In this paper, we report the study concerning the preparation and application of anti-human heterogeneous AFP-R-LCA monoclonal antibodies (VG5 VD12 VB5 VA8 VD12). These McAbs had higher affinity and specificity to AFP-R-LCA than the routinely used anti-AFP polyclonal antibody. Competitive assays indicated that they could bind to new antigenic determinants which are different from the previously reported a and b sites. In an assay of the McAbs, we first set up a two site sandwich ELISA method and then tested, using this method, serum samples from 69 patients with PHC, 67 patients with benign liver diseases, 30 pregnant women and 30 normal controls. The results showed that this two site sandwich ELISA method had low pseudo-positive rate. The detection range was 5 1000 ng/ml, with the properties of simplicity, accuracy and reproducibility. It could be used not only for the early diagnosis of PHC in patients with AFP levels less than 400 ng/ml, but also for the differential diagnosis of PHC from benign liver diseases.

The primary curative modality for hilar cholangiocarcinoma is surgery. Some reports suggest that radical resection may provide the best survival rate for patients with hilar cholangiocarcinoma. In resected patients, however, gross or microscopic residual disease is common. Local recurrence is the most common cause of failure and mortality. In the past 10 years, preoperative, intraoperative and postoperative radiotherapy has been used as an adjuvant treatment for these patients. Some studies have proved adjuvant radiotherapy on hilar cholangiocarcinoma may be of value.

To study parameters influencing the prognosis of patients suffering from gallbladder carcinoma.MethodsA retrospective clinical analysis was made on 56 cases of gallbladder carcinoma, admitted to our hospital between 1995～2001.ResultsThere were 20 males and 36 femals. Thirty four patients(61%) complicated with gallstons.Abdominal pain(47/56,84%) and jaundice(23/56,41%) were the major complaints.Ultrasonography,CT scan and CA 19 9 measurement were helpful for preoperative diagnosis. Thirty cases(including 5 Nevin stage Ⅱ cases,3 stage Ⅲ cases,4 stage Ⅳ cases,and 18 stage Ⅴ cases) received radical or extended radical chelecystectomy, 11 cases with Nevin stage Ⅴ underwent palliative resection and 15 cases of Nevin stage Ⅴ were subjected to bypass procedure and/ or biopsy.The statistical analysis showed staging of Nevin,surgical procedure,gallstone,adjuvant radiotherapy and chemotherapy significantly affected the survival.Conclusions Early diagnosis, radical resection, active and comprehensive adjuvant radiotherapy with/or chemotherapy help to improve the prognosis of gallbladder carcinoma.

Objectives To evaluate the methodology of preoperative diagnosis for Mirizzi syndrome. Methods Fifteen cases of Mirizzi syndrome were retrospectively investigated. The data of semeiology and imaging including B-type ultrasound, endoscopic retrograde cholangiopancreatography (ERCP) and MR cholangiopancreatography (MRCP) were compared with each other and analyzed. Results Preoperative data were consistent with and suggestive of Mirizzi syndrome in 93% (14/15) of cases, and in 67% (10/15) of cases, respectively. Conclusions Preoperative B-type ultrasound is the primary examination. ERCP and MRCP further elevate preoperative definite diagnosis. In patients with preoperative tentative diagnosis of Mirizzi syndrome, jaundice lasting for more than 7 week is suggestive of cholecystocholedochal fistula.

Objective To study the effect of PEI on disseminating HCC cells in the peripheral blood in patients with recurrent HCC. MethodsWe examined blood samples from 29 recurrent HCC patients by nested RT-PCR for the determination of AFP?mRNA before and 1, 2, 3 and 4 weeks after PEI.ResultsBefore PEI 14 (48%) patients out of the 29 cases with recurrent HCC were positive with AFP?mRNA. Four weeks after a course of PEI only 2 cases (7%) remained AFP?mRNA positive.ConclutionsPEI effectively eradicating disseminating HCC cells in the peripheral blood shows a favourable potential for the treatment of recurrent HCC.

AFP from fetal serum and serum of patients with primary hepatic cancer were purified by affinity chromatography. Then, the lentil lectin-reactive and nonreactive variants of these purified glycoproteins were prepared by affinity chromatography with immobilized lectin. Glycopeptides and oligosaccharides were prepared from variants by protease treatment and hydrazinolysis, respectively, and subjected to carbohydrate and amino acid analysis. A small difference in the carbohydrate compositions of each variant was observed. Analysis of chemical compositions of AFP variants is useful for the differential diagnosis between benign liver diseases and primary hepatic cancer.

