Evaluation of the significance of hepatic functional reserve for the operation of liver cancer complicated with cirrhosis.

PURPOSE: To evaluate the significance of hepatic functional reserve for the operation of liver cancer complicated with cirrhosis. METHODS: Fifty-six patients suffering from liver cancer complicated with cirrhosis were divided into three levels, A, B and C, according to Child-Pugh grading system. Based on indocyanine green retention rate at 15 min (ICGR15) value, patients were divided into three intervals, ≤15%, 15-25% and ≥25%. According to the existence of complications, patients were divided into the complication group and the no complication group. RESULTS: Child-Pugh grading included 50 cases of level A, 45 cases of B and 29 cases of C. ICGR15 value included 47 cases of ≤15% interval, 47 cases of 15-25% and 30 cases of ≥25%. As the IGCR15 value increased, the levels of all indicators were obviously increased. Among the 124 patients, 35 cases (28.23%) suffered complications The median follow-up time was 25.0 months. The survival rate of the complication group was 60.00% (21 cases), significantly lower than that of the no complication group (84.27%). Child-Pugh grading of the complication group included 4 cases of level A, 12 cases of B and 19 cases of C. ICGR15 value included 15 cases of 15~25% interval and 20 cases of ≥25%. CONCLUSION: Child-Pugh grading and ICGR15 value can both reflect hepatic functional reserve and are of great clinical significance for complication and survival. There is a fairly good relevance between ICGR15 and levels of AFP, ALT and indicators of liver fibrosis.

Codon 104 variation of p53 gene provides adaptive apoptotic responses to extreme environments in mammals of the Tibet plateau.

Mutational changes in p53 correlate well with tumorigenesis. Remarkably, however, relatively little is known about the role that p53 variations may play in environmental adaptation. Here we report that codon asparagine-104 (104N) and glutamic acid-104 (104E), respectively, of the p53 gene in the wild zokor (Myospalax baileyi) and root vole (Microtus oeconomus) are adaptively variable, meeting the environmental stresses of the Tibetan plateau. They differ from serine-104 (104S) seen in other rodents, including the lowland subterranean zokor Myospalax cansus, and from serine 106 (106S) in humans. Based on site-directed mutational analysis in human cell lines, the codon 104N variation in M. baileyi is responsible for the adaptive balance of the transactivation of apoptotic genes under hypoxia, cold, and acidic stresses. The 104E p53 variant in Microtus oeconomus suppresses apoptotic gene transactivation and cell apoptosis. Neither 104N nor 104E affects the cell-cycle genes. We propose that these variations in p53 codon 104 are an outcome of environmental adaptation and evolutionary selection that enhance cellular strategies for surviving the environmental stresses of hypoxia and cold (in M. baileyi and M. oeconomus) and hypercapnia (in M. baileyi) in the stressful environments of the Qinghai-Tibet plateau.