Primary liver cancer is the fourth most common malignancy and the second most common cause of cancer death in China, posing a serious threat to the health of Chinese people. Hepatocellular carcinoma (HCC) represents more than 90% of primary liver cancers, among them 66% of patients are with intermediate-advanced HCC. Therefore, prevention strategies and conversion therapies to patients with intermediate-advanced HCC are particularly important. Hepatic arterial infusion chemotherapy (HAIC) is one of the important treatment methods to treat intermediate-advanced HCC. The tumor objective response rates and surgery conversion rates of HAIC-based conversion therapies are promising. The authors review the history of HAIC and the HAIC-based conversion therapies in this article.

Objectives To investigate the diagnostic value and safety of needle cutting biopsy for the primary and metastatic hepatic cancer during the treatment of percutaneous radiofrequency ablation and ethanol injection guided by ultrosound or CT. Methods The clinical data of 48 patients underwent the treatment of percutaneous radiofrequency ablation and ethanol injection as well as biopsy were analyzed. Results Among 48 patients,46 case(95.8%) were diagnosed by pathological examination and 2 cases (4.2%) failed to be diagnosed. There were no serious complications in all the patients. Conclusion Detachable needle cutting biopsy was safe and effective for the diagnosis of the primary and metastatic hepatic cancer during the treatment of percutaneous radiofrequency ablation and ethanol injection guided by ultrasound or CT.

0.05); 88.6%, 60.0%, and 51.4% for those in group A2, and 59.3%, 48.1%, and 25.9% for those in group B2, respectively (P 8 cm.

Objective To investigate the effect and safety of the application of radiofrequency ablation(RFA) and ethanol injectionunder the different guidance means for105 patients with primary and metastatic hepatic cancer.Methods Aretrospective study was accom-plished on the radiofrequency ablation and ethanol injection for105 patients with primary and metastatic hepatic cancer under the guidance ofultrasound(56 cases),CT(12 cases),laparoscope(9 cases),open surgery(26 cases) and ultrasound associated with laparoscopic(2cases).Results The operations of RFA with the shortest time were guided by ultrasound(0.8?0.3) h,while the longest operations wereguided by open surgery(3.6?2.5) h(P

Molecular-targeted therapy is a new method and tendency in the treatment of hepatocellular carcinoma (HCC). To date, sorafinib, a multi-targeted gent, is the only one proved to be effective in improving the survival of patients with advanced HCC. Sorafinib is also the first line systemic agent for advanced HCC. Other multi-targeted agents, such as sunitinib, are also proved to be effective. Erlotinib, gefitinib and eetuximab, which target epidermal growth factor receptor, show effectiveness but still need further investigation. Bevacizumab, which targets vascular endothelial growth factor and vascular endothelial growth factor receptor, shows excellent results and deserves more clinical trials. The effects of bortezomib, sirolimus and imatinib, which target other pathways, are still under investigation. The future studies of molecular-targeted therapy for HCC should be focused on the combination of different targeted medicine, and combination of molecular-targeted therapy and chemotherapy, as well as individualized therapy.

Objective To evaluate the relationship between the tumor encapsulation,lymphocytic infiltration,fibroplasia and cirrhosis and transcatheter arterial chemoembolization(TACE)methods for hepatocellular carcinoma(HCC).Methods Histopathological changes were studied in 59 cases of HCCs treated with four kinds of TACE and 58 cases of HCCs treated with surgical resection alone.Results In TACE group the encapsulation,lymphocytic infiltration,fibroplasia was more severe and extensive than that in group of surgical resection alone(?0.05),had relation to TACE time(?

Objective To investigate the feasibility,curative effect and problems of combined ultrasound-guided percutaneous radiofrequency ablation and ethanol injection(PRFA+EI) on small liver cancer located in first porta hepatis.Methods Twenty-six patients,who diagnosed as primary and metastatic liver cancer that located in first porta hepatis and was less than 5 cm in diameter by clinical evidence or pathology,were performed PRFA+EI between Jan 2001 and Oct 2004.The necrosis of the tumors was determined by MRI,Doppler ultrasound or CT after the treatment for one month and the regular examinations were tested every 3 months.The primary tumor recurrence rate and cumulative survival rate were calculated.Results The seroconversion rate of AFP was 76.9%(10/13).The complete necrosis rate of liver cancer in first porta hepatis was 84.6%(22/26) by MRI and CT.The primary tumor recurrence rate of 6 months and 1 year were 23.1%(6/26) and 26.9%(7/26),respectively.The 1-,2-,3-year cumulative survival rate were 92.3%(24/26),82.3% (14/17),75.0%(9/12),respectively.There was no occurrence of bile ducts stenosis.Conclusion The small live cancer located in first porta hepatis is not the contraindication of PRFA+EI.If the puncture point and route is selected properly,electrodes deployed exactly using ultrasound guidance and the size of heating area controlled appropriately,the PRFA+EI is an effective treatment for small liver cancer located in first porta hepatis.

