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2.
Artigo em Inglês | MEDLINE | ID: mdl-37988203

RESUMO

In the rapidly advancing ubiquitous intelligence society, the role of data as a valuable resource has become paramount. As a result, there is a growing need for the development of autonomous economic agents (AEAs) capable of intelligently and autonomously trading data. These AEAs are responsible for acquiring, processing, and selling data to entities such as software companies. To ensure optimal profitability, an intelligent AEA must carefully allocate its portfolio, relying on accurate return estimation and well-designed models. However, a significant challenge arises due to the sensitive and confidential nature of data trading. Each AEA possesses only limited local information, which may not be sufficient for training a robust and effective portfolio allocation model. To address this limitation, we propose a novel data trading market where AEAs exclusively possess local market information. To overcome the information constraint, AEAs employ federated learning (FL) that allows multiple AEAs to jointly train a model capable of generating promising portfolio allocations for multiple data products. To account for the dynamic and ever-changing revenue returns, we introduce an integration of the histogram of oriented gradients (HoGs) with the discrete wavelet transformation (DWT). This innovative combination serves to redefine the representation of local market information to effectively handle the inherent nonstationarity of revenue patterns associated with data products. Furthermore, we leverage the transform domain of local model drifts in the global model update process, effectively reducing the communication burden and significantly improving training efficiency. Through simulations, we provide compelling evidence that our proposed schemes deliver superior performance across multiple evaluation metrics, including test loss, cumulative return, portfolio risk, and Sharpe ratio.

4.
Med Sci Monit ; 28: e938747, 2022 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-36285562

RESUMO

The manuscript is being retracted due to non-original and duplicated content in the figure images, which raise concerns regarding the credibility of the study. Reference: Wusheng Lu, Jinhuang Lin, Dequan Zheng, Chunyong Hong, Laishun Ke, Xinyu Wu, Peineng Chen. Overexpression of MicroRNA-133a Inhibits Apoptosis and Autophagy in a Cell Model of Parkinson's Disease by Downregulating Ras-Related C3 Botulinum Toxin Substrate 1 (RAC1). Med Sci Monit, 2020; 26: e922032. DOI: 10.12659/MSM.922032.


Assuntos
MicroRNAs , Doença de Parkinson , Humanos , Proteínas rac1 de Ligação ao GTP/genética , Proteínas rac1 de Ligação ao GTP/metabolismo , MicroRNAs/genética , Doença de Parkinson/genética , Autofagia/genética , Apoptose
6.
J Gastrointest Oncol ; 12(2): 762-769, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34012664

RESUMO

BACKGROUND: To evaluate the safety and efficacy of transcatheter arterial chemoembolization (TACE) with 131iodine-doxorubicin-eluting gelatin microspheres (131I-DEM TACE) compared with conventional TACE (cTACE) with polyvinyl alcohol foam (PVA) embolization microspheres. METHODS: A total of 22 patients diagnosed with hepatocellular carcinoma were equally divided into 2 groups. The patients who underwent TACE with 131I-DEM (25.7×107 Bq of 131iodine and 10 mg of doxorubicin) were compared to controls who received cTACE with PVA embolization microspheres. Therapeutic effects were evaluated by the tumor regression rates, levels of alpha-fetoprotein in serum, survival rates, and complications. RESULTS: The operative complications of the 2 groups were not significantly different (P=0.753). The radioactivity ratio of the tumor to the liver was approximately 4.1:1 for the 131I-DEM TACE group. In the 131I-DEM TACE group, 54.5% of patients achieved tumor regression of more than 50%, compared to 36.6% of patients in the cTACE group. AFP levels in serum declined in 100% of patients in the 131I-DEM TACE group and 50% of patients in the cTACE group. The median survival time of the patients was 12.0±3.3 months for the 131I-DEM TACE group and 10.0±3.3 months for the cTACE group. There were no significant differences in survival between the 2 groups (P=0.414). CONCLUSIONS: 131I-DEM may become a potential radiochemoembolization agent to treat patients with unresectable hepatocellular carcinoma through TACE.

