Histopathologic characteristics of colorectal cancer with liver metastasis

PURPOSE: Although prognostic factors of colorectal cancer have been studied, factors associated with liver metastasis have not been fully investigated. The aim of this study was to clarify the histopathologic characteristics of colorectal cancer with liver metastasis. METHODS: We performed a retrospective histopathologic study on 335 patients who underwent resection of colorectal cancer during 15 years. Histopathologic parameters of tumors with liver metastasis were compared with those without liver metastasis. RESULTS: Forty-one patients (12 percent) had simultaneous liver metastasis. Tumors having liver metastasis, when compared with those not having liver metastasis, were characterized by high frequency of tumor size more than 6 cm (51vs. 28 percent;P<0.01), presence of serosal invasion (98vs. 66 percent;P<0.01), lymphatic invasion (34vs. 15 percent;P<0.01), venous invasion (24vs. 3 percent;P<0.01), and lymph node metastasis (85vs. 39 percent;P<0.01). Multivariate analysis showed that factors independently associated with liver metastasis were serosal invasion, venous invasion, and lymph node metastasis. Accuracy in the diagnosis of liver metastasis was highest for venous invasion (88 percent) and lowest for serosal invasion (41 percent). Among 98 patients with both serosal invasion and lymph node metastasis, tumors with and without liver metastasis were different in frequency of venous invasion (26vs. 6 percent;P<0.01) and extracolic lymph node metastasis (68vs. 47 percent;P<0.05). CONCLUSION: In colorectal cancer important factors associated with liver metastasis were serosal invasion, venous invasion, and lymph node metastasis. Significant determinants for liver metastasis from colorectal cancer were venous invasion and extracolic lymph node metastasis.Presented at the meeting of The Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan, July 4, 1997.     

18F-fluoromisonidazole positron emission tomography may be applicable in the evaluation of colorectal cancer liver metastasis

BackgroundPositron emission tomography (PET) imaging is a non-invasive functional imaging method used to reflect tumor spatial information, and to provide biological characteristics of tumor progression. The aim of this study was to focus on the application of ¹⁸F-fluoromisonidazole (FMISO) PET quantitative parameter of maximum standardized uptake value (SUVmax) ratio to detect the liver metastatic potential of human colorectal cancer (CRC) in mice.MethodsColorectal liver metastases (CRLM) xenograft models were established by injecting tumor cells (LoVo, HT29 and HCT116) into spleen of mice, tumor-bearing xenograft models were established by subcutaneously injecting tumor cells in the right left flank of mice. Wound healing assays were performed to examine the ability of cell migration in vitro. ¹⁸F-FMISO uptake in CRC cell lines was measured by cellular uptake assay. ¹⁸F-FMISO-based micro-PET imaging of CRLM and tumor-bearing mice was performed and quantified by tumor-to-liver SUVmax ratio. The correlation between the ¹⁸F-FMISO SUVmax ratio, liver metastases number, hypoxia-induced factor 1α (HIF-1α) and serum starvation-induced glucose transporter 1 (GLUT-1) was evaluated using Pearson correlation analysis.ResultsCompared with HT29 and HCT116, LoVo-CRLM mice had significantly higher liver metastases ratio and shorter median survival time. LoVo cells exhibited stronger migration capacity and higher radiotracer uptake compared with HT29 and HCT116 in in vitro. Moreover, ¹⁸F-FMISO SUVmax ratio was significantly higher in both LoVo-CRLM model and LoVo-bearing tumor model compared to models established using HT29 and HCT116. In addition, Pearson correlation analysis revealed a significant correlation between ¹⁸F-FMISO SUVmax ratio of CRLM mice and number of liver metastases larger than 0.5 cm, as well as between ¹⁸F-FMISO SUVmax ratio and HIF-1α or GLUT-1 expression in tumor-bearing tissues.Conclusions¹⁸F-FMISO parameter of SUVmax ratio may provide useful tumor biological information in mice with CRLM, thus allowing for better prediction of CRLM and yielding useful radioactive markers for predicting liver metastasis potential in CRC.     

