1.Ferroptosis and liver diseases.
Xin LI ; Liang TAO ; Meijuan ZHONG ; Qian WU ; Junjia MIN ; Fudi WANG
Journal of Zhejiang University. Medical sciences 2024;53(6):747-755
As the central organ of metabolism, the liver plays a pivotal role in the regulation of the synthesis and metabolism of various nutrients within the body. Ferroptosis, as a newly discovered type of programmed cell death caused by the accumulation of iron-dependent lipid peroxides, is involved in the physiological and pathological processes of a variety of acute and chronic liver diseases. Ferroptosis can accelerate the pathogenetic process of acute liver injury, metabolic associated fatty liver disease, alcoholic liver disease, viral hepatitis, and autoimmune hepatitis; while it can slower disease progression in advanced liver fibrosis and hepatocellular carcinoma. This suggests that targeted regulation of ferroptosis may impact the occurrence and development of various liver diseases. This article reviews the latest research progress of ferroptosis in various liver diseases, including acute liver injury, metabolic associated fatty liver disease, alcoholic liver disease, viral hepatitis, autoimmune hepatitis, liver fibrosis and hepatocellular carcinoma. It aims to provide insights for the prevention and treatment of acute and chronic liver diseases through targeting ferroptosis.
Humans
;
Liver Diseases/etiology*
;
Ferroptosis/physiology*
;
Liver Neoplasms/pathology*
;
Carcinoma, Hepatocellular/pathology*
;
Liver Cirrhosis/etiology*
;
Liver/pathology*
;
Hepatitis, Autoimmune/metabolism*
;
Liver Diseases, Alcoholic/metabolism*
2.Clinical analysis of liver dysfunction induced by SHR-1210 alone or combined with apatinib and chemotherapy in patients with advanced esophageal squamous cell carcinoma.
Ling QI ; Bo ZHANG ; Yun LIU ; Lan MU ; Qun LI ; Xi WANG ; Jian Ping XU ; Xing Yuan WANG ; Jing HUANG
Chinese Journal of Oncology 2023;45(3):259-264
Objective: To investigate the clinical characteristics of abnormal liver function in patients with advanced esophageal squamous carcinoma treated with programmed death-1 (PD-1) antibody SHR-1210 alone or in combination with apatinib and chemotherapy. Methods: Clinical data of 73 patients with esophageal squamous carcinoma from 2 prospective clinical studies conducted at the Cancer Hospital Chinese Academy of Medical Sciences from May 11, 2016, to November 19, 2019, were analyzed, and logistic regression analysis was used for the analysis of influencing factors. Results: Of the 73 patients, 35 had abnormal liver function. 13 of the 43 patients treated with PD-1 antibody monotherapy (PD-1 monotherapy group) had abnormal liver function, and the median time to first abnormal liver function was 55 days. Of the 30 patients treated with PD-1 antibody in combination with apatinib and chemotherapy (PD-1 combination group), 22 had abnormal liver function, and the median time to first abnormal liver function was 41 days. Of the 35 patients with abnormal liver function, 2 had clinical symptoms, including malaise and loss of appetite, and 1 had jaundice. 28 of the 35 patients with abnormal liver function returned to normal and 7 improved to grade 1, and none of the patients had serious life-threatening or fatal liver function abnormalities. Combination therapy was a risk factor for patients to develop abnormal liver function (P=0.007). Conclusions: Most of the liver function abnormalities that occur during treatment with PD-1 antibody SHR-1210 alone or in combination with apatinib and chemotherapy are mild, and liver function can return to normal or improve with symptomatic treatment. For patients who receive PD-1 antibody in combination with targeted therapy and chemotherapy and have a history of long-term previous smoking, alcohol consumption and hepatitis B virus infection, liver function should be monitored and actively managed in a timely manner.
Humans
;
Esophageal Squamous Cell Carcinoma/drug therapy*
;
Esophageal Neoplasms/pathology*
;
Prospective Studies
;
Programmed Cell Death 1 Receptor/therapeutic use*
;
Antineoplastic Combined Chemotherapy Protocols/adverse effects*
;
Liver Diseases/etiology*
3.SpyGlass in Diagnosis of Hepatocellular Carcinoma with Right Hepatic Duct Tumor Thrombus Hemorrhage: A Case Report.