7.
Med Sci Monit ; 26: e922032, 2020 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-32713934

RESUMO

BACKGROUND Parkinson's disease (PD) is a movement disorder. microRNA (miR)-133 expression is reduced in PD patients and in mice with a dopamine neuron deficiency. We aimed to identify the mechanism of miR-133a in apoptosis and autophagy in PD. MATERIAL AND METHODS The optimal concentration of MPP⁺ (1-methyl-4-phenylpyridinium ion) was initially determined to construct a PD cell model. Gain-of function experiments were carried out to evaluate the role of miR-133a in PD. The levels of miR-133a, RAC1 (Ras-related C3 botulinum toxin substrate 1), apoptosis-related factors, and autophagy-related factors were detected after detection of cell proliferation, cell cycle, and apoptosis. Transmission electron microscopy was applied to observe autophagosomes, and immunofluorescence staining was performed to detect LC3 and further analyze the effect of miR-133a on autophagy in a PD cell model. RESULTS Low miR-133a expression was detected in a cell model of MPP⁺-induced PD. After overexpressing miR-133a, cell proliferation increased, and apoptosis (cleaved caspase-3 and Bax levels decreased, while Bcl2 levels increased) and autophagy was inhibited (LC3II/I and Beclin-1 levels decreased, while p62 levels increased). MiR-133a targeted RAC1. RACY upregulation attenuated the inhibitory effects of miR-133a on PC12 cell apoptosis and autophagy. CONCLUSIONS Our data highlighted that miR-133a overexpression prevented apoptosis and autophagy in a cell model of MPP⁺-induced PD by inhibiting RAC1 expression.


Assuntos
MicroRNAs/genética , Doença de Parkinson/genética , 1-Metil-4-fenilpiridínio/farmacologia , Animais , Apoptose/genética , Autofagia/genética , Proliferação de Células/efeitos dos fármacos , MicroRNAs/metabolismo , Células PC12 , Doença de Parkinson/metabolismo , Doença de Parkinson/patologia , Ratos , Receptor IGF Tipo 1/genética , Receptor IGF Tipo 1/metabolismo , Proteínas rac1 de Ligação ao GTP/genética , Proteínas rac1 de Ligação ao GTP/metabolismo
8.
BMC Cancer ; 18(1): 216, 2018 02 21.
Artigo em Inglês | MEDLINE | ID: mdl-29466970

RESUMO

BACKGROUND: There is currently limited information regarding the prognostic ability of the dNLR-PNI (the combination of the derived neutrophil-to-lymphocyte ratio [dNLR] and prognostic nutritional index [PNI]) for hepatocellular carcinoma (HCC). This study aimed to assess the predictive ability of the dNLR-PNI in patients with intermediate-to-advanced HCC after transarterial chemoembolization (TACE). METHODS: A total of 761 HCC patients were enrolled in the study. The dNLR-PNI was retrospectively calculated in these patients, as follows: patients with both an elevated dNLR and a decreased PNI, as determined using the cutoffs obtained from receiver operating characteristic curve analysis, were allocated a score of 2, while patients showing one or neither of these alterations were allocated a score of 1 or 0, respectively. RESULTS: During the follow-up period, 562 patients died. Multivariate analysis suggested that elevated total bilirubin, Barcelona Clinic Liver Cancer C stage, repeated TACE, and dNLR-PNI were independently associated with unsatisfactory overall survival. The median survival times of patients with a dNLR-PNI of 0, 1, and 2 were 31.0 (95% confidence interval [CI] 22.5-39.5), 16.0 (95% CI 12.2-19.7) and 6.0 (95% CI 4.8-7.2) months, respectively (P < 0.001). CONCLUSIONS: The dNLR-PNI can predict the survival outcomes of intermediate-to-advanced HCC patients undergoing TACE, and should be further evaluated as a prognostic marker for who are to undergo TACE treatment.


Assuntos
Carcinoma Hepatocelular/terapia , Quimioembolização Terapêutica , Inflamação , Neoplasias Hepáticas/terapia , Adulto , Idoso , Feminino , Humanos , Contagem de Leucócitos , Linfócitos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Neutrófilos , Estado Nutricional , Prognóstico , Estudos Retrospectivos
9.
Oncotarget ; 8(49): 85599-85611, 2017 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-29156744