(18)F-DG PET/CT in detection of recurrence and metastasis of colorectal cancer

AIM To evaluate the value of 18F-DG PET/CT in detecting recurrence and/or metastasis of colorectal cancer (CRC).METHODS Combined visual analysis with semiquantitative analysis, the 18F-DG PET/CT wholebody imaging results and the corresponding clinical data of 68 postoperative CRC patients including 48 male and 20 female with average age of 58.1 were analyzed retrospectively.RESULTS Recurrence and/or metastasis were confirmed in 56 patients in the clinical follow-up after the PET/CT imaging. The sensitivity of PET/CT diagnosis of CRC recurrence and/or metastasis was 94.6%, and the specificity was 83.3%. The positive predictive value (PPV)was 96.4% and the negative predictive value (NPV) was 76.9%. PET/CT imaging detected one or more occult malignant lesions in 8 cases where abdominal/pelvic CT and/or ultrasonography showed negative findings, and also detected more lesions than CT or ultrasonography did in 30.4% (17/56) cases. Recurrence and/or metastasis was detected in 91.7% (22/24) cases with elevated serum CEA levels by 18F-DG PET/CT imaging.CONCLUSION 18F-DG PET/CT could detect the recurrence and/or metastasis of CRC with high sensitivity and specificity.     

结直肠癌肝转移的治疗进展

结直肠癌的发病率和死亡率逐年上升,肝转移是主要死因。本文阐述了目前临床上使用较多的治疗方式及进展。分为系统性治疗,包括了新辅助化疗、转化治疗和分子靶向治疗;及局部治疗,包括手术切除、放射治疗、射频消融及介入治疗等。各种治疗手段各有优缺点,多学科综合治疗团队模式的推广,将为结直肠癌肝转移患者制定出较适合的方案,实现个体化治疗。     

Fascioliasis presenting as colon cancer liver metastasis on 18Ffluorodeoxyglucose positron emission tomography/computed tomography: A case report

BACKGROUND Fascioliasis is caused by watercress and similar freshwater plants or drinking water or beverages contaminated with metacercariae. Fascioliasis can radiologically mimic many primary or metastatic liver tumors. Herein, we aimed to present the treatment process of a patient with fascioliasis mimicking colon cancer liver metastasis.CASE SUMMARY A 35-year-old woman who underwent right hemicolectomy due to cecum cancer was referred to our clinic for management of colon cancer liver metastasis. Both computed tomography and 18 F-fluorodeoxyglucose positron emission tomography revealed several tumoral lesions localized in the right lobe of the liver. After a 6-course FOLFOX(folinic acid, fluorouracil, oxaliplatin) and bevacizumab regimen, the hypermetabolic state on both liver and abdominal lymph nodes continued, and chemotherapy was extended to a 12-course regimen. The patient was referred to our institute when the liver lesions were detected to be larger on dynamic liver magnetic resonance imaging 6 weeks after completion of chemotherapy. Right hepatectomy was performed, andhistopathological examination was compatible with fascioliasis. Fasciola hepatica Ig G enzyme-linked immunosorbent assay was positive. The patient was administered two doses of triclabendazole(10 mg/kg/dose) 24 h apart. During the follow-up period, dilatation was detected in the common bile duct, and Fasciola parasites were extracted from the common bile duct by endoscopic retrograde cholangiopancreatography(ERCP). Triclabendazole was administered to the patient after ERCP.CONCLUSION Parasitic diseases, such as those caused by Fasciola hepatica, should be kept in mind in the differential diagnosis of primary or metastatic liver tumors, such as colorectal cancer liver metastasis, in patients living in endemic areas.     

Hepatectomy for liver metastasis of colorectal cancer

Objective  The objective of this study was to investigate whether hepatic resection (HR) can increase the survival of liver metastasis of colorectal cancer (CRC). Materials and methods  CRC patients (n = 669) with liver metastasis treated at the Zhongshan Hospital, Fudan University from 1/2000 to 7/2007 were included in the study to investigate the relationship between HR and cancer survival. Results  CRC patients (n = 669) with liver metastases who had primary tumor resection were grouped in synchronous liver metastasis (SLM; 56.7%, n = 379) and metachronous liver metastasis (MLM) groups (43.3%, n = 290). Hepatic resection rates were lower (32.5%, n = 123) in the SLM than the MLM group (44.8%, n = 130, P < 0.05). The 30-day mortality rate in the MLM (2.3%) was significantly lower than SLM (2.4%) groups. The 5-year survival rates (36.6%) was same compared to SLM group (33.1%, P > 0.05). One-, 2-, and 3-year survival of stages I and II operation cases were 92.5% vs 86.5%, 0.7% vs 58.0%, and 42.1% vs 44.9% (P > 0.05) in the SLM group, respectively. Recurrence after first hepatic resection associated with a 2.23-fold increased risk of death (P < 0.01). Incision margins larger than 1 cm and HR for recurrence associated with 34% and 27% (P < 0.05) decreased death risk. Conclusions  Hepatic resection could help the survival of liver metastasis of colorectal cancer, and stage I surgery is safe for this disease. Xu Jianmin, Wei Ye, and Zhong Yunshi contributed equally to this paper.     