Li-Hua GUO ; Min MIAO ; Guo-Liang YE
Chinese Medical Sciences Journal 2023;38(4):309-314
Hepatocelluar carcinoma presenting as a biliary duct tumor thrombus is a relatively rare entity, with poor prognosis. The primary clinical manifestation of this disease is obstructive jaundice, which can often be misdiagnosed. A 59-year-old female patient was admitted with sudden onset of abdominal pain. Laboratory tests suggested obstructive jaundice, and enhanced magnetic resonance imaging of the upper abdomen did not show obvious biliary dilatation. Endoscopic ultrasound and endoscopic retrograde cholangiopancreatography suggested an occupying lesion in the upper bile duct. SpyGlass and biopsy finally confirmed hepatocellular carcinoma with right hepatic duct tumor thrombus hemorrhage. The SpyGlass Direct Visualization System, as an advanced biliary cholangioscopy device, showed the advantages of single-person operation as well as easy access to and visualization of the lesion.
Female
;
Humans
;
Middle Aged
;
Carcinoma, Hepatocellular/diagnostic imaging*
;
Jaundice, Obstructive/etiology*
;
Liver Neoplasms/diagnostic imaging*
;
Hepatic Duct, Common/pathology*
;
Thrombosis/complications*
;
Hemorrhage/complications*
4.Home care with acupuncture increased the quality of life in a patient with advanced cancer with neuropathic pain induced by bone metastasis: a case report.
Journal of Integrative Medicine 2018;16(3):208-210
A 66-year-old female patient was diagnosed with hepatocellular carcinoma accompanied by neuropathic pain induced by a metastatic tumor that compromised root and spinal canal. Although her pain was relieved following medical treatment, breakthrough pain occurring 1-2 times a day was still distressing. Neuropathic pain in her right lower limb caused discomfort and irritability and decreased her quality of life. We had limited options to adjust her prescription drug regime, due to the side effect of these drugs. Although acupuncture therapy was only performed at her home once a week, the efficacy was outstanding. The patient did not report any further instances of breakthrough pain, and she did not require additional bolus morphine. She could comfortably live in her familiar surroundings with her family and did not require any emergency room visits or admission into the hospital during the last month of her life. She had excellent quality of life in the terminal period of her life, and could even participate in a family function during this time. The present case report suggests that acupuncture may have a role in treating neuropathic pain induced by bone metastasis in patients with advanced cancer across clinical and in-home settings.
Acupuncture Therapy
;
Aged
;
Bone Neoplasms
;
complications
;
secondary
;
Carcinoma, Hepatocellular
;
pathology
;
Female
;
Home Care Services
;
Humans
;
Liver Neoplasms
;
pathology
;
Neoplasms
;
pathology
;
Neuralgia
;
etiology
;
therapy
;
Quality of Life
5.A Case Series of Liver Abscess Formation after Transcatheter Arterial Chemoembolization for Hepatic Tumors.
Wei SUN ; Fei XU ; Xiao LI ; Chen-Rui LI
Chinese Medical Journal 2017;130(11):1314-1319
BACKGROUNDLiver abscess is a serious complication following transcatheter arterial chemoembolization (TACE). Much attention has been paid to this condition as it may interfere with the treatment process and result in a poor prognosis of the patient. This study aimed to analyze the causes of liver abscess, a complication, after TACE for hepatic tumors and to summarize management approaches.
METHODSFrom June 2012 to June 2014, of 1480 consecutive patients who underwent TACE at our hospital, five patients developed liver abscess after TACE procedures for hepatic tumors. Of the five patients, each receiving conventional TACE, one underwent three sessions, two underwent two sessions, and the remaining two underwent one session of TACE. Demographic and clinical characteristics, together with management approaches and prognosis, were collected through a review of medical records.
RESULTSThese five patients were confirmed to have post-TACE liver abscess through clinical manifestations, laboratory, and imaging tests. After percutaneous drainage and anti-inflammatory treatments, the symptoms present in four patients with liver abscess significantly improved as evidenced by shrinkage or disappearance of the abscess cavity, and the patients recovered completely after sufficient drainage. The remaining patient experienced recurrent symptoms and abdominal abscess, achieved no significant improvement after treatment, and eventually died of severe infection and multiple organ failures.
CONCLUSIONSTACE must be implemented with extreme caution to avoid liver abscess. An effective management relies on an early diagnosis, prompt use of sufficient doses of appropriate antibiotics, and active implementation of abscess incision, drainage, and aspiration.
Adult ; Aged ; Carcinoma, Hepatocellular ; therapy ; Chemoembolization, Therapeutic ; adverse effects ; Humans ; Liver ; pathology ; Liver Abscess ; diagnosis ; etiology ; Liver Neoplasms ; therapy ; Male ; Middle Aged ; Retrospective Studies
6.Adeno-Associated Virus 2-Mediated Hepatocellular Carcinoma is Very Rare in Korean Patients.