RESUMO

BACKGROUND: There is paucity of information concerning whether AFP change is a predictor of prognosis for recurrent hepatocellular carcinoma (RHCC) patients after trans-arterial chemoembolization (TACE). METHODS: A total of 177 RHCC patients who received TACE as first-line therapy were retrospectively analyzed. The patients were classified into three groups according to their pre-TACE and post-TACE AFP levels (group A: AFP decreased, group B: AFP consistent normal, and group C: AFP increased). The recurrence to death survival (RTDS) and overall survival (OS) were estimated by the Kaplan-Meier method, and compared by the log-rank test. Multivariate analyses were performed to identify prognostic factors for OS and RTDS. RESULTS: There was no significant difference among the three groups concerning the baseline characteristics. The median overall survival (OS) was 74.5 months in group A (95% confidence interval (CI): 63.5, 85.6), 64.0 months in group B (95% CI: 52.3, 75.7) and 29.0 months in group C (95% CI: 24.1, 33.9; P<0.001). The median recurrence to death survival (RTDS) was 66.5 months (95% CI: 53.4, 79.6) in group A, 50.4 months (95% CI: 39.5, 61.4) in group B and 17.7 months (95% CI: 13.4, 22.1; P<0.001) in group C. Multivariate analysis revealed that tumor size at resection stage, tumor number at recurrent stage, cycles of TACE, mRECIST response and AFP change after TACE were significant independent risk factors for RTDS and OS. CONCLUSIONS: AFP change could predict the prognoses of patients with RHCC who received trans-arterial chemoembolization, which may help clinicians make subsequent treatment decision.

10.
Medicine (Baltimore) ; 96(45): e8512, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29137051

RESUMO

The neutrophil-to-lymphocyte ratio (NLR) reflects the systematic inflammatory status, and the aspartate aminotransferase-to-alanine aminotransferase ratio (AAR) is a biomarker of liver fibrosis and cirrhosis. These values can be conveniently obtained from routine blood tests; however, their combined clinical utility has not been extensively studied in patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE). This study aimed to investigate the prognostic value of NLR-AAR in patients with unresectable HCC undergoing TACE. Data for 760 patients with newly diagnosed HCC were retrospectively evaluated. The NLR-AAR was calculated as follows: patients in whom both the NLR and AAR were elevated according to the receiver operating characteristic (ROC) curve analysis were assigned a score of 2; patients showing an elevation in one or neither of these indicators were assigned a score of 1 or 0, respectively. Univariate and multivariate analyses were performed to identify the clinicopathological variables associated with overall survival. An ROC curve was also generated and the area under the curve (AUC) was calculated to evaluate the discriminatory ability of each index at 1, 3, and 5 years of follow-up, as well as overall. The NLR-AAR consistently had a greater AUC value at 1 year (0.669), 3 years (0.667), and 5 years (0.671) post-TACE compared with either NLR or AAR alone. The median survival times of patients with a NLR-AAR of 0, 1, and 2 were 31.0 (95% confidence interval [CI] 24.0-38.0), 15.0 (95% CI 11.2-18.8), and 5.0 (95% CI 4.0-5.9) months, respectively (P < .001). Multivariate analysis showed that the NLR-AAR, elevated total bilirubin level, and vascular invasion were independently associated with overall survival. NLR and AAR, when combined to produce an inflammation-based index and fibrosis score, is an independent marker of poor prognosis in patients with HCC receiving TACE.


Assuntos
Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Carcinoma Hepatocelular/sangue , Neoplasias Hepáticas/sangue , Contagem de Linfócitos , Neutrófilos/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais , Carcinoma Hepatocelular/terapia , Quimioembolização Terapêutica/métodos , Feminino , Humanos , Estimativa de Kaplan-Meier , Neoplasias Hepáticas/terapia , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Adulto Jovem
11.
Sci Rep ; 7(1): 13873, 2017 10 24.
Artigo em Inglês | MEDLINE | ID: mdl-29066730

RESUMO

For many malignancies, inflammation-based scores correlate with survival. The neutrophil-to-lymphocyte ratio (NLR) and prognostic nutritional index (PNI) are immunonutritional indices associated with postoperative outcomes in patients with hepatocellular carcinoma (HCC). We evaluated whether a combined preoperative NLR and PNI score was prognostically superior to either index alone in 793 patients with unresectable HCC after transarterial chemoembolization. Patient demographic, clinical, and pathological data were also collected and analysed. A receiver-operating characteristic (ROC) analysis was used to classify patients as follows: NLR-PNI 0 group (NLR ≤ 2.2 and PNI > 46), NLR-PNI 1 group (NLR > 2.2 or PNI ≤ 46) and NLR-PNI 2 group (NLR > 2.2 and PNI ≤ 46). Regarding 1-, 3-, and 5-year survival, the NLR-PNI score had superior discriminative abilities (i.e., higher area under the ROC curve), compared with either the NLR or PNI alone, and patients in the NLR-PNI 0, 1, and 2 groups had median survival times of 33 (95% confidence interval: 22.8-43.2), 14 (10.9-17.1), and 6 (9.9-14.1) months, respectively. In multivariate analyses, the Barcelona Clinic Liver Cancer, total bilirubin, vascular invasion, and NLR-PNI score adversely affected overall survival. In conclusion, the NLR-PNI score can improve the accuracy of prognoses for patients with unresectable HCC.