Preoperative evaluation of colorectal cancer using CT colonography,MRI, and PET/CT

Imaging studies are a major component in the evaluation of patients for the screening,staging and surveillance of colorectal cancer.This review presents commonly encountered findings in the diagnosis and staging of patients with colorectal cancer using computed tomography(CT)colonography,magnetic resonance imaging(MRI),and positron emission tomography(PET)/CT colonography.CT colonography provides important information for the preoperative assessment of T staging.Wall deformities are associated with muscular or subserosal invasion.Lymph node metastases from colorectal cancer often present with calcifications.CT is superior to detect calcified metastases.Three-dimensional CT to image the vascular anatomy facilitates laparoscopic surgery.T staging of rectal cancer by MRI is an established modality because MRI can diagnose rectal wall laminar structure.N staging in patients with colorectal cancer is still challenging using any imaging modality.MRI is more accurate than CT for the evaluation of liver metastases.PET/CT colonography isvaluable in the evaluation of extra-colonic and hepatic disease.PET/CT colonography is useful for obstructing colorectal cancers that cannot be traversed colonoscopically.PET/CT colonography is able to localize synchronous colon cancers proximal to the obstruction precisely.However,there is no definite evidence to support the routine clinical use of PET/CT colonography.     

18F-FDG PET-CT显像在胰腺转移癌中的应用价值

目的 分析胰腺转移癌的PET-CT表现,提高对该病变的检出率.方法 回顾性分析31例经临床确诊的胰腺转移癌的PET-CT图像,并与26例胰腺原发癌进行比较.由两位经验丰富的专科医师在融合图像上确定病灶所在位置,经过帧对帧的图像分析,确认病灶放射性摄取明显高于周围正常胰腺者为阳性.沿PET所示病灶边缘勾画感兴趣区,由工作站自动算出最大标准摄取值（SUVmax）,SUVmax＞ 2.5为阳性病灶.结果 31例胰腺转移癌的原发灶为肺癌22例,胃癌及结肠癌各2例,上颌窦癌、甲状腺癌、黑色素瘤、胆囊癌及肾癌各1例.21例（67.7％）为单发,10例（32.3％）为多发或弥漫性病灶.单发病灶中7例（33.3％）位于胰头颈部,14例（66.7％）位于胰体尾部.26例原发胰腺癌18例（69.2％）位于胰头颈部,8例（30.8％）位于胰体尾部.胰腺转移癌与原发癌的发生部位差异具有统计学意义（x2 =6.102,P=0.014）.CT平扫仅发现17例胰腺有病灶,呈结节状,略低密度,大部分病灶边界欠清晰.31例转移性胰腺癌PET显像均显示病灶,平均SUVmax为7.42±3.48,显著高于胰腺原发癌的5.39±1.71 （F=4.87,P=0.032）.此外,PET-CT同时发现30例有其他脏器或淋巴结转移.结论 18F-FDG PET-CT在检出并诊断胰腺转移癌中有毋庸置疑的优势.     

Radiomics in colorectal cancer patients

The main therapeutic options for colorectal cancer are surgical resection and adjuvant chemotherapy in non-metastatic disease. However,the evaluation of the overall adjuvant chemotherapy benefit in patients with a high risk of recurrence is challenging. Radiological images can represent a source of data that can be analyzed by using automated computer-based techniques,working on numerical information coded within Digital Imaging and Communications in Medicine files: This image numerical analysis...     

