Androgen receptors in hepatocellular carcinoma and surrounding liver: relationship with tumor size and recurrence rate after surgical resection

Background/Aims: This study aimed to evaluate the parameters associated with the presence of androgen receptors in hepatocellular carcinoma and surrounding non-tumoral liver. Furthermore, we have assessed whether androgen receptor positively influences disease recurrence after surgical resection.Methods: Androgen receptor concentration was calculated by receptor binding assay in tumoral and non-tumoral liver in 43 patients (40 of them with cirrhosis) with hepatocellular carcinoma who underwent surgical resection.Results: Androgen receptors were found in 28 of the tumoral and in 30 of the non-tumoral samples, at concentrations ranging between 5 and 211 fmol/mg protein. The presence of androgen receptors within the tumor was significantly related to a smaller tumor size. Thereby, 22 of the 29 nodules ≤3 cm contained androgen receptors, while this occurred in only six of the 14 tumors larger than 3 cm (p<0.05). In contrast, the only parameter associated with the presence of androgen receptors in the non-tumoral liver was a lower gamma-glutamyltranspeptidase concentration. Disease recurrence after surgical resection was not only related to some tumor characteristics (increased alfa-fetoprotein concentration, presence of satellites, differentiation degree), but also to the presence of androgen receptors in the surrounding liver. Thus, the probability of recurrence after 1- and 2-year follow up in patients with androgen-positive livers was 33% and 50%, respectively, while it was 0% and 20% in those with androgen-negative livers (p<0.05). In contrast, the presence of androgen receptors within the tumor was not associated with a higher recurrence rate.Conclusions: These results show that only two thirds of hepatocellular carcinomas contained androgen receptors and that this feature was more frequent in small tumors. In addition, our data indicate that the presence of androgen receptors within the tumor does not imply a different outcome after surgical resection. In contrast, the presence of these receptors in the surrounding non-tumoral liver may be considered a risk factor for a higher incidence of disease recurrence.     

兔肝VX2瘤血供程度对HIFU作用效果影响的初步研究

目的 探讨兔肝VX2瘤实质期血供程度对高能聚焦超声(HIFU)后肿瘤靶点处温度及凝固性坏死体积(V)大小的影响,为进一步精确控制HIFU剂量、提高治疗效率提供实验依据.方法 制作瘤兔24只并分成:10、15、20 d、无血供组(10 d成模后处死)4组,在对应时间进行相同参数HIFU辐照,对靶点实时测温,做出时间-温度曲线(TTC),测量V,对坏死周边残存肿瘤组织及正常肝组织进行微血管密度(MVD)计数.结果 (1)肿瘤MVD:10 d组＞15 d组＞20 d组(P＜0.05).(2)峰值温度(Tmax)、峰值时间(T1)、温升斜率(k1):10 d组、15 d组、20 d组之间比较差异无统计学意义(P＞0.05),此三组与无血供组比较差异有统计学意义(P＜0.05).(3)温降斜率(k2):10 d组＞15d组＞20 d组＞无血供组(P＜0.05);温降时间(T2):10 d组＜15 d组＜20 d组＜无血供组(P＜0.05);(4)V:10 d组＜15 d组＜20 d组＜无血供组(P＜0.05).结论 肿瘤血供程度对HIFU“温升”过程无显著影响,而对“冷却”过程有显著的影响.肿瘤血供越丰富,辐照后散热越快,组织越易恢复到正常温度,形成V越小.     

Epigenetic effects of ethanol on liver and gastrointestinal injury

INTRODUCTIONEthanol actions are diverse and fascinatingly complex. Chronic ethanol causes injury to almost all organ systems including liver and gastrointestine (GI)[1] and has serious medical and public health implications[2]. Alcohol increases the risk …     

Hepatic expression of A disintegrin and metalloproteinase (ADAM) and ADAMs with thrombospondin motives (ADAM-TS) enzymes in patients with chronic liver diseases

BACKGROUND/AIMS: ADAMs (A Disintegrin And Metalloprotease) are multifunctional, membrane-bound and soluble cell surface glycoproteins with numerous functions in cell physiology. We assessed the expression of ADAMs in fibrotic liver disease of different aetiologies and clarified whether the expression of ADAMs is related to histological staging of fibrosis. In addition, the expression of ADAMs was determined in different cell types of liver. METHODS: Seventy-one biopsy samples from patients with chronic liver diseases were analyzed for mRNA expression of ADAM-8, -9, -12, -28, -TS1, -TS2, matrix metalloprotease (MMP)-2, -9 and tissue inhibitor of metalloproteinases-1 and -2 by quantitative real-time RT-PCR. RESULTS: The ADAM expression in liver injury is independent of aetiology. A strong correlation between ADAM -9, -28, -TS1 versus MMP-2 and SMA was identified. Activated hepatic stellate cells (HSC) showed increased mRNA expression of ADAM-8, -9, -12, -28, -TS2 compared to quiescent HSC. Significant differences between histological stages of fibrosis were found for ADAM-28, MMP-2 and MMP-9. CONCLUSIONS: The results suggest that ADAMs are differentially expressed in the liver. We assume that ADAM-9, -TS1 and -TS2 play a crucial role in extracellular matrix remodeling during fibrotic processes in the liver.     