Assuntos
Carcinoma Hepatocelular/imunologia , Carcinoma Hepatocelular/terapia , Neoplasias Hepáticas/imunologia , Neoplasias Hepáticas/terapia , Linfócitos/citologia , Neutrófilos/citologia , Avaliação Nutricional , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/patologia , Quimioembolização Terapêutica , Feminino , Humanos , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/patologia , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Estadiamento de Neoplasias , Prognóstico , Análise de Sobrevida , Resultado do Tratamento
12.
EURASIP J Wirel Commun Netw ; 2017(1): 64, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-32104170

RESUMO

An asynchronous time difference of arrival (ATDOA) positioning system requires no time synchronization among all the anchor and target nodes, which makes it highly practical and can be easily deployed. This paper first presents an ATDOA localization model, and then primarily focuses on two new localization algorithms for the system. The first algorithm is a two-step positioning algorithm that combines semidefinite programming (SDP) with a Taylor series method to achieve global convergence as well as superior estimation accuracy, and the second algorithm is a constrained least-squares method that has the advantage of low complexity and fast convergence while maintaining good performance. In addition, a novel receiver re-selection method is presented to significantly improve estimation accuracy. In this paper, we also derive the Cramer-Rao lower bound (CRLB) of the ATDOA positioning system using a distance-dependent noise variance model, which describes a realistic indoor propagation channel.

13.
J Surg Res ; 209: 8-16, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-28032575

RESUMO

BACKGROUND: The recurrence of patients with hepatocellular carcinoma (HCC) beyond the Milan criteria after liver resection (LR) is common. This study aimed to clarify whether LR plus postoperative adjuvant transcatheter arterial chemoembolization (TACE) could improve the outcomes of patients with HCC beyond the Milan criteria after LR. METHODS: A total of 754 consecutive patients with HCC beyond the Milan criteria who received LR alone (n = 459) or LR + TACE (n = 295) were included. A propensity scoring matched model (PSM) was used to adjust for the baseline differences between the groups. RESULTS: The 1, 3, and 5-y recurrence-free survival (76.7%, 40.4%, and 30.8%, respectively, for the LR-alone group versus 78.3%, 50.5%, and 46.2%, respectively, for the LR + TACE group; P = 0.004) and overall survival (94.1%, 58.3%, and 36.3%, respectively, for the LR-alone group versus 95.3%, 71.3%, and 54.9%, respectively, for the LR + TACE group; P < 0.001) rates of patients who underwent LR alone were much lower than in the LR + TACE group. Multivariate Cox proportional hazards regression analysis showed that LR alone was an independent risk factor for postoperative recurrence and poor long-term survival. After one-to-one PSM, 284 patients who underwent LR alone and 284 patients who underwent LR + TACE were selected for further analyses. Similar results were observed in the PSM model. CONCLUSIONS: This study showed that LR + TACE may be beneficial for patients with HCC beyond the Milan criteria. Postoperative adjuvant TACE should be considered to patients with HCC beyond the Milan criteria.


Assuntos
Carcinoma Hepatocelular/cirurgia , Quimioembolização Terapêutica , Neoplasias Hepáticas/cirurgia , Adulto , Idoso , Carcinoma Hepatocelular/mortalidade , China/epidemiologia , Feminino , Humanos , Neoplasias Hepáticas/mortalidade , Masculino , Pessoa de Meia-Idade , Pontuação de Propensão , Estudos Retrospectivos , Fatores de Risco
14.
Int J Low Extrem Wounds ; 15(1): 74-7, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26238676

RESUMO

Diabetic foot is a kind of limb- and life-threatening complication that is difficult to treat with conventional therapy, especially when accompanied with peripheral arterial insufficiency and severe infection. We present a diabetic patient with a postamputation wound infected by multidrug-resistant Acinetobacter baumannii/haemolyticus, which was resistant to almost all antibiotics. As the clinical response to antimicrobial therapy was poor, antibiotic was discontinued. Autologous platelet-rich gel with anticoagulation, negative pressure wound therapy, and improvement of microcirculation were used successfully to eradicate infection of the superbug and achieve final wound closure.