术前血清CEA、CA19-9、CA50联合检测在结直肠癌肝转移预测中的应用

目的研究术前血清CEA、CA19-9、CA50联合检测在结直肠癌肝转移预测中的应用价值。 方法选择2015年1月至2017年1月在中国医学科学院肿瘤医院接受手术治疗的结直肠癌患者316例为研究对象,其中结直肠癌伴有肝转移的患者158例作为实验组,并按照性别、年龄等匹配结直肠癌不伴有肝转移的患者158例作为对照组。对所有患者的术前血清癌胚抗原（CEA）、糖类抗原19-9（CA19-9）以及糖类抗原50（CA50）进行检测,采用单因素及多因素分析以上肿瘤标志物单独或联合检测在结直肠癌肝转移中的预测价值。 结果单因素及多因素分析结果表明,术前血清CEA、CA19-9、CA50升高与结直肠癌发生肝转移显著相关（P<0.05）,CEA、CA19-9、CA50单独预测结直肠癌肝转移的敏感度分别为62.7%、57.4%、67.1%;特异度分别为58.2%、53.5%、56.6%。CEA、CA19-9、CA50联合诊断预测直肠癌肝转移的敏感度和特异度分别为74.3%、76.3%。 结论术前血清CEA、CA19-9、CA50升高是结直肠癌肝转移的独立预测因素,但三者单独预测结直肠癌肝转移的敏感度和特异度均较低。三者联合检测对于预测结直肠癌肝转移的敏感度和特异度均较高,可以作为结直肠癌肝转移的预测模型。     

Diagnostic accuracy of fluorine-18-fluorodeoxyglucose positron emission tomography in gallbladder cancer: A meta-analysis

AIM: To meta-analyze published data about the diagnostic accuracy of fluorine-18-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET) and PET/computed tomography (PET/CT) in the evaluation of primary tumor in patients with gallbladder cancer (GBCa).METHODS: A comprehensive literature search of studies published through 30^th June 2014 regarding the role of ¹⁸F-FDG PET and PET/CT in the evaluation of primary gallbladder cancer (GBCa) was performed. All retrieved studies were reviewed. Pooled sensitivity and specificity of ¹⁸F-FDG PET or PET/CT in the evaluation of primary GBCa were calculated. The area under the summary receiving operator characteristics curve (AUC) was calculated to measure the accuracy of these methods. Sub-analyses considering the device used (PET vs PET/CT) were carried out.RESULTS: Twenty-one studies comprising 495 patients who underwent ¹⁸F-FDG PET or PET/CT for suspicious GBCa were selected for the systematic review. The meta-analysis of 13 selected studies provided the following results: sensitivity 87% (95%CI: 82%-92%), specificity 78% (95%CI: 68%-86%). The AUC was 0.88. Improvement of sensitivity and specificity was observed when PET/CT was used.CONCLUSION: ¹⁸F-FDG-PET and PET/CT demonstrated to be useful diagnostic imaging methods in the assessment of primary tumor in GBCa patients, nevertheless possible sources of false-negative and false-positive results should be kept in mind. PET/CT seems to have a better diagnostic accuracy than PET alone in this setting.     

Novel experimental models of human cancer metastasis in nude mice: Lung metastasis,intraabdominal carcinomatosis with ascites,and liver metastasis

Summary The ability of RPMI4788 cells, a human colon cancer cell line, to produce experimental metastases in the lung, intraperitoneal cavity, and liver was studied in nude mice. Injection of 2×10⁶ tumor cells into the tail vein of nude mice produced metastatic lung tumors, and an intraportal injection of 5×10⁶ cells produced metastatic liver tumors. An intraabdominal carcinomatosis with ascites was formed after an i.p. injection of 5×10⁶ tumor cells. The nude mice with lung metastasis or intraabdominal carcinomatosis always died within a few weeks. Macroscopic observation showed that the number of lung metastatic nodules on day 21 after tumor inoculation was 311.3±78.2 (mean±SD) in BALB/C nude mice, and 187.5±26.7 in ICR nude mice. In survival experiments, the mice with intraabdominal carcinomatosis showed a mean survival of 29.0±1.7 (mean±SD) days in BALB/C nude mice and 43.6±6.1 days in ICR nude mice. These novel experimental models of metastases in nude mice produced by injection of RPMI4788 cells had high reproducibility and may be useful not only for the study of the metastatic process but also for testing anticancer drugs.     

大肠癌肝转移的外科治疗

在大肠癌的自然进程中,约50%以上的患者出现肝转移,肝转移是晚期大肠癌死亡的主要原因。根治性手术切除是大肠癌肝转移患者唯一的治愈机会。然而初始可切除的患者比例非常小,所以转化性化疗联合靶向治疗、介入治疗及放疗使这些患者得到手术根治的机会,可以延长生存期、改善生存质量。     

结直肠癌患者组织中miR-99a和miR-100表达水平与肿瘤转移的关系

目的 探讨结直肠癌组织中miR-99a、miR-100的表达水平与肿瘤转移的关系.方法 收集2014年1月至2019年1月台州市第一人民医院收治的84例行手术治疗的结直肠癌患者的肿瘤组织、癌旁组织和正常组织标本,采用实时荧光定量PCR法检测各组织中miR-99a、miR-100的表达水平,收集患者的临床病理参数及随访情...     

