肝癌术后复发转移预测研究进展

肝细胞肝癌(hepatocellular carcinoma,HCC,以下简称"肝癌")位居全球恶性肿瘤发病率第5位、死因第3位,在我国则已成为恶性肿瘤的第2位杀手。手术切除是肝癌治疗的主要手段,但肝癌根治性切除术后5年转移复发率为61.5%,即使小肝癌也达43.5%。其预后差的主要原因是肝癌易侵犯血管而导致肝内播散,从而出现肝内高转移率及肝癌术后的高复发率。肝癌复发、转移已成为影响病     

合并门静脉癌栓的肝细胞癌外科治疗策略

<正>肝细胞肝癌位列全世界肿瘤发病率第5位,在我国,其发病率及病死率均居恶性肿瘤的第2位,此外,肝癌术后5年的累计复发率为77%～100%[1]。门静脉癌栓(portal vein tumor thrombus,PVTT)形成是肝癌的生物学特征之一,也是肝癌术后复发和肝内播散的主要原因。临床报道肝癌合并PVTT发生率为44.0%～62.2%[2],无干预情况下中位生存期仅为2.7个月[3]。对于该类患者的处理,以往     

Hedgehog信号通路在肝癌发生发展中的生物学作用

原发性肝癌居所有常见恶性肿瘤第6位,死亡率高居第3位[1-3]。我国肝癌发病率为28.71/105,占所有恶性肿瘤的第4位(10.04%);死亡率居第2位(14.42%)[4]。由于肝癌发病隐匿、早期诊断困难、癌细胞生长迅速等特点,导致大多数病人确诊时已属晚期,手术切除率<30%[5]。目前临床应用的化疗、消融及肝动脉栓塞术等治疗具有一定的适应证,肿瘤残留与复发严重影响疗效。因此,深入研究肝癌发生、发展的     

科学肝切除-新时代肝癌肝切除的思考

肝细胞癌(简称肝癌)是我国最常见的恶性肿瘤之一,居我国恶性肿瘤死亡率的第2 位.肝切除是目前治疗肝癌最有效的方法之一.随着对肝脏解剖研究的深入以及近年来肝脏外科手术技术和影像学技术的发展,以肝段为基础的解剖肝切除得到了广泛应用.但是,肝癌切除术后的长期疗效仍没有得到显著提高,术后5 年累积复发率仍在70％以上.     

肝细胞性肝癌的外科治疗

肝癌是世界第五位常见的恶性肿瘤,5年生存率只有7%,2002年598 000人死于肝癌,是第三位的癌症死因.肝细胞性肝癌(hepatocellularcarcinoma,HCC)是为数不多的危险因素较为明确的恶性肿瘤之一,80%的HCC归因于HBV、HCV感染.随着HCV感染病例的增加,西方发达国家HCC的发病率也逐渐升高.肝切除和肝移植是主要的治愈性手段.     

基因芯片技术在肝癌转移复发早期预测诊断中的价值

肝细胞癌(hepatocellular carcinoma,HCC)(简称肝癌)位居全球恶性肿瘤发病率第5位,死因第3位;每年新发病564000例．死亡549000例．其中一半以上发生在我国．已成为我国恶性肿瘤第2位杀手。虽经数十年不懈努力．肝癌临床研究取得了许多重大进展,部分肝癌病人因早期发现、早期诊断、早期治疗及综合治疗而获得长期生存。但     

原发性肝癌转移途径的解剖学基础

原发性肝癌（primary carcinoma of liver，PLC）是肝细胞和（或）肝内胆管上皮细胞发生的恶性肿瘤。PLC是我国常见的恶性肿瘤之一，男性占第3位，女性占第4位”，每年患病人数为11万-13万。肝癌以血行转移最常见，肝细胞癌侵犯肝血窦，在肝门静脉和肝静脉内形成癌栓，并向肝内和肝外转移。肺为肝外转移的主要器官，其他有肾上腺、骨、肾及脑等；其次为淋巴途径转移；种植性转移最少见。转移率与肿瘤大小、生长方式、机体免疫等因素有关。尸检肝癌转移率高达70％以上。PLC转移有其解剖学基础，本文从解剖学角度对PLC的转移途径做一综述。     

原发性肝癌免疫节点抑制剂疗法的研究进展

<正>原发性肝癌(primary liver cancer, PLC)是常见的恶性肿瘤之一,其发病率位居全球癌症发病率第6位,死亡率位居肿瘤相关死因第3位^[1]。肝移植、肝切除术和经皮消融治疗是早期肝癌常用的治疗手段,其5年生存率可达70%～80%。经导管肝动脉化疗栓塞术(transarterial chemoembolization, TACE)常用于治疗进展期肝癌,但进展期肝癌的疗效明显低于早期肝癌^[2]。     

原发性肝癌诊疗指南（2022年版）

原发性肝癌是目前我国第4位常见恶性肿瘤及第2位肿瘤致死病因,严重威胁我国人民的生命和健康 ［1, 2, 3］。原发性肝癌主要包括肝细胞癌（hepatocellular carcinoma,HCC）、肝内胆管癌（intrahepatic cholangiocarcinoma,ICC）和混合型肝细胞癌-胆管癌（c...     