Assuntos
Amputação Cirúrgica , Pé Diabético/cirurgia , Infecção da Ferida Cirúrgica/terapia , Idoso de 80 Anos ou mais , Antibacterianos , Terapia Combinada , Humanos , Masculino
15.
Dig Dis Sci ; 61(2): 464-73, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26441282

RESUMO

BACKGROUND: In living donor liver transplantation (LDLT), the hepatic hemodynamics plays important roles in graft regeneration, and the hepatic blood inflows are associated with graft size. However, the data of interplay between the hepatic arterial buffer response (HABR) and graft-to-recipient weight ratio (GRWR) in clinical LDLT are lacking. AIMS: To identify the effect of the HABR on the hepatic hemodynamics and recovery of graft function and to evaluate the safe lower limit of the GRWR in carefully selected recipients. METHODS: Portal venous and hepatic arterial blood flow was measured in recipients with ultrasonography, and the graft functional recovery, various complications, and survive states after LDLT were compared. RESULTS: In total, 246 consecutive patients underwent LDLT with right lobe grafts. In total, 26 had a GRWR < 0.7 % (A), 29 had a GRWR between 0.7 and 0.8 % (B), and 181 had a GRWR > 0.8 % (C). For small-for-size syndrome, there was no significant difference (P = 0.176). Graft survival rates at 1, 3, and 5 year were not different (P = 0.710). The portal vein flow and portal vein flow per 100 g graft weight peaks were significantly higher in the A. Hepatic arterial velocity and hepatic arterial flow decreased in all the three groups on postoperative day 1; however, the hepatic arterial flow per 100 g graft weight was close to healthy controls. CONCLUSIONS: HABR played important roles not only in the homeostasis of hepatic afferent blood supply but also in maintaining enough hepatic perfusion to the graft.


Assuntos
Artéria Hepática/fisiologia , Homeostase/fisiologia , Transplante de Fígado , Fígado/irrigação sanguínea , Adulto , Idoso , Velocidade do Fluxo Sanguíneo , Feminino , Sobrevivência de Enxerto , Hemodinâmica , Humanos , Doadores Vivos , Masculino , Pessoa de Meia-Idade , Veia Porta/fisiologia , Adulto Jovem
16.
Eur J Gastroenterol Hepatol ; 27(8): 933-40, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25933127

RESUMO

OBJECTIVE: The aim of this study was to investigate appropriate treatment strategies for recurrent intrahepatic hepatocellular carcinoma (HCC) in patients who fulfilled the Milan criteria at primary hepatectomy. PATIENTS AND METHODS: A total of 124 patients who underwent curative-intent resection of HCC at our center between January 2007 and March 2014 were retrospectively enrolled; patients had initially fulfilled the Milan criteria, but developed intrahepatic recurrence. Seventy-four patients underwent transarterial chemoembolization (TACE) and another 50 patients underwent repeat resection (RR) or radiofrequency ablation (RFA). The recurrent HCCs were classified into intrahepatic metastasis and multicentric occurrence by pathologic analysis. Demographic and clinical data and overall survival rates were compared between the RR/RFA and the TACE groups. Subgroup analysis on the basis of the recurrence pattern (early recurrence or late recurrence) was carried out, and prognostic factors for survival were investigated. RESULTS: The 1-, 3-, and 5-year overall survival rates for the 124 patients after retreatment were 88.3, 55.4, and 44.3%, respectively. The 1-, 3-, and 5-year overall survival rates after retreatment were not significantly different between the RR/RFA and the TACE groups (P=0.140). Subgroup analysis showed that for late recurrence, survival in the RR/RFA group was better than those of patients in the TACE group (P=0.045). CONCLUSION: TACE may be as effective as RR or RFA for early intrahepatic recurrence, whereas RR/RFA is the preferred option for patients with late recurrence after curative resection of HCC who initially fulfilled the Milan criteria. Prognosis was determined by the number of recurrent tumors and the Child-Pugh class at the time of recurrence.