Clinical usefulness of ^18F-FDG PET/CT in the restaging of esophageal cancer after surgical resection and radiotherapy

AIM： To evaluate the clinical usefulness of lSF-fluorodeoxyglucose positron emission and computed tomography QSF-FDG PET/CT） in restaging of esophageal cancer after surgical resection and radiotherapy. METHODS： Between January 2007 and Aug 2008, twenty histopathologically diagnosed esophageal cancer patients underwent 25 PET/CT scans （three patients had two scans and one patient had three scans） for restaging after surgical resection and radiotherapy. The standard reference for tumor recurrence was histopathologic confirmation or clinical follow-up for at least ten months after ^18F-FDG PET/CT examinations. RESULTS： Tumor recurrence was confirmed histopathologically in seven of the 20 patients （35%） and by clinical and radiological follow-up in 13 （65%）. ^18F-FDG PET/CT was positive in 14 patients （68.4%） and negative in six （31.6%）. ^18F-FDG PET/CT was true positive in 11 patients, false positive in three and true negative in six. Overall, the accuracy of ^18F-FDG PET/CT was 85%, negative predictive value （NPV） was 100%, and positive predictive value （PPV） was 78.6%.The three false positive PET/CT findings comprised chronic inflammation of mediastinal lymph nodes （n = 2） and anastomosis inflammation （n = 1）. PET/ CT demonstrated distant metastasis in 10 patients. ^18F-FDG PET/CT imaging-guided salvage treatment in nine patients was performed. Treatment regimens were changed in 12 （60%） patients after introducing ^18F-FDG PET/CT into their conventional post-treatment follow-up program. CONCLUSION： Whole body ^18F-FDG PET/CT is effective in detecting relapse of esophageal cancer after surgical resection and radiotherapy. It could also have important clinical impact on the management of esophageal cancer, influencing both clinical restaging and salvage treatment of patients.     

The role of 18fluoro-deoxyglucose positron emission tomography/computed tomography in resectable pancreatic cancer

BackgroundThe role of ¹⁸fluoro-deoxyglucose positron emission tomography/computed tomography in pancreatic ductal adenocarcinoma is debated. We retrospectively assessed the value of ¹⁸fluoro-deoxyglucose positron emission tomography/computed tomography in addition to conventional imaging as a staging modality in pancreatic cancer.Methods¹⁸Fluoro-deoxyglucose positron emission tomography/computed tomography was performed in 72 patients with resectable pancreatic carcinoma after multi-detector computed tomography positron emission tomography was considered positive for a maximum standardized uptake value >3.ResultsOverall, 21% of patients had a maximum standardized uptake value ≤3, and 60% of those had undergone neoadjuvant treatment (P = 0.0001). Furthermore, 11% of patients were spared unwarranted surgery since positron emission tomography/computed tomography detected metastatic disease. All liver metastases were subsequently identified with contrast-enhanced ultrasound. Sensitivity and specificity of positron emission tomography/computed tomography for distant metastases were 78% and 100%. The median CA19.9 concentration was 48.8 U/mL for the entire cohort and 292 U/mL for metastatic patients (P = 0.112).ConclusionsThe widespread application of ¹⁸fluoro-deoxyglucose positron emission tomography/computed tomography in patients with resectable pancreatic carcinoma seems not justified. It should be considered in selected patients at higher risk of metastatic disease (i.e. CA19.9 > 200 U/mL) after undergoing other imaging tests. Neoadjuvant treatment is significantly associated with low metabolic activity, limiting the value of positron emission tomography in this setting.     

Serological diagnostic factors for liver metastasis in patients with colorectal cancer

AIM:To investigate the serological diagnostic factors for liver metastasis in patients with colorectal cancer.METHODS:One hundred and six adult in-patients with colorectal cancer were studied and divided into patients with liver metastasis(n = 56) and patients without liver metastasis(n = 50).Serum levels of tumor and biochemical markers for liver were measured at the time of diagnosis.RESULTS:The mean survival time was 55.9 mo,36.8 mo and 68.3 mo for the overall patients,patients with liver metastasis and ...     

