共查询到20条相似文献,搜索用时 15 毫秒
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Stravitz RT Heuman DM Chand N Sterling RK Shiffman ML Luketic VA Sanyal AJ Habib A Mihas AA Giles HC Maluf DG Cotterell AH Posner MP Fisher RA 《The American journal of medicine》2008,121(2):119-126
Objective
Liver transplantation has become an effective treatment for cirrhotic patients with early-stage hepatocellular carcinoma. We hypothesized that the quality of surveillance for hepatocellular carcinoma influences prognosis by affecting access to liver transplantation.Methods
A total of 269 patients with cirrhosis and hepatocellular carcinoma were retrospectively categorized into 3 groups according to quality of surveillance: standard-of-care (n = 172) (group 1); substandard surveillance (n = 48) (group 2); and absence of surveillance in patients not recognized to be cirrhotic (n = 59) (group 3).Results
Three-year survival in the 60 patients who underwent liver transplantation was 81% versus 12% for patients who did not undergo transplantation (P <.001). The percentages of patients who underwent transplantation according to tumor stage at diagnosis (T1, T2, T3, and T4) were 58%, 35%, 10%, and 1%, respectively. Hepatocellular carcinoma was diagnosed at stages 1 and 2 in 70% of patients in group 1, 37% of patients in group 2, and only 18% of patients in group 3 (P <.001). Liver transplantation was performed in 32% of patients in group 1, 13% of patients in group 2, and 7% of patients in group 3 (P <.001). Three-year survival from cancer diagnosis in patients in group 3 (12%) was significantly worse than in patients in group 1 (39%) or group 2 (27%) (each P <.05). Eighty percent of patients in group 3 had subtle abnormalities of cirrhosis on routine laboratory tests.Conclusion
The quality of surveillance has a direct impact on hepatocellular carcinoma stage at diagnosis, access to liver transplantation, and survival. 相似文献4.
Progressive fibrosis significantly correlates with hepatocellular carcinoma in patients with a sustained virological response 下载免费PDF全文
Yoshihiko Tachi Takanori Hirai Akihiro Miyata Kei Ohara Tadashi Iida Youji Ishizu Takashi Honda Teiji Kuzuya Kazuhiko Hayashi Masatoshi Ishigami Hidemi Goto 《Hepatology research》2015,45(2):238-246
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Shoji Kubo Kazuki Oba Kazuhiro Hirohashi Hiromu Tanaka Taichi Shuto Shigekazu Takemura Takatsugu Yamamoto Akihiro Tamori Masaru Enomoto Shuhei Nishiguchi 《Hepatology research》2005,31(2):73-78
The etiologic role of alcoholic liver disease for hepatocellular carcinoma is uncertain. To assess the role of alcoholic liver disease on the development of carcinoma, we examined history of alcohol abuse and viral markers in the sera and/or resected specimens in 454 patients who underwent liver resection for hepatocellular carcinoma. Sera from 20 of the 454 patients were negative for hepatitis B, C, and D viruses. Of the 20 patients, one patient had autoimmune hepatitis, one had primary biliary cirrhosis, two had non-alcoholic steatohepatitis. Of the remaining 16 patients, 8 patients were alcohol abusers and 5 of the 8 patients were heavy alcohol abusers. Hepatitis G virus was not detected in sera form the 16 patients. Although hepatitis B x gene was detected in the cancerous and/or non-cancerous tissues in all three alcohol abusers but not heavy abusers and in 5 of 6 non-alcohol abusers whose surgical specimens were available, the gene was detected in only one of the five heavy alcohol abusers. The five heavy alcohol abusers had advanced hepatic fibrosis and active hepatitis. Alcoholic liver disease with advanced hepatic fibrosis and active hepatitis is a possible cause for the development of hepatocellular carcinoma. 相似文献
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Halla M. Ragab Nabila Abd El Maksoud Mona A. Amin Wafaa Abd Elaziz 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2021,15(1):87-92
