1.The impact of HCC family history on the prognosis of HCC patients after curative hepatectomy
Jian YAN ; Chuzhi PAN ; Zhicheng YAO ; Yuesi ZHONG ; Mingliang LI ; Ruiyun XU ; Meihai DENG
Chinese Journal of General Surgery 2012;27(10):798-801
Objective To evaluate HCC family history on recurrence and survival of HCC patients after curative hepatectomy. Methods The family history,postoperative recurrence rate,1,2 and 5 year survival rate of 79 HCC patients who received surgical resection were collected.Patients were divided into two groups:34 cases in familial aggregation HCC group (FH group ) and 45 cases in non- familial aggregation HCC group (NH group).All these HCC patients were followed up for 3 months to10 years after surgery,and the median follow-up period was 48.5 months.We analyzed the survival rate of HCC patients by Kaplan -Meier survival curve to compare the postoperative recurrence rate and survival rate between two groups. Results 34 cases of HCC probands came from 33 families,and there were 104 cases of HCC patients in these families,an average of 3.2 cases per family.There were 6 families in which 3 or more cases developed HCC,and there were 13 families in which father or (and) mother had HCC accounting for 39.4%.The six months,1 year,2 year posthepatectomy recurrence rate in FH group was 15.1%,22.3%,40.1%,significantly higher than NH group of 10.3%,17.4%,25.6% (x2 =5.762,6.434,5.987,P <0.05),and 1,2,5 year's survival rate in FH group was 57%,46%,40.3%,much lower than NH group of 85.3%,75.2% and61.5% (x2 =8.986,9.765,7.634,P<0.05). Conclusions Family history of HCC affects the prognosis of HCC patients after surgery. Patients with HCC family history have higher postoperative recurrence rate and worse prognosis than that of patients who do not have HCC family history.
2.Multilocus sequence typing of Acinetobacter baumanni strains and the distribution of blaOXA-51-like genes in those isolates in Guangzhou
Yujun LI ; Chuzhi PAN ; Penghao GUO ; Ziwen ZHAO ; Zhuxiang ZHAO ; Changquan FANG ; Huiling CHEN
Chinese Journal of Microbiology and Immunology 2014;(9):707-712
Objective To investigate the distribution of blaOXA-51-like genes and the clonal relation-ship among Acinetobacter baumannii strains isolated from three teaching hospitals in Guangzhou , China. Methods Fifty-two Acinetobacter baumannii isolates were genotyped by multilocus sequence typing (MLST).eBURST algorithm was performed to define clonal complexes (CCs).blaOXA-51-like genes were am-plified by using polymerase chain reaction ( PCR) and sequenced .Results MLST grouped the A.bauman-nii isolates into 5 existing sequence types (STs) and 7 new STs.STn4 carried allele G1 with a T→C muta-tion at the 3rd nucleotide site (nt3) on the gpi111 locus.STn5 carried allele A1, possessing A→C muta-tions at nt156 and nt159 on the gltA1 locus.ST195 and ST208 accounted for 69.2%of all isolates.Clonal relationship analysis showed that ST 195 and ST208 belonged to CC92.Fifty-one A.baumannii isolates car-ried OXA-66 and the rest one carried OXA-199.Conclusion A.baumannii strains that belonged to CC92 and carried OXA-66 were the predominant genotype circulating in Guangzhou , China.
3.Clinical efficacy of sorafenib in preventing recurrence of primary liver cancer after radical surgery
Bingfeng CHEN ; Chuzhi PAN ; Shuxian CHEN ; Yunbiao LING ; Zhaofeng TANG ; Ruiyun XU ; Weidong PAN
Chinese Journal of Hepatic Surgery(Electronic Edition) 2016;5(1):38-42
Objective To evaluate the clinical efifcacy of sorafenib in preventing the recurrence of primary liver cancer after radical surgery. Methods Seventy patients with primary liver cancer undergoing radical surgery in the Third Affiliated Hospital of Sun Yat-sen University between June 2009 and June 2012 were enrolled in this prospective study. The informed consents of all patients were obtained and the local ethical committee approval had been received. According to different postoperative therapies, the patients were divided into the sorafenib group (n=24) and control group (n=46). In the sorafenib group, there were 22 males and 2 females with a mean age of (48±10) years. A dose of 400 mg sorafenib was orally administered twice daily for consecutive 6 months. In the control group, there were 40 males and 6 females with a mean age of (48±11) years. The patients were orally administered with placebo. All patients received postoperative follow-up. Postoperative recurrence rate, survival rate and drug-induced adverse reactions were observed. Postoperative recurrence rate and incidence of adverse reactions of two groups were compared using Chi-square test or Fisher exact probability test. Postoperative survival rate was analyzed by Kaplan-Meier plot and Log-rank test. Results In the sorafenib group, the 1-, 2-and 3-year recurrence rates were 25%(6/24), 42%(10/24), 50%(12/24) respectively, and 28%(13/46), 46%(21/46), 53%(25/46) respectively in the control group. No signiifcant difference was observed between two groups (χ2=0.020, 0.102, 0.120;P>0.05). The 1-, 2-and 3-year cumulative survival rates in the sorafenib group were 95.83%, 87.50%and 70.83%, and no signiifcant difference was observed compared with 91.30%, 82.61%and 63.04%in the control group (χ2=0.078, P>0.05). In the sorafenib group, the incidence of hand-foot skin reaction, diarrhea, hypertension and erythema were 42%(10/24), 29%(7/24), 21%(5/24) and 25%(6/24), which were signiifcantly higher compared with 7%(3/46), 7%(3/46), 2%(1/46) and 4%(2/46) in the control group (χ2=10.663, 4.885, 4.828, 4.762;P<0.05). Conclusion Sorafenib can neither decrease postoperative recurrence of peimary liver cancer after radical surgery nor enhance the overall survival rate.