Macroscopic portal vein tumor thrombi of liver metastasis from colorectal cancer

We present a case of multiple colorectal liver metastases with macroscopic portal vein thrombi. A 55-year-old woman presented to us with rectosigmoid cancer and presented with two liver metastases. The tumor in the posterior sector was associated with invasion of first order branches of the portal vein. We performed low anterior resection, hepatic posterior sectorectomy and partial left anterior sectorectomy. Both the colorectal cancer and liver tumors exhibited histological characteristics of moderately differentiated adenocarcinoma with a substantial amount of mucin production. The liver metastases were associated with prominent tumor thrombi in many branches of the portal vein. Stronger staining for endoglin (CD 105) than for Fas ligand (Fas L) and matrix metalloproteinase (MMP-2) was observed in both the colorectal cancer and metastatic liver tumor cells. Expression of the vascular endothelial growth factor within the tumor cells was seen in both the colorectal cancer as well as the metastatic liver tumor cells. Six months after the operation, she was diagnosed to have multiple, more than about 20 liver metastases, and in 9 months after the operation, the patient died. The colorectal cancer with liver metastases associated with portal vein tumor thrombosis was poor prognosis, found neoplastic microvessel formation.     

Invasion and metastasis of liver cancer: expression of intercellular adhesion molecule 1

To study the relationship between intercellular adhesion molecule 1 (ICAM-1) and liver cancer metastasis and to find predicting factors that could indicate the growth and metastasis of liver cancer. Methods: ICAM-1 expression in fresh tissue of normal liver and hepatocellular cancer (HCC) was examined by immunoperoxidase staining. Serum soluble intercellular adhesion molecule 1 (sICAM-1) from patients with a benign HCC tumor, and the expression of ICAM-1 in the orthotopically transplanted LCI-D20 tumor of a nude mouse liver cancer metastasis model, and in human hepatoma, the tumor surrounding tissue and normal liver, was analyzed semiquantitatively by the immuno-dot blot method. Tissue ICAM-1 expression (mRNA level) was detected by Northern blotting. Results: ICAM-1 expression in LD1-20 D metastatic liver cancer had a positive correlation with tumor size and the time after implantation. It increased suddenly as metastasis occurred being 3.03 ± 0.51 before metastasis and 8.24 ± 0.95 after metastasis, P < 0.01, then remained high, appending on the number of sites involved (monosite metastasis 5.48 ± 0.49, multisite metastasis 10.05 ± 1.17, P < 0.05). All six cases of normal liver samples were negative in anti-ICAM-1 immunohistochemical staining, 80.0% (36/45) of the HCC showed some ICAM-1 expression. The rate of positive cells was a little higher in large tumors, tumors with an intact capsule and tumors with metastasis, but there was no significant difference. It was noticed that two cancer emboli also had high ICAM-1 expression. The ICAM-1 concentration in HCC (13.43 ± 0.09) was higher than that in tumor surrounding the liver (5.89 ± 0.17, P < 0.01) and that in normal liver (4.27 ± 0.21, P < 0.01). sICAM-1, like tissue ICAM-1, was higher in HCC patients than in patients (with benign liver tumor and normal controls. Both tissue ICAM-1 and sICAM-1 were higher in the metastasis group than in the group without metastasis (tissue ICAM-1 20.24 ± 0.30 vs 10.23 ± 0.12 P < 0.05; sICAM-1 12.18 ± 0.25 vs 9.77 ± 0.54 P < 0.05). Northern blot analysis revealed that ICAM-1 expression, as indicated by mRNA level, was also higher in HCC and in cancer emboli than in tumor surrounding liver and normal liver. Conclusions: Tissue ICAM-1 and serum sICAM-1 could indicate the stage of HCC, and the potential of hepatoma cells for invasion and metastasis. They may play an important role in the metastasis cascade. Received: 20 January 1998 / Accepted: 25 June 1998     

吲哚菁绿清除试验在结直肠癌肝转移患者化疗性肝损伤评估中的作用

手术是目前结直肠癌肝转移患者获得生存延长的最佳治疗手段,临床实践中多数结直肠癌肝转移患者需要术前化疗,而化疗性肝损伤的严重程度及其对围术期安全性的影响亟须精确评估。吲哚菁绿（ICG）清除试验是肝储备功能定量检测的手段之一。对于肝硬化造成永久性的肝损伤,ICG试验可以精准地反映其肝储备功能的异常。但ICG试验能否反映化疗性肝损伤对肝储备功能的影响尚存在争议。本综述将从ICG试验反映肝储备功能的原理、应用及ICG指标异常与化疗性肝损伤有无和严重程度的相关性,以及与肝切除安全性的关系和ICG指标的影响因素等多个角度进行文献归纳总结,探讨ICG试验在化疗性肝损伤的评估中的作用。