Objective Partial hepatectomy, liver transplantation, and radio frequency ablation for hepatocellular carcinoma (HCC) were compared to select the most suitable method for HCC. Methods 1198 patients with HCC in 3 hospitals in Guangzhou were divided into 3 groups: group Ⅰ , small HCC; group Ⅱ > HCC without vascular invasions and group Ⅲ , HCC with vascular invasion. The patients either received partial hepatectomy, transplantation or ablation. The 1-, 2- or 3-year survival rates, the 3-year recurrent rates and Child-Pugh grades in the 3 groups were compared. Results For small HCC, there was a significant increase in the 3-year survival rate (P<0. 05) and a significant decease in the recurrent rate (P<0. 05) in patients who received transplantation, compared with those who received hepatic resection. Patients who received ablation had a higher 3-year survival rate and a lower recurrence (P<0. 05) in comparison with those who received hepatectomy. There was no significant difference(P<0. 05) between transplantation and ablation, but there were more Child A patients who received hepatectomy and ablation, and more Child B and C patients who received transplantation. For advanced HCC, there was no significant different in the 3-year survival rates for the 3 therapies, but the 3-year recurrence was lower (P<0. 05) in the transplantation group. Conclusions For small HCC, superiority of transplantation versus resection was obvious. Ablation (diameter <3 cm) was also superior to resection, whereas ablation was as effective as transplantation. There were more Child B and C patients in the transplantation group than the ablation and resection groups. Therefore, small HCC with hepatic decompensation should receive liver transplantation. Transplantation was advantageous in having less tumor recurrent but there was no difference in the 3 therapies for advanced HCC.

Objective　To evaluate the relationship between the tumor encapsulation,lymphocytic infiltration,fibroplasia and cirrhosis and transcatheter arterial chemoembolization(TACE)methods for hepatocellular carcinoma(HCC).Methods　Histopathological changes were studied in 59 cases of HCCs treated with four kinds of TACE and 58 cases of HCCs treated with surgical resection alone.Results　In TACE group the encapsulation,lymphocytic infiltration,fibroplasia was more severe and extensive than that in group of surgical resection alone(Ρ＜0.01）.The TACE method and treatment time had effect on encapsulation and fibroplasia of tumor,but treatment interval was no effect.The rate of cirrhosis among TACE method had no significantly difference（Ρ＞0.05）,had relation to TACE time（Ρ＜0.05）.Conclusion　The changes in the encapsulation,lymphocytic infiltration,fibroplasia are more easily find by polytimes,multimaterial chemoembolization than that by one time single material chemoembolization and chemotherapy alone.The superselective cathetering can avoid the damage of normal liver.

OBJECTIVE:To optimize the extraction technology of Yigu granule. METHODS:L9(34)orthogonal test was used, using comprehensive scores of transfer rate of icariin,gentiopicroside,loganic acid and yield rate as evaluation indexes,alcohol volume fraction,the amount of solvent,extraction times and extraction time as investigation factors,extraction technology of Yigu granule was optimized,and the verification test was conducted. RESULTS:The optimized extraction technology was 10-fold 60%ethanol reflux extraction for twice,1 h once. Results of verification test showed,average transfer rates of icariin,gentiopicroside and loganic acid were 81.28%(RSD=1.54%,n=3),48.71%(RSD=2.37%,n=3)and 59.82%(RSD=2.52%,n=3);aver-age yield rate was 31.48%(RSD=1.97%,n=3). CONCLUSIONS:The optimized extraction technology for Yigu granule is sta-ble and feasible with good reproducibility,which can provide basis for the follow-up study of production process.