Kyoung Jin PARK ; Jongan LEE ; June Hee PARK ; Jae Won JOH ; Choon Hyuck David KWON ; Jong Won KIM
Annals of Laboratory Medicine 2016;36(5):469-474
BACKGROUND: The incidence and etiology of hepatocellular carcinoma (HCC) vary widely according to race and geographic regions. The insertional mutagenesis of adeno-associated virus 2 (AAV2) has recently been considered a new viral etiology of HCC. The aim of this study was to investigate the frequency and clinical characteristics of AAV2 in Korean patients with HCC. METHODS: A total of 289 unrelated Korean patients with HCC, including 159 Hepatitis-B-related cases, 16 Hepatitis-C-related cases, and 114 viral serology-negative cases, who underwent surgery at the Samsung Medical Center in Korea from 2009 to 2014 were enrolled in this study. The presence of AAV2 in fresh-frozen tumor tissues was investigated by DNA PCR and Sanger sequencing. The clinical and pathological characteristics of AAV2-associated HCC in these patients were compared with previous findings in French patients. RESULTS: The AAV2 detection rate in Korean patients (2/289) was very low compared with that in French patients (11/193). Similar to the French patients, the Korean patients with AAV2-related HCC showed no signs of liver cirrhosis. The Korean patients were younger than the French patients with the same AAV2-associated HCC; the ages at diagnosis of the two Korean patients were 47 and 39 yr, while the median age of the 11 French patients was 55 yr (range 43-90 yr). CONCLUSIONS: AAV2-associated HCC was very rare in Korean patients with HCC. Despite a limited number of cases, this study is the first to report the clinical characteristics of Korean patients with AAV2-associated HCC. These findings suggest epidemiologic differences in viral hepatocarcinogenesis between Korean and European patients.
Adult
;
Asian Continental Ancestry Group
;
Capsid Proteins/genetics
;
Carcinoma, Hepatocellular/etiology/*pathology/virology
;
DNA, Viral/chemistry/genetics/metabolism
;
DNA-Binding Proteins/genetics
;
Dependovirus/*genetics/isolation & purification/pathogenicity
;
Female
;
Humans
;
Incidence
;
Inverted Repeat Sequences/genetics
;
Liver Neoplasms/etiology/*pathology/virology
;
Male
;
Middle Aged
;
Parvoviridae Infections/complications/epidemiology
;
Polymerase Chain Reaction
;
Republic of Korea
;
Sequence Analysis, DNA
;
Viral Proteins/genetics
7.Icteric Intraductal Hepatocellular Carcinoma and Bile Duct Thrombus Masquerading as Hilar Cholangiocarcinoma.
Ye Xin KOH ; Ser Yee LEE ; Aik Yong CHOK ; Alexander Yf CHUNG
Annals of the Academy of Medicine, Singapore 2016;45(3):113-116
Aged
;
Bile Duct Diseases
;
complications
;
diagnostic imaging
;
pathology
;
Bile Duct Neoplasms
;
diagnosis
;
Carcinoma, Hepatocellular
;
complications
;
diagnostic imaging
;
pathology
;
Diagnosis, Differential
;
Humans
;
Jaundice, Obstructive
;
etiology
;
Klatskin Tumor
;
diagnosis
;
Liver Neoplasms
;
complications
;
diagnostic imaging
;
pathology
;
Male
;
Middle Aged
;
Thrombosis
;
complications
;
diagnostic imaging
;
pathology
;
Tomography, X-Ray Computed
8.Primary Adenocarcinoma with Focal Choriocarcinomatous Differentiation in the Sigmoid Colon.
Sook Kyoung OH ; Hyung Wook KIM ; Dae Hwan KANG ; Cheol Woong CHOI ; Yu Yi CHOI ; Hong Kyu LIM ; Ja Jun GOO ; Sung Yeol CHOI
The Korean Journal of Gastroenterology 2015;66(5):291-296
Primary colorectal choriocarcinoma is a rare neoplasm. Only 19 cases have been reported worldwide, most of which involved adenocarcinomas. The prognosis is usually poor, and the standard therapy for this tumor has not been established. A 61-year-old woman presented with constipation and lower abdominal discomfort. She was diagnosed with primary adenocarcinoma with focal choriocarcinomatous differentiation in the sigmoid colon and liver metastasis. Because the serum beta-human chorionic gonadotropin level was not significantly elevated, and because only focal choriocarcinomatous differentiation was diagnosed, we selected the chemotherapy regimen that is used for the treatment of metastatic colorectal adenocarcinoma. The patient survived for 13 months after the initial diagnosis. This is the first case in Korea to assess the suppressive effects of the standard chemotherapy for colorectal adenocarcinoma against coexisting colorectal choriocarcinoma and adenocarcinoma.