Objective To investigate the inhibitory effects of IL-18 gene on HCC growth in vivo. MethodsThe recombinant adenovirus vector containing IL-18 gene was constructed and cotransfected into 293 cells together with EcoT22 I-digested Ad5 DNA-TPC, the recombinant adenoviruses were generated, and injected into a rat model bearing HCC. Results The recombinant adenovirus vector containing IL-18 gene inhibited the proliferation of HCC cell line CBRH 3. The rats receiving IL-18 gene injection within 3 days after inoculation of CBRH 3 all had long term survival, while those injected at day 5 or 7 survived a limited longer period than control groups (P

Objective To investigate the etiology of iatrogenic bile duct injury and experience in its diagnosis and treatment. Methods A retrospective study was conducted on the clinical data of 86 patients with iatrogenic trauma in the bile duct. Results These 86 cases have received a total of 156 sessions of surgical procedures, including 2 explorations in 66 cases,3 explorations in 6 cases. Lateral bile duct injury in 22 cases was treated by suture repair and T tube stent. Eight cases suffering from iatrogenic transection of the common bile duct were retrieved by cholangiojejunostomy and T tube stent. Nine cases with inadvertent CBD ligature were managed by a lysis and T tube stent. Roux en Y cholangiojejunostomy was adopted in 77 cases. Sixty cases were followed up for 1～10 years, with good result in 90% of the cases. Conclusions Most CBD iatrogenic injury cases were encountered as a result of cholecystectomy.Roux en Y cholangiojejunostomy is the choice of therapy.

Objective To explore the clinical features, treatment and prognosis of intrabepatic biliary cystadenocarcinoma (IBC). Methods We retrospectively analyzed clinical data of 17 patients with pathologically confirmed IBC, treated between January 2002 and September 2007. Results Of the 17 patients, 4 were men and 13 were women, with a mean age of 49.3 years (range 45 -68). Serum level of AFP was normal in all patients. CA19-9 was abnormally elevated in only two patients and the other two had abnormal serum level of CEA. Seven cases underwent radical resection, 7 underwent complete tumor resection combined with removal of tumor thrombi in the bile duct, 3 received palliative surgery. On histopathological examination, 10 were biliary cystadenocarcinoma,2 were biliary cystadenoma with partial eanceration,2 were papillary cystadenocarcinoma,2 were mutinous papillary cystadenocarcinoma and 1 was of mixed cystadenocarcinoma and hepatocellular carcinoma. According to tumor differentiation, the number of well, moderate and poor-differentiated group was 7, 3 and 7 cases respectively. The medality of surgery (β= - 0.692, P = 0.01) and tumor differentiation (β = - 2.041, P = 0.007) effected the prognosis significantly. Conclusions IBC occurs mainly in elderly women. CA19-9 examination does not help in the establishment of diagnosis of IBC. The occurrence of tumor thrombosis in common bile duct doesn't necessarily indicate poor prognosis, hence a IBC patient will still have a satisfactory prognosis should the primary tumor be completely resected and tumor thrombi removed.

Objective To analyze factors influcing the surgical curative effect of hilar cholangiocarcinoma. Methods A retrospective clinical analysis was made on 198 patients with hilar cholangiocarcinoma, who were surgically treated in our hospital from 1997 to 2002. Jaundice (94.5%, 187 cases), pruritus (56.6%, 112 cases) and abdominal pain (33.8%, 67 cases) were the main symptoms. According to Bismuth-Corlette classification, there were 14 type Ⅰ cases, 19 type Ⅱ cases, 12 type Ⅲa caese, 15 type Ⅲb cases, 112 type Ⅳ cases and 26 unclassifiable cases. 144 patients received laparotomy, and tumor resection was performed in 120 cases, including radical resection in 59 caese (41.0%) and palliative resection in 61 cases. 54 cases were treated by endoscopic therapy or PTCD. 16 cases received postoperative adjuvant radiation. Results Occupation, preoperative maximum tatal serum bilirubin level, operative procedure and postoperative adjuvant radiation affected postoperative survival. The postoperative survival of ENBD group, ERBD or EMBE group, biliary exploration & drainage group, palliative resection group and radical resction group differed statistically as a whole (?2= 87.048?9, P