1.Clinical application progress of immunization and targeted therapy for Hepatocellular Carcinoma in special populations
Fazhu FEI ; Jiajun LU ; Shuai ZHANG ; Hao LI ; Bin REN
The Journal of Practical Medicine 2024;40(6):738-742
Hepatocellular carcinoma(HCC)has become the second leading cause of cancer-related death worldwide,ranking 6th among all tumors.Due to the lack of obvious early symptoms,most patients are diagnosed in the advanced stage,and the clinical benefits of surgical resection and hepatic artery chemoembolization and radiofrequency ablation are very limited.In recent years,the advent of immune-targeted therapies has revolutionized the systemic and systemic treatment of patients with advanced HCC,however,there is a lack of strong clinical evidence on the safety and efficacy of immune and targeted therapies for special populations,including patients with human immunodeficiency virus(HIV)infection,active autoimmune disease,decompensated cirrhosis(Child B or C),patients with diabetes-associated metabolic syndrome,patients with portal hypertension,vascular invasion,or portal vein thrombosis(PVT),and patients with liver transplantation(LT).This article reviews the current research progress of immune and targeted drugs in special populations.
2.Research advances in nonalcoholic fatty liver disease in individuals with HIV infection
Jiajun LU ; Fazhu FEI ; Bin REN
Journal of Clinical Hepatology 2023;39(6):1446-1453
The prevalence rate of nonalcoholic fatty liver disease (NAFLD) tends to increase in the general population around the world, and the incidence rate of liver malignancies caused by NAFLD is also increasing continuously. Obesity is an independent risk factor for NAFLD. Among the individuals with HIV infection who have a normal body weight, 25% have NAFLD, and lean NAFLD is relatively common in individuals with HIV infection. With reference to related articles in China and globally, this article reviews the epidemiology, pathophysiology, histology, diagnosis, screening, intervention, treatment, and clinical management of NAFLD, in order to improve the awareness of NAFLD in individuals with HIV infection among the public, clinicians, and related institutions.
3.Current status of ex vivo liver resection and autotransplantation in treatment of benign liver lesions
Shuai ZHANG ; Fazhu FEI ; Zhixin WANG ; Haining FAN ; Haijiu WANG ; Lizhao HOU
Journal of Clinical Hepatology 2024;40(12):2543-2547
Benign liver lesions mainly include hepatic hemangioma, focal nodular hyperplasia of the liver, hepatocellular adenoma, and hepatic angiomyolipoma. Hepatic alveolar echinococcosis is a type of parasitic disease, and since it mainly occurs in the liver, it is also a benign lesion of the liver. The clinical treatment of benign liver lesions is mainly based on follow-up observation, supplemented by surgical resection. For patients with end-stage diseases, liver transplantation can be performed due to the large volume of the lesion, the invasion of a number of surrounding large vessels, unclear anatomic location, and the possibility of intraoperative rupture and massive hemorrhage. Since patients with poor liver function based on the liver allocation score for organ donation are more likely to get donor liver, it is difficult for patients with benign liver lesions to obtain the corresponding donor liver resources due to the growth pattern of benign liver lesions, thereby leading to the limited application of allogeneic liver transplantation. Since its emergence in the 1980s, ex vivo liver resection and autotransplantation (ELRA) has brought a new way for the treatment of such patients. This article summarizes the current application of ELRA in benign liver lesions, in order to provide a reference for diagnosis and treatment by clinical medical staff.