原发性肝癌复发转移的研究进展综述

<正>原发性肝细胞癌(hepatocellular carcinoma,HCC简称肝癌)是最常见的原发性肝肿瘤。是严重威胁人类健康的恶性肿瘤之一。全世界范围内肝癌的发病率呈明显的地域性差别,该病的发病率以亚非地区较高,而我国又以其高发和病死率居前。最近的统计数据表明,肝癌的发病率居全球恶性肿瘤的第5位,病     

Perioperative and long-term morbidity and mortality after above-knee and below-knee amputations in diabetics and nondiabetics

We performed a retrospective review of a vascular surgery quality assurance database to evaluate the perioperative and long-term morbidity and mortality of above-knee amputations (AKA, n = 234) and below-knee amputations (BKA, n = 720) and to examine the effect of diabetes mellitus (DM) (181 of AKA and 606 of BKA patients). All patients in the database who had AKA or BKA from 1990 to May 2001 were included in the study. Perioperative 30-day cardiac morbidity and mortality and 3-yr and 10-yr mortality after AKA or BKA were assessed. The effect of DM on 30-day cardiac outcome was assessed by multivariate logistic regression and the effect on long-term survival was assessed by Cox regression analysis. The perioperative cardiac event rate (cardiac death or nonfatal myocardial infarction) was at least 6.8% after AKA and at most 3.6% after BKA. Median survival was significantly less after AKA (20 mo) than BKA (52 mo) (P < 0.001). DM was not a significant predictor of perioperative 30-day mortality (odds ratio, 0.76 [0.39-1.49]; P = 0.43) or 3-yr survival (Hazard ratio, 1.03 [0.86-1.24]; P = 0.72) but predicted 10-yr mortality (Hazard ratio, 1.34 [1.04-1.73]; P = 0.026). Significant predictors of the 30-day perioperative mortality were the site of amputation (odds ratio, 4.35 [2.56-7.14]; P < 0.001) and history of renal insufficiency (odds ratio, 2.15 [1.13-4.08]; P = 0.019). AKA should be triaged as a high-risk surgery while BKA is an intermediate-risk surgery. Long-term survival after AKA or BKA is poor, regardless of the presence of DM.     

Postoperative nausea and vomiting and opioid-induced nausea and vomiting: guidelines for prevention and treatment

Postoperative nausea and vomiting (PONV) causes patient discomfort, lowers patient satisfaction, and increases care requirements. Opioid-induced nausea and vomiting (OINV) may also occur if opioids are used to treat postoperative pain. These guidelines aim to provide recommendations for the prevention and treatment of both problems. A working group was established in accordance with the charter of the Sociedad Espa?ola de Anestesiología y Reanimación. The group undertook the critical appraisal of articles relevant to the management of PONV and OINV in adults and children early and late in the perioperative period. Discussions led to recommendations, summarized as follows: 1) Risk for PONV should be assessed in all patients undergoing surgery; 2 easy-to-use scales are useful for risk assessment: the Apfel scale for adults and the Eberhart scale for children. 2) Measures to reduce baseline risk should be used for adults at moderate or high risk and all children. 3) Pharmacologic prophylaxis with 1 drug is useful for patients at low risk (Apfel or Eberhart 1) who are to receive general anesthesia; patients with higher levels of risk should receive prophylaxis with 2 or more drugs and baseline risk should be reduced (multimodal approach). 4) Dexamethasone, droperidol, and ondansetron (or other setrons) have similar levels of efficacy; drug choice should be made based on individual patient factors. 5) The drug prescribed for treating PONV should preferably be different from the one used for prophylaxis; ondansetron is the most effective drug for treating PONV. 6) Risk for PONV should be assessed before discharge after outpatient surgery or on the ward for hospitalized patients; there is no evidence that late preventive strategies are effective. 7) The drug of choice for preventing OINV is droperidol.     

Body composition assessment and methodology in nonathletic and athletic adolescent and adult males and females

The purpose of this review is to outline methodology for assessing body composition utilizing anthropometric and densitometric techniques. The objective of body composition assessment is to measure body fat and lean body mass. The quantity of these components varies due to growth, physical activity, dietary regimens, and aging. Anthropometric techniques incorporate selected skinfolds, circumferences, skeletal widths, or other variables to estimate body composition within k2.0-4.0%. These techniques are adequate for field testing of groups or individuals, but are population specific. Densitometry measures body volume irrespective of physique, sex, or age. This laboratory technique estimates body composition within 1.0-2.0%, is more difficult to administer, but is not population specific. Some limitation exists with any present technique due to biological variability and incomplete research of reference body composition in children, females, and the aged. J Orthop Sports Phys Ther 1984;5(6):336-347.