Background and aimsCD163, a surface hemoglobin-haptoglobin scavenger receptor, is expressed on macrophages and monocytes and up-regulated during macrophage activation. This study aimed to evaluate CD163 in nonalcoholic steatohepatitis patients as a diagnostic and prognostic marker in such patients. Methods: Serum samples were collected from 41 NAFLD patients and 14 healthy controls. All cases were subjected to clinical assessment, abdominal ultrasound examination, laboratory assessment including liver function and enzymes, kidney function, and lipid profile. Fib-4 and NAFLD fibrosis score were calculated for all patients. Also, serum levels of CD163 were detected by ELISA technique. Results: The present study showed that BMI, NAFLD fibrosis score (NFS), uric acid, cholesterol, and triglyceride levels were significantly elevated in the NAFLD cases compared with healthy controls (P < 0.05). The serum level of sCD163 was considerably higher in NAFLD cases (9.97 ± 9.97 ng/ml) vs. healthy controls (1.87 ± 0.83 ng/ml) (p < 0.001). Circulating level of sCD163 was significantly higher in the obese-diabetic subjects and diabetic non-obese patients as compared with the lean healthy subjects (11.15 ± 7.69 ng/ml) and 11.46 ± 13.83 ng/ml vs. 1.87 ± 0.83 ng/ml, P < 0.05; respectively. The sensitivity and specificity of this marker was 85.4%, and 92.9 for distinguishing patients with NAFLD in obese and/or diabetic subjects from healthy controls. Conclusion: serum level of CD163 can be used as a diagnostic marker for individuals with NAFLD. However, it didn’t correlate with NAFLD fibrosis score of those patients and thus couldn’t predict the severity of disease. 相似文献
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Sarcopenia is a poor prognostic factor following hepatic resection in patients aged 70 years and older with hepatocellular carcinoma 下载免费PDF全文
Norifumi Harimoto Tomoharu Yoshizumi Masahiro Shimokawa Kazuhito Sakata Kouichi Kimura Shinji Itoh Toru Ikegami Tetsuo Ikeda Ken Shirabe Yoshihiko Maehara 《Hepatology research》2016,46(12):1247-1255
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Clinical characteristics and outcome of a cohort of 101 patients with hepatocellular carcinoma 总被引:25,自引:1,他引:25
Rabe C Pilz T Klostermann C Berna M Schild HH Sauerbruch T Caselmann WH 《World journal of gastroenterology : WJG》2001,7(2):208-215
AIM: To conduct a cohort study of 101 patients with hepatocellular carcinoma (HCC) presenting to a tertiary care medical referral center in Germany between 1997 and 1999. METHODS AND RESULTS: Data were retrospectively analyzed by chart review. In 95 cases (72 males and 23 females) sufficient data were available for analysis. Twenty five (29%) of 85 patients were HBsAg or anti HBc positive, 21/85 (25%) were anti HCV positive, and 6/85 (7%) were positive for both HBV and HCV-markers. Age was significantly lower in HBV positive patients than in the other two groups. Thirty one (34%) of 90 patients had histories of alcohol abuse. In 79/94 (84%) patients, cirrhosis was diagnosed. Of these cirrhotic patients, 29/79 (37%) belonged to Child Pugh's group (CHILD) A, 32/79 (40%) to CHILD B, and 18/79 (23%) to CHILD C. AFP was elevated in 61/91 (67%) patients. A single tumor nodule was found in 38/94 (40%), more than one nodule in 31/94 (34%), and 25/94 (26%) had a diffusely infiltrating tumor, i.e. the tumor margins could not be seen on imaging procedures. Portal vein thrombosis was present in 19/94 (20%). Imaging data consistent with lymph node metastases were found in 10/92 (11%), while distant metastases were found in 8/93 (9%). According to Okuda 28/94 (30%) were grouped to stage I, 53/94 (56%) were grouped to stage II, and 13/94 (14%) were grouped to stage II. Survival data were available for 83 patients. The Kaplan-Meier estimate for median survival was 8 4 months. Factors influencing survival were