A variety of managements, including systemic and local chemotherapy, radiofrequency ablation and others, are used after multidisciplinary team discussion to improve the survival of patients with unresectable liver metastasis, and to enlarge the cohort of patients who can be managed with curative intent. Patients should be divided into different clinical groups according to characteristics of the patient and tumor, and then receive different treatments. For the patients who may be converted to be resectable after chemotherapy, we should choose efficient convertible chemotherapy with short courses to get the best response rate. For KRAS wild-type patients, cetuximab combined with FOLFOX/FOLFIRI, in which 5-fluorouracil is continuously infused, is recommended. In addition, resection of the primary tumor is recommended at the right time for asymptomatic patients with unresectable liver metastases. There is no consensus on the preferred treatment modality for systemic and local therapies.
Colorectal Neoplasms ; drug therapy ; pathology ; surgery ; therapy ; Humans ; Liver Neoplasms ; drug therapy ; secondary ; surgery

Microcirculation of liver cancer is the micro-vascular system which comes from the tissue of liver cancer. It can offer the nutritional requirement for accelerating the cancer cell proliferation and metastasis. The intrinsic mechanism of angiogenesis is the key link in the formation of liver cancer microcirculation system. Liver regeneration microenvironment also plays an important role in the construction of liver cancer microcirculation, through the improvement of liver regeneration microenvironment affecting tumor microcirculation is the new strategy of prevention and treatment of liver cancer. In recent years, it is found that many kinds of Chinese medicine can inhibit angiogenesis, decrease the microvessel density, and delay or prevent the development of liver cancer.
Humans ; Liver Neoplasms ; drug therapy ; pathology ; therapy ; Liver Regeneration ; Medicine, Chinese Traditional ; Microcirculation ; Tumor Microenvironment

OBJECTIVETo establish hepatic metastasis models of two colorectal carcinoma cell lines in mice for studying mechanism involved in colorectal carcinoma metastasis and its potential countermeasures.

METHODSMurine and human colorectal carcinoma CT26 and LoVo cells were inoculated into the spleen of Balb/c mice and Balb/c nude mice, respectively. The conditions of all the mice were observed, and the survival time and liver metastases were recorded.

RESULTSAll mice inoculated with CT26 cells and a few with LoVo cells developed liver metastases without metastases in any other organs. Pathological examination identified the liver metastatic foci as poorly differentiated colonic adenocarcinoma. Compared with the mice inoculated with LoVo cells, those with CT26 cells had a higher rate of liver metastasis and a shorter survival time.

CONCLUSIONThe mouse model has been established successfully, which well mimics the pathological process of liver metastasis of colorectal cancer.

Animals ; Cell Line, Tumor ; Colorectal Neoplasms ; pathology ; Disease Models, Animal ; Drug Evaluation, Preclinical ; Female ; Humans ; Liver ; pathology ; Liver Neoplasms ; drug therapy ; pathology ; secondary ; Mice ; Spleen ; pathology

OBJECTIVETo investigate the effect of FOLFOX4 neoadjuvant chemotherapy on the non-tumoral liver in patients with metastatic colorectal carcinoma.

METHODSA large series of surgically resected liver metastases(n=42) was selected and the morphological changes were examined by light and electron microscope. The mRNA and protein levels of connective tissue growth factor (CTGF) expression were detected by semi-quantitative RT-PCR and Western blotting analysis.

RESULTSTwelve (63.2%) of the 19 post-chemotherapy liver resection specimens had sinusoidal dilatation and hemorrhage. In contrast, 23 livers treated by surgery alone remained normal. Neoadjuvant chemotherapy could significantly enhance the mRNA and protein levels of CTGF expression in hepatic stellate cells.

CONCLUSIONSystemic FOLFOX4 neoadjuvant chemotherapy in metastatic colorectal carcinoma frequently causes morphological injuries involving hepatic microvasculature and induces CTGF expression in hepatic stellate cells to participate in hepatic fibrosis.

Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms ; pathology ; Female ; Humans ; Liver ; pathology ; Liver Neoplasms ; drug therapy ; pathology ; secondary ; Male ; Middle Aged ; Neoadjuvant Therapy

OBJECTIVETo investigate the clinical characteristics, treatment and prognosis of splenic marginal zone lymploma (SMZL).

METHODSA total of 91 cases of SMZL admitted in our hospital from January 2002 to March 2013 were enrolled in this study. The clinical characteristics and immunophenotypes were summarized, and the clinical therapeute response and prognostic factors were analyzed statistically.

RESULTSThe median age of 91 patients was 56 (28-79); all the patients displayed splenomegaly with 73.6% of large spleen, hepatomegaly (14.6%) and lymphadenophathy (28.2%); the bone marrow involvement was observed in 98.9% patients, the B symptom was found in 47.1% patients. The positive expression of CD20 was observed in 100% patients, the positive expression of CD5 was in 8.3% patients, the positive expression of CD23 was found in 47.6% patients, no specific antigen was observed by now for SMZL. The clinical treatment showed that total ORR was 87.7%, CRR was 53.8% in chemotherapy group, chemotherapy combined with rituximab showed a better response than that of chemotherapy alone, which ORR was 100%, CRR was 72.4%, the difference between them was statistically significant. The Hb < 120 g/L, elevated LDH level and treatment without rituximab were the poor prognostic factors for PFS, while the elevated LDH level was related with OS of patients.

CONCLUSIONThe patients with SMZL often display splenomegaly, involvement in bone marrow and absence of specific immunophenotypes. Chemotherapy combined with rituximab can definitely improve the outcome of SMZL. The Hb level, LDH level and treatment combined with or without rituximab seem to be related to the prognosis of the disease.

Adult ; Aged ; Bone Marrow ; pathology ; Humans ; Immunophenotyping ; Liver ; pathology ; Lymphoma ; drug therapy ; pathology ; Middle Aged ; Prognosis ; Rituximab ; therapeutic use ; Spleen ; pathology ; Splenic Neoplasms ; drug therapy ; pathology

Antineoplastic Agents ; therapeutic use ; Carcinoma, Hepatocellular ; drug therapy ; pathology ; Humans ; Interferon-alpha ; therapeutic use ; Liver Neoplasms ; drug therapy ; pathology ; Neoplasm Recurrence, Local ; drug therapy ; prevention & control

Antineoplastic Agents ; pharmacology ; Carcinoma, Hepatocellular ; drug therapy ; pathology ; Cell Division ; drug effects ; Cisplatin ; pharmacology ; Humans ; Inhibitory Concentration 50 ; Liver Neoplasms ; drug therapy ; pathology ; Tumor Cells, Cultured ; drug effects

OBJECTIVETo establish human hepatocellular carcinoma multidrug-resistance cell line (HepG2/ADM) and to determine the effect of low-frequency pulse ultrasound (US) on MDR cells and investigate its mechanism.

METHODSUsing gradual increase of adriamycin (ADM) concentrations in culture, an adriamycin-resistant human hepatocellular carcinoma cell sub line (HepG2/ADM) was established in vitro. HepG2/ADM cells were cultured in vitro and randomly divided into 4 groups: the control group (HepG2/ADM only), the group ADM by 1.0 mug/ml adriamycin for 1 h, the group US by low-frequency pulse ultrasound for 10 min, and the group US by low-frequency pulse ultrasound and treated with adriamycin simultaneously at same time. A sonication at a frequency of 0.8 MHz, was delivered with an intensity level of 0.5W/cm2, with continuous exposure of 10 min was applied. The ability of US to induce the apoptosis of MDR was evaluated by analyses of fluorescence microscopy, DNA fragmentation assay and flow cytometry assay.

RESULTSHepG2/Adm was resistant to many anti-tumor agents, and its IC50 of ADM was 26 times higher than that of parent cell line HepG2. Significant over expressions of P-gp, MRP, LRP and GSTs were detected. HepG2/ADM cells radiated by US had the typical characteristics of apoptosis. Compared with the control group (HepG2/ADM, 3.47%); the apoptosis rates were higher in US (12.23%). The therapeutic alliance of US with ADM for MDR cells, have a significant change in the ratio of apoptosis (18.81%, t=1.46 to 5.36, P<0.01).

