 7 years after undergoing resection of a malignant hemangiopericytoma arising from the greater omentum. She had not followed up 6 mo after surgery. Various imaging studies showed a single large, well-capsulated liver tumor with central necrosis, accompanied by hypervascularity typical of a vascular tumor. Preoperative laboratory HBsAg and anti-HCV workup were both negative. Under the impression of recurrent malignant hemangiopericytoma, right trisegmentectomy was performed to completely resect the tumor. Pathological examination confirmed the diagnosis of recurrent hemangiopericytoma. Even though the incidence of the hemangiopericytoma is relatively low, malignant hemangiopericytoma has a tendency to recur frequently after a long-term disease-free interval. Also, the recurrent hemangiopericytoma is not easily detected early during follow-up until it becomes symptomatic because there are no specific tumor markers, and because of the diversity with regard to site of recurrence. The authors suggest that Positron Emission Tomogram （PET） may be a useful tool for the detection of recurrent hemangioperioltoma. We describe herein some characteristics and behaviors of malignant hemangiopericytoma, particularly after surgical resection.
文摘Objective：The objective was to qualitatively and quantitatively evaluate hepatic metastases using computed tomography （CT） virtual noncontrast （VNC） spectral imaging in a retrospective analysis.Methods：Forty hepatic metastases patients underwent CT scans including the conventional true noncontrast （TNC） and the tri-phasic contrast-enhanced dual energy spectral scans in the hepatic arterial,portal venous,and equilibrium phases.The tri-phasic spectral CT images were used to obtain three groups of VNC images including in the arterial （VNCa）,venous （VNCv）,and equilibrium （VNCe） phase by the material decomposition process using water and iodine as a base material pair.The image quality and the contrast-to-noise ratio （CNR） of metastasis of the four groups were compared with ANOVA analysis.The metastasis detection rates with the four nonenhanced image groups were calculated and compared using the Chisquare test.Results：There were no significant differences in image quality among TNC,VNCa and VNCv images （P 〉 0.05）.The quality of VNCe images was significantly worse than that of other three groups （P 〈 0.05）.The mean CNR of metastasis in the TNC and VNCs images was 1.86,2.42,1.92,and 1.94,respectively; the mean CNR of metastasis in VNCa images was significantly higher than that in other three groups （P 〈 0.05）,while no statistically significant difference was observed among VNCv,VNCe and TNC images （P 〉 0.05）.The metastasis detection rate of the four nonenhanced groups with no statistically significant difference （P 〉 0.05）.Conclusions：The quality of VNCa and VNCv images is identical to that of TNC images,and the metastasis detection rate in VNC images is similar to that in TNC images.VNC images obtained from arterial phase show metastases more clearly.Thus,VNCa imaging may be a surrogate to TNC imaging in hepatic metastasis diagnosis.
基金DONG Ping and HE Xiao-wei contributed equally to this work. This study was supported by grants from the National Natural Science Foundation of China （No. 30640060, 30872502, 30972918, 81172026, 81172029）, Natural Science Foundation of Zhejiang Province for Outstanding Young Researcher Groups （No. R2080452）, Foundation of Medical School, Shanghai Jiao Tong University （No. 09XJ21012） and Natural Science Foundation of Zhejiang Province （No. Y206860）.
文摘Background The precise molecular mechanisms underlying the gallbladder carcinoma （GBC） metastasis has not been fully elucidated. Methods In the present study, metastasis-associated proteins were identified by comparative proteomic analysis. The functional study of the candidate protein vimentin was further investigated. First, a pair of higher and lower metastatic sublines （termed GBC-SD/M3 and GBC-SD, respectively）, originated from the same parental cell line, was screened by spontaneous tumorigenicity and metastasis in vivo in animal study and further characterized by metastatic phenotypes analysis in vitro. Subsequently, a proteomic approach comprised two-dimensional gel electrophoresis analysis and mass spectroscopy was used to identify and compare the protein expression patterns between higher metastatic GBC-SD/M3 and lower metastatic GBC-SD cell lines. Then twenty-six proteins were identified. Results Among the 26 proteins identified, fourteen proteins were up-regulated and 12 proteins were down-regulated in GBC-SD/M3. Vimentin was identified and found to be overexpressed in GBC-SD/M3 as compared with GBC-SD. This result was further confirmed by quantitative PCR and Western blotting analysis. Furthermore, the cell migration and invasion potency of GBC-SD/M3 in vitro was remarkably suppressed after small interference RNA-mediated knockdown of vimentin. Moreover, immunoblot and immunohistochemical analysis on 12 human GBC specimens showed consistently increased vimentin expression in metastases compared with primary tumors. Conclusion Tumor vimentin level may reflect the pathological progression in some GBC and may be a useful marker for predicting tumor metastasis and a therapeutic target for the treatment of GBC patients with metastases.
文摘Background and Objective:Pancreatic neuroendocrine tumors(PanNETs)are derived from the islet cells of the pancreas and have been increasing in incidence.Most of these tumors are nonfunctional although some can secrete hormones and lead to hormone-specific clinical syndromes.Surgery is the mainstay of treatment for localized tumors,however,surgical resection is controversial in metastatic PanNETs.This narrative review seeks to summarize the current literature surrounding surgery,specifically in the controversial area of metastatic PanNETs,review current treatment paradigms,and understand the benefits of surgery in this group of patients.Methods:Authors searched PubMed using the terms“surgery pancreatic neuroendocrine tumor”,“metastatic neuroendocrine tumor”,and“liver debulking neuroendocrine tumor”from January 1990 to June 2022.Only English language publications were considered.Key Content and Findings:There is no consensus among the leading specialty organizations regarding surgery for metastatic PanNETs.When considering surgery for metastatic PanNETs,tumor grade and morphology,location of the primary tumor,extra-hepatic or extra-abdominal disease,as well as liver tumor burden and metastatic distribution should be considered.Because the liver is the most common site of metastasis and liver failure is the most common cause of death in patients with hepatic metastases,attention is centered here on debulking and other ablative techniques.Liver transplantation is rarely used for hepatic metastases but could be beneficial in a small subset of patients.Retrospective studies have demonstrated improvement in survival and symptoms after surgery for metastatic disease,but the lack of prospective randomized control trials significantly limits analysis of surgical benefits in patients with metastatic PanNETs.Conclusions:Surgery is the standard of care for localized PanNETs,while it remains controversial in metastatic disease.Many studies have shown a survival and symptomatic benefit to surgery and liver debulking in select groups of patients.However,most of the studies on which recommendations are based in this population are retrospective in nature and are subject to selection bias.This presents an opportunity for future investigation.