4.Diagnosis and treatment experience of ectopic para-aortic pheochromocytoma
Jiadong WEI ; Zhiqiang YE ; Yichun XU ; Heping FANG ; Chuzhi PAN ; Jiezhong WU ; Meihai DENG
Chinese Journal of Hepatic Surgery(Electronic Edition) 2015;(1):38-41
Objective To investigate the diagnosis and treatment of ectopic para-aortic pheochromocytoma. Methods Clinical data of 2 cases with ectopic para-aortic pheochromocytoma in the Third Affiliated Hospital of Sun Yat-sen University from August 2012 to December 2013 were analyzed retrospectively. The informed consents of both patients were obtained and local ethical committee approval had been received. Both patients were female with the age of 54, 57 years old. The occurrence of disease, diagnosis, treatments and efficacy were observed. Results Case 1 was admitted in hospital for complaint of 1-month distending pain in upper abdominal and ifnding of retroperitoneal space-occupying lesion for 8 d. Solid space-occupying lesion at the right side of mid-upper abdomen was found by abdominal ultrasound and computer tomography (CT) examination. The preoperative diagnosis was abdominal mesenchymoma. Case 2 was admitted in hospital for complaint of palpitation, chest pain and ifnding of hepatic space-occupying lesion for 10 d and had a history of 5-year hypertension. Cystic solid space-occupying lesion in the hepatic caudate lobe was found by abdominal ultrasound, CT and magnetic resonance imaging (MRI) examinations and cystadenoma was suspected. The 2 patients underwent resection of ectopic para-aortic pheochromocytoma under general anesthesia by tracheal intubation. The intraoperative exploration found that touching the tumor had great impacts on blood pressure and heart rate and ectopic para-aortic pheochromocytoma was diagnosed. The patients were transferred to surgical intensive care unit (ICU) for monitoring and treatment. Pheochromocytoma was confirmed by the pathological examination. The patients were recovered and discharged from hospital and remained well till the paper submission date. Conclusions Ectopic para-aortic pheochromocytoma is a rare disease without characteristic clinical features. It is dififcult for preoperative diagnosis. The conifrmation is mainly depends on the pathological ifndings. Surgical resection is the priority of treatment. Fully assessment of operative risk before operation, avoiding touching tumor tissues during operation, complete excision of tumor capsule, close monitoring on the blood pressure after operation can achieve a good clinical treatment outcome.
5.Mechanism of activated hepatic stellate cells promote angiogenesis of hepatocellular carcinoma
Yajun TANG ; Chuzhi PAN ; Yi LU ; Zhaofeng TANG ; Nan LIN
Chinese Journal of Hepatic Surgery(Electronic Edition) 2016;5(5):323-327
ObjectiveTo investigate the mechanism of activated hepatic stellate cells (aHSC) promote the angiogenesis of hepatocellular carcinoma (HCC).MethodsaHSCs were collected after being cultured for 1, 3, 5, 7 d respectively . The relative expression of aHSC angiopoietin-1 (Ang-1) messenger ribonucleic acid (mRNA) was detected by real-time fluorescence quantitative polymerase chain reaction (PCR). The expression of aHSC Ang-1 protein was observed by immunolfuorescence staining. The impact of aHSC on the proliferation of hepatic vascular endothelial cells (HVEC) was observed by Transwell chamber. The impact of aHSC on HVEC tube formation was observed by tube formation assay. The experimental data were compared using one-way analysis of variance and LSD-t test.ResultsAfter aHSC were cultured for 1, 3, 5, 7 d, the relative expression of aHSC Ang-1 mRNA was respectively 1.000±0.024, 1.920±0.080, 6.230±0.320 and 7.820±0.380, which gradually increased as the culture time went on (LSD-t=7.32, 13.68, 8.34;P<0.05). The immunolfuorescence staining showed that Ang-1 and smooth muscle actin antibody (aSMA) were co-expressed in the aHSC. Transwell chamber indirect co-culture showed that aHSC could promote the proliferation of HVEC, and the effect weakened after Ang-1 antibody was added. Tube formation assay showed that HVEC could polymerize and gradually developed tubular structure in the aHSC conditioned medium, and the effect signiifcantly weakened after Ang-1 antibody was added. ConclusionaHSC may promote the proliferation and angiogenesis of HVEC in HCC by secreting Ang-1.