the Okuda score, the presence of portal vein thrombosis, and the presence of ascites. The presence of non complicated liver cirrhosis by itself, distant metastases, or infection with hepatitis viruses did not influence survival. AFP positivity by itself did not influence survival, though patients with an AFP value greater than 100 microg/L did experience shortened survival. Treatment besides tamoxifen or supportive care was associated with prolonged survival. The influence of therapy on survival was most pronounced in Okuda stage II patients. There was longer survival in those Okuda stage II patients who were treated with percutaneous ethanol injection. CONCLUSION: Even in a low incidence area such as Germany, the majority of HCC is caused by viral hepatitis and therefore potentially preventable. Reflecting the high proportion of advanced stage tumors in our patients, the median survival was poor. Patients who received active therapy had a longer survival. 相似文献
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Akihiko Shibamoto Tadashi Namisaki Junya Suzuki Takahiro Kubo Satoshi Iwai Fumimasa Tomooka Soichi Takeda Yuki Fujimoto Masahide Enomoto Koji Murata Takashi Inoue Yuki Tsuji Yukihisa Fujinaga Norihisa Nishimura Koh Kitagawa Hiroaki Takaya Kosuke Kaji Hideto Kawaratani Takemi Akahane Akira Mitoro Hitoshi Yoshiji 《Hepatology research》2023,53(8):713-722
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肝硬变肝癌的细菌感染 总被引:6,自引:0,他引:6
目的进行肝硬变肝癌患者细菌感染的流行病学研究。方法回顾性地研究了719例肝硬变肝癌患者各种细菌感染的发生率。结果全组细菌感染发生率为15.4%,当肝硬变程度按 Child-Pugh 分级时,A 级感染率为2.3%,B 级为8.0%,C 级为26.4%,随着肝硬变程度的加剧,细菌感染率越高,严重的细菌感染发生在 B 级和 C 级肝硬变肝癌患者。结论肝癌患者对细菌的易感性主要与肝硬变有关,而与肝癌本身无关。 相似文献
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Ho Joong Choi Dong Goo Kim Gun Hyung Na Jae Hyun Han Tae Ho Hong Young Kyoung You 《World journal of gastroenterology : WJG》2013,19(29):4737-4744
AIM: To investigate risk factors for hepatocellular carcinoma (HCC) recurrence after living donor liver transplantation (LDLT) and efficacy of various criteria. METHODS: From October 2000 to November 2011, 233 adult patients underwent LDLT for HCC at our institution. After excluding nine postoperative mortality cases, we analyzed retrospectively 224 patients. To identify risk factors for recurrence, we evaluated recurrence, disease-free survival (DFS) rate, survival rate, and various other factors which are based on the characteristics of both the patient and tumor. Additionally, we developed our own criteria based on our data. Next, we compared our selection criteria with various tumor-grading scales, such as the Milan criteria, University of California, San Francisco (UCSF) criteria, TNM stage, Barcelona Clinic Liver Cancer (BCLC) stage and Cancer of the Liver Italian Program (CLIP) scoring system. The median follow up was 68 (6-139) mo.RESULTS: In 224 patients who received LDLT for HCC, 37 (16.5%) experienced tumor recurrence during the follow-up period. The 5-year DFS and overall survival rates after LDLT in all patients with HCC were 80.9% and 76.4%, respectively. On multivariate analysis, the tumor diameter {5 cm; P < 0.001; exponentiation of the B coefficient [Exp(B)], 11.89; 95%CI: 3.784-37.368} and alpha fetoprotein level [AFP, 100 ng/mL; P = 0.021; Exp(B), 2.892; 95%CI: 1.172-7.132] had significant influences on HCC recurrence after LDLT. Therefore, these two factors were included in our criteria. Based on these data, we set our selection criteria as a tumor diameter ≤ 5 cm and AFP ≤ 100 ng/mL. Within our new criteria (140/214, 65.4%), the 5-year DFS and overall survival rates were 88.6% and 81.8%, respectively. Our criteria (P = 0.001), Milan criteria (P = 0.009), and UCSF criteria (P = 0.001) showed a significant difference in DFS rate. And our criteria (P = 0.006) and UCSF criteria (P = 0.009) showed a significant difference in overall survival rate. But Milan criteria did not show significan 相似文献