Adenocarcinoma/*diagnosis/drug therapy/pathology
;
Antineoplastic Agents/administration & dosage
;
Antineoplastic Combined Chemotherapy Protocols/therapeutic use
;
CA-19-9 Antigen/analysis
;
Chorionic Gonadotropin, beta Subunit, Human/blood
;
Colon, Sigmoid/pathology
;
Colonic Neoplasms/*diagnosis/drug therapy/pathology
;
Colonoscopy
;
Constipation/etiology
;
Female
;
Fluorouracil/therapeutic use
;
Humans
;
Leucovorin/therapeutic use
;
Liver Neoplasms/secondary
;
Middle Aged
;
Organoplatinum Compounds/therapeutic use
;
Prognosis
;
Tomography, X-Ray Computed
9.Cholangiocarcinoma with a paraneoplastic leukemoid reaction mimicking a pyogenic liver abscess.
Hyoju HAM ; Hee Yeon KIM ; Kyung Jin SEO ; Su Lim LEE ; Chang Wook KIM
The Korean Journal of Internal Medicine 2015;30(1):110-113
No abstract available.
Bile Duct Neoplasms/complications/*diagnosis
;
*Bile Ducts, Intrahepatic/chemistry/pathology/radiography
;
Biopsy
;
Cholangiocarcinoma/complications/*diagnosis
;
Diagnosis, Differential
;
Fever/diagnosis/*etiology
;
Humans
;
Immunohistochemistry
;
Leukocytosis/*diagnosis/etiology
;
*Liver/chemistry/pathology/radiography
;
Liver Abscess, Pyogenic/*diagnosis
;
Magnetic Resonance Imaging
;
Male
;
Middle Aged
;
Paraneoplastic Syndromes/*diagnosis/etiology
;
Predictive Value of Tests
;
Tomography, Spiral Computed
;
Tumor Markers, Biological/analysis
10.The Safety and Clinical Outcomes of Chemoembolization in Child-Pugh Class C Patients with Hepatocellular Carcinomas.
Tae Won CHOI ; Hyo Cheol KIM ; Jeong Hoon LEE ; Su Jong YU ; Beomsik KANG ; Saebeom HUR ; Myungsu LEE ; Hwan Jun JAE ; Jin Wook CHUNG
Korean Journal of Radiology 2015;16(6):1283-1293
OBJECTIVE: To evaluate the safety and clinical outcomes of chemoembolization in Child-Pugh class C patients with hepatocellular carcinomas (HCC). MATERIALS AND METHODS: The study comprised 55 patients with HCC who were classified as Child-Pugh class C and who underwent initial chemoembolization between January 2003 and December 2012. Selective chemoembolization was performed in all technically feasible cases to minimize procedure-related complications. All adverse events within 30 days were recorded using the Common Terminology Criteria for Adverse Events (CTCAE). The tumor response to chemoembolization was evaluated using the modified Response Evaluation Criteria In Solid Tumors. RESULTS: Thirty (54.5%) patients were within the Milan criteria, and 25 (45.5%) were beyond. The mortality of study subjects at 30 days was 5.5%. Major complications were observed in five (9.1%) patients who were all beyond the Milan criteria: two hepatic failures, one hepatic encephalopathy, and two CTCAE grade 3 increases in aspartate aminotransferase/alanine aminotransferase abnormality. The mean length of hospitalization was 6.3 ± 8.3 days (standard deviation), and 18 (32.7%) patients were discharged on the next day after chemoembolization. The tumor responses of the patients who met the Milan criteria were significantly higher (p = 0.014) than those of the patients who did not. The overall median survival was 7.1 months (95% confidence interval: 4.4-9.8 months). CONCLUSION: Even in patients with Child-Pugh class C, chemoembolization can be performed safely with a selective technique in selected cases with a small tumor burden.
Adult
;
Aged
;
Alanine Transaminase/metabolism
;
Aspartate Aminotransferases/metabolism
;
Carcinoma, Hepatocellular/mortality/*pathology/therapy
;
Chemoembolization, Therapeutic/adverse effects
;
Female
;
Hepatic Encephalopathy/etiology
;
Humans
;
Length of Stay
;
Liver Neoplasms/mortality/*pathology/therapy
;
Liver Transplantation
;
Male
;
Middle Aged
;
Proportional Hazards Models
;
Severity of Illness Index
;
Survival Rate
;
Treatment Outcome
;
Tumor Burden

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