经静脉二次谐波超声造影对正常兔肝造影分期的声学定量分析

目的　利用声学定量技术对正常兔肝的超声造影分期进行探讨。方法　对 10只健康大白兔进行二次谐波超声造影 ,观察经耳缘静脉注射造影剂时 ,门静脉主干血流阻断前后 ,肝组织声学定量 (AD)曲线形态及测值变化 ;及经耳缘静脉和经肠系膜静脉注射造影剂时 ,肝组织AD曲线形态及测值变化。结果　经耳缘静脉注射造影剂 ,正常兔肝组织AD曲线形态呈单峰形 ,近似直角三角形 ,可分为上升段、高峰段和下降段 ,峰值密度(PI)值为 (18.4± 1.7)dB。上升段为肝动脉期 ,高峰段和下降段均为门静脉期 ;门静脉主干血流阻断后 ,肝组织AD曲线形态与阻断前基本相似 ,但峰值略减低 ,其PI值平均减低 2dB。经耳缘静脉注射造影剂后 10～ 15s再经肠系膜静脉注射造影剂 ,肝组织AD曲线呈“驼峰征” ,第二个峰高于第一个峰。结论　正常兔肝声学造影肝动脉期短暂 ,门静脉期长。肝组织回声增强主要由于肝动脉来源造影剂所致 ,门静脉来源造影剂增强幅度低 ,仅起次要作用     

Radiographic contribution to diagnosis and treatment of complications from peritoneoscopy

Peritoneoscopy is a valuable nonsurgical procedure for evaluating patients with malignant disease. Directed biopsies of suspected tumor masses may be obtained, and peritoneoscopy can frequently obviate the need for laparotomy. Although the complication rate is low, the radiologist must be aware of potential problems. Radiologists may participate not only in the diagnosis and localization of these complications but also in their therapy by interventional techniques. The radiographic findings in four patients with complications of peritoneoscopy are presented.     

囊性肝包虫病自然发展规律的探讨

本文对Ｂ超诊断并经手术病理证实的９１５例共１３７２个肝包虫囊肿（简称肝包囊）进行了分类研究。分析认为：肝包囊病经历着从发生发展到死亡的自然过程，其中人体对包囊病的免疫防御和修复机能可能起着重要作用，不同类型包囊代表着肝包囊病不同的自然发展阶段。     

肝癌内放射治疗的并发症及其防治

目的 :观察磷微球治疗晚期肝癌的并发症并探讨其防治方法。方法 :1994年至 1998年 ,采用3 2 磷 -玻璃微球 (phosphorus- 32glassmicrospheres,3 2 P -GMS) 2 6 - 17 9mCi,术中栓塞法附加肝动脉结扎及置管化疗 2 3例 (OAE +HAL) ,经Seldinger导管栓塞法 2 1例 (TAE) ,以纯甘油或碘化油作媒介加化疗药制成放化疗综合性栓塞液。结果 :全组OAE +HAL组副反应高于TAE组 ;均无骨髓抑制和肾毒性 ;肝功能指标多呈一过性改变 ,4例肝功恶化 ;肺、脾、胆、胰异位栓塞各为 2、1、4、2例。 4 4例肿瘤缩小率为 4 6 7± 2 4 5 % (0 - 91 8% ) ,9/2 3例癌栓缩小 ,2 5 /2 7例AFP下降 ,肿瘤稳定期 5 3± 3 9月 ,平均生存 12 5± 9 2月。结论 :3 2 P -GMS可成为治疗肝癌安全有效的临床医用生物材料。良好的病例选择、合理的内照射剂量是有效降低术后近期并发症和提高远期疗效的关键。     

Stimulated acoustic emission to image a late liver and spleen-specific phase of Levovist in normal volunteers and patients with and without liver disease

Quantitative studies were performed to investigate liver- specific uptake of the microbubble Levovist®, using stimulated acoustic emission (SAE), which can detect microbubbles even when stationary or slow-moving. These comprised studies of biodistribution comparing the liver and kidney in five normal volunteers, reproducibility in 34 patients, comparison between cirrhotics and controls (n = 9 each) and maximal depth of effect at different frequencies (180 measurements in 31 patients). Stimulated acoustic emission lasted beyond 30 min, with strongly liver-specific properties in each volunteer and was highly reproducible. No difference in the amount of SAE in the superficial liver was seen between cirrhotic and normal livers, but attenuation was higher in cirrhotics. This demonstrates a frequency-dependent effect on liver SAE penetration. We conclude that the liver uptake of Levovist® lasts over 30 min, is reproducible, occurs even where diffuse liver disease is present and can be used to assess tissue attenuation in a novel fashion.