Assuntos
Carcinoma Hepatocelular/cirurgia , Ablação por Cateter , Quimioembolização Terapêutica , Técnicas de Apoio para a Decisão , Hepatectomia , Neoplasias Hepáticas/cirurgia , Recidiva Local de Neoplasia/terapia , Adulto , Carcinoma Hepatocelular/mortalidade , Carcinoma Hepatocelular/patologia , Ablação por Cateter/efeitos adversos , Ablação por Cateter/mortalidade , Quimioembolização Terapêutica/efeitos adversos , Quimioembolização Terapêutica/mortalidade , Feminino , Hepatectomia/efeitos adversos , Hepatectomia/mortalidade , Humanos , Estimativa de Kaplan-Meier , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/mortalidade , Recidiva Local de Neoplasia/patologia , Valor Preditivo dos Testes , Modelos de Riscos Proporcionais , Reoperação , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
17.
Clin Res Hepatol Gastroenterol ; 39(4): 451-7, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25623860

RESUMO

BACKGROUND: As a bridge to liver transplantation or downstaging therapy for hepatocellular carcinoma (HCC) patients, preoperative transarterial chemoembolization (TACE) has potential risks in causing damage to hepatic artery (HA), resulting in severe postoperative complications. AIM: To evaluate the impact of pre-TACE on postoperative hepatic artery complications (HAC) for HCC patients in a single liver transplant center. MATERIALS AND METHODS: Clinical data of 450 HCC patients undergoing orthotopic liver transplantation (OLT) from January 2001 to December 2013 were retrospectively analyzed. Patients were divided into Group 1 (with pre-TACE) and Group 2 (without pre-TACE). Preoperative characteristics and postoperative HAC were compared. RESULTS: One hundred and eleven patients (69 men; median age, 37±9.9 years) in Group 1 were compared with 339 patients (244 men; median age, 38.8±8.0 years) in Group 2. Patients were comparable in donor/recipients characteristics between groups. Histological review for native liver samples showed that Edema was the most often seen complication following pre-OLT TACE (troncluar: 87 vs 9; segmental: 91 vs 10; liver parenchyma: 93 vs 8; P=0.000). Fibrosis, thrombosis and aneurysm were only seen in Group 1. There were no significant difference in postoperative HAC (5/111 (4.5%) vs 5/339 (1.5%), P=0.131) between groups. CONCLUSION: Our single institution experience showed that it might be safe to perform pre-TACE in HCC patients before OLT. It would not increase postoperative HAC risk.


Assuntos
Carcinoma Hepatocelular/terapia , Quimioembolização Terapêutica/métodos , Neoplasias Hepáticas/terapia , Transplante de Fígado , Terapia Neoadjuvante , Cuidados Pré-Operatórios , Adulto , Antibióticos Antineoplásicos/administração & dosagem , Anticorpos Monoclonais/administração & dosagem , Carcinoma Hepatocelular/irrigação sanguínea , Doxorrubicina/administração & dosagem , Edema/etiologia , Feminino , Artéria Hepática , Humanos , Neoplasias Hepáticas/irrigação sanguínea , Masculino , Complicações Pós-Operatórias , Estudos Retrospectivos
18.
PLoS One ; 9(8): e103228, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25133493

RESUMO

PURPOSE: This study is to evaluate the Hangzhou criteria (HC) for patients with HCC undergoing surgical resection and to identify whether this staging system is superior to other staging systems in predicting the survival of resectable HCC. METHOD: 774 HCC patients underwent surgical resection between 2007 and 2009 in West China Hospital were enrolled retrospectively. Predictors of survival were identified using the Kaplan-Meier method and the Cox model. The disease state was staged by the HC, as well as by the TNM and BCLC staging systems. Prognostic powers were quantified using a linear trend χ2 test, c-index, and the likelihood ratio (LHR) χ2 test and correlated using Cox's regression model adjusted using the Akaike information criterion (AIC). RESULTS: Serum AFP level (P = 0.02), tumor size (P<0.001), tumor number (P<0.001), portal vein invasion (P<0.001), hepatic vein invasion (P<0.001), tumor differentiation (P<0.001), and distant organ (P = 0.016) and lymph node metastasis (P<0.001) were identified as independent risk factors of survival after resection by multivariate analysis. The comparison of the different staging system results showed that BCLC had the best homogeneity (likelihood ratio χ2 test 151.119, P<0.001), the TNM system had the best monotonicity of gradients (linear trend χ2 test 137.523, P<0.001), and discriminatory ability was the highest for the BCLC (the AUCs for 1-year mortality were 0.759) and TNM staging systems (the AUCs for 3-, and 5-year mortality were 0.738 and 0.731, respectively). However, based on the c-index and AIC, the HC was the most informative staging system in predicting survival (c-index 0.6866, AIC 5924.4729). CONCLUSIONS: The HC can provide important prognostic information after surgery. The HC were shown to be a promising survival predictor in a Chinese cohort of patients with resectable HCC.