CONCLUSIONHepG2/ADM could have the biological characteristics of human multidrug-resistance cell line. The US sonication of 0.8 MHz could induce apoptosis of HepG2/ADM cell in vitro, and could act synergistically with Adriamycin.

Apoptosis ; Carcinoma, Hepatocellular ; drug therapy ; pathology ; Cell Line, Tumor ; DNA Fragmentation ; Doxorubicin ; pharmacology ; Drug Resistance, Multiple ; Drug Resistance, Neoplasm ; Flow Cytometry ; Humans ; Liver Neoplasms ; drug therapy ; pathology ; Ultrasonics

The experimental researches of applying emodin for prevention and treatment of liver diseases in recent years were reviewed. Emodin can inhibit the growth of liver tumor cells in vitro and in vivo, inducing cell apoptosis is one of its mechanisms. Emodin also has the effects of liver protection, anti-liver fibrosis, and so on, the mechanisms for those effects still need more studies.
Animals ; Apoptosis ; drug effects ; Cell Line, Tumor ; Emodin ; pharmacology ; therapeutic use ; Humans ; Liver Cirrhosis ; drug therapy ; Liver Neoplasms ; drug therapy ; pathology ; Protective Agents ; pharmacology ; therapeutic use

OBJECTIVE: To investigate the antitumor activity of decoction and study its liver and kidney toxicity and its effect on the immune system in a tumor-bearing mouse model. METHODS: Hepatoma H22 tumor-bearing mouse models were randomized into model group, cyclophosphamide (CTX) group, and low-, moderate-, and high-dose decoction groups (JW-L, JW-M, and JW-H groups, respectively). The antitumor activity of decoction was assessed by calculating the tumor inhibition rate and pathological observation of the tumor tissues. Immunohistochemistry was used to detect the expressions of Bax, Bcl-2, Bax/Bcl-2 and caspase-3 in the tumors. The liver and kidney toxicity of decoction was analyzed by evaluating the biochemical indicators of liver and kidney functions. The immune function of the tumor-bearing mice were assessed by calculating the immune organ index, testing peripheral blood routines, and detection of serum IL-2 and TNF-α levels using enzyme-linked immunosorbent assay. RESULTS: Compared with that in the model group, the tumor mass in CTX, JW-M and JW-H groups were all significantly reduced ( < 0.05) with cell rupture and necrosis in the tumors. Immunohistochemistry revealed obviously up-regulated expressions of Bax and caspase-3 and down- regulated expression of Bcl-2 protein with an increased Bax/Bcl-2 ratio in CTX, JW-M and JW-H groups. Treatment with decoction significantly reduced Cr, BUN, AST and ALT levels, improved the immune organ index, increased peripheral blood leukocytes, erythrocytes and hemoglobin levels, and up-regulated the levels of TNF-α and IL-2 in the tumor-bearing mice. These changes were especially significant in JW-H group when compared with the parameters in the model group ( < 0.01). CONCLUSIONS decoction has a strong anti-tumor activity and can improve the liver and kidney functions of tumor-bearing mice. Its anti-tumor effect may be attributed to the up-regulation of Bax, caspase-3, TNF-α and IL-2 levels and the down-regulation of Bcl-2 expression as well as the enhancement of the non-specific immune function.
Animals ; Antineoplastic Agents, Phytogenic ; pharmacology ; Carcinoma, Hepatocellular ; drug therapy ; immunology ; metabolism ; pathology ; Drugs, Chinese Herbal ; pharmacology ; Kidney ; drug effects ; Liver ; drug effects ; pathology ; Liver Neoplasms ; drug therapy ; immunology ; metabolism ; pathology ; Mice ; Necrosis ; Neoplasm Proteins ; metabolism ; Random Allocation ; Up-Regulation