Assuntos
Carcinoma Hepatocelular/diagnóstico , Neoplasias Hepáticas/diagnóstico , Carcinoma Hepatocelular/mortalidade , Carcinoma Hepatocelular/cirurgia , Feminino , Hepatectomia , Humanos , Estimativa de Kaplan-Meier , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/cirurgia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Estadiamento de Neoplasias , Prognóstico , Modelos de Riscos Proporcionais , Curva ROC
19.
Hepatogastroenterology ; 60(122): 248-51, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23574651

RESUMO

Hepatocellular carcinoma (HCC) is a common malignancy in the world and is mainly treated by surgery resection. It is believed that even after radical resection, the recurrence and metastasis rates remain at a high level. This threatens the health and safety of patients. Postoperative adjuvant transcatheter arterial chemoembolization (TACE) is regarded as a common strategy for HCC patients at a high recurrence risk. However, there is a debate on the effects of postoperative TACE and range of applications in the medical world. Here we review the effects of postoperative TACE on the prognosis of HCC.


Assuntos
Carcinoma Hepatocelular/terapia , Quimioembolização Terapêutica/métodos , Neoplasias Hepáticas/terapia , Carcinoma Hepatocelular/mortalidade , Terapia Combinada , Humanos , Neoplasias Hepáticas/mortalidade , Prognóstico , Taxa de Sobrevida
20.
World J Gastroenterol ; 19(47): 9104-10, 2013 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-24379637

RESUMO

AIM: To investigate the safety and effectiveness of combined (131)I-metuximab and transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). METHODS: One hundred and eighty-five patients (159 men and 26 women) with advanced HCC were enrolled in this study from February 2009 to July 2011. There were 95 patients in the combined metuximab and TACE group, and 90 patients in the TACE only group. The patients were followed for 12 mo. Clinical symptoms, blood cell counts, Karnofsky Performance Score (KPS) evaluation and therapeutic effects according to the Response Evaluation Criteria in Solid Tumors were recorded and evaluated. RESULTS: The 1-mo effective rates (complete response + partial response + stable disease) of the test group and control group were 71.23% and 38.89%, respectively (P < 0.001). The 6-, 9- and 12-mo survival rates were 86.42%, 74.07% and 60.49% for the test group and 60.0%, 42.22% and 34.44% for the control group (P < 0.001). The incidence of adverse events (gastrointestinal symptoms, fever and pain) and blood cell toxicity were significantly higher for the test group than for the control group (P < 0.001). No severe (131)I-metuximab-related complications were identified. With respect to efficacy, patients in the test group had greater improvement in tumor-related pain (P = 0.014) and increase in KPS (P < 0.001) than those in the control group. CONCLUSION: Combination of (131)I-metuximab and TACE prolonged the survival time in patients with HCC compared with TACE alone. The combination treatment was safe and effective.


Assuntos
Anticorpos Monoclonais/administração & dosagem , Carcinoma Hepatocelular/terapia , Quimioembolização Terapêutica , Radioisótopos do Iodo/administração & dosagem , Neoplasias Hepáticas/terapia , Radioimunoterapia , Compostos Radiofarmacêuticos/administração & dosagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Monoclonais/efeitos adversos , Carcinoma Hepatocelular/irrigação sanguínea , Carcinoma Hepatocelular/mortalidade , Carcinoma Hepatocelular/patologia , Quimioembolização Terapêutica/efeitos adversos , Criança , Feminino , Artéria Femoral , Humanos , Injeções Intra-Arteriais , Radioisótopos do Iodo/efeitos adversos , Estimativa de Kaplan-Meier , Avaliação de Estado de Karnofsky , Neoplasias Hepáticas/irrigação sanguínea , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Radioimunoterapia/efeitos adversos , Compostos Radiofarmacêuticos/efeitos adversos , Taxa de Sobrevida , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
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