1.Effect of nucleos (t)ide analog antiviral treatment on the pathological differentiation and prognosis of ;hepatitis B virus-related hepatocellular carcinoma
Mingyan XU ; Shupeng SONG ; Yinghua LAN ; Yanxin HUANG ; Lisheng JIANG ; Qin YAN ; Rongshan FAN ; Yongguo LI
Chinese Journal of Infectious Diseases 2016;34(12):723-726
Objective To explore the effect of nucleos(t)ide analog (NA)antiviral treatment on the pathological differentiation of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC)and the prognostic factors of HCC.Methods Totally 127 patients with HBV-related HCC who were hospitalized and received partial hepatectomy in First Affiliated Hospital of Harbin Medical University from March 2007 to November 2013 were included in this study.Sixteen cases received antiviral treatment before operation and the remaining 111 cases had no history of NA treatment.The differences of histopathological grading were compared between the two groups.Twenty-nine patients received antiviral treatment for the first time after surgery,and the rest 82 patients did not.All these patients were followed up for survival and recurrence.Multivariate analysis was used to explore the prognostic factors for HCC.The categorical variables were analyzed byχ2 test or Fisher exact test.Survival rate was compared with Log-rank test. Univariate or multivariate Cox regression analysis was used to explore the related factors of survival. Results The proportions of well-,moderately- or poorly-differentiated HCC in patients with antiviral treatment before surgery were 18.75 %,68.75 % and 12.5 %,respectively.Whereas the proportions in those without treatment were 16.22%,66.67% and 17.11 %,respectively.There was no significant difference in histopathological grading of HCC between the two groups (χ2=0.224,P =0.885 ).The overall median survival time was 39 months.The 6-month,1-and 2-year survival rates were 91 .7%, 77.5 % and 59.3%,respectively.The 6-month,1- and 2-year survival rate of postoperative antiviral treatment were 96.3%,92.4% and 78.5 %,respectively,which were significantly higher than those of no antiviral treatment group (85 .9%,70.0% and 48.5 %,respectively;χ2= 6.967,P = 0.008 ). Univariate analysis showed that tumor number,size,portal vein transfer,AFP level,postoperative antiviral treatment,histopathological grading,TNM staging,BCLC staging,γ-GT and PTA were prognostic factors for postoperative HCC survival.Multivariate analysis showed that AFP level (HR=1 , 95 %CI :1 .0004—1 .002,P =0.004),postoperative antiviral treatment (HR =0.38,95 %CI :0.38—0.15 ,P =0.04)and BCLC stage (B vs A:HR=1 .55 ,95 %CI :0.76—3.18;C vs A:HR=3.63,95 %CI :1 .31 —10.09,P =0.04)were independent prognostic factors.Conclusions Preoperative antiviral treatment has no impact on the histopathological grading of HCC. BCLC stage, AFP level and postoperative antiviral treatment are independent prognostic factors for HBV-related HCC.
2.Risk factors of residual tumor in single small hepatocellular carcinoma after thermal ablation treatment
Yue HAN ; Weihua ZHI ; Shupeng FAN ; Dong YAN ; Fei XU
Chinese Journal of Internal Medicine 2022;61(5):543-547
Objective:To evaluate the risk factors of residual tumor after thermal ablation in patients with small hepatocellular carcinoma.Methods:This was a retrospective study recruiting 107 patients diagnosed as single hepatocellular carcinoma with maximum diameter ≤3 cm from December 2009 to August 2015 in National Cancer Center. The cohort enrolled 81 males and 26 females, including 83 patients younger than 70 years old. All patients were treated with radiofrequency ablation or microwave ablation, and evaluated by CT or MRI after 4-6 weeks compared with baseline data. Potentially related factors were analyzed such as patients′ characteristics, tumor location and adjacent, ablation pattern, hepatitis B/C infection. A multivariate logistic regression analysis was conducted for the independence of risk factors.Results:Six patients (5.6%) with residual tumor was detected in the whole population of 101 cases. Univariate analysis suggested that tumor adjacent to vascular structure, poor differentiation, AFP≥200 μg/L were the risk factors of residue disease (all P<0.05). Multivariate logistic regression suggested that pathological type of poorly differentiated tumor was the only independent risk factor ( HR=2.26,95% CI 0.25-20.50, P=0.030). Conclusions:Poorly differentiated pathology is an independent predictive factor for residual disease in small hepatocellular carcinoma after thermal ablation. Such patients should be routinely followed up after operation.
3.Repair of a severe defect of the lower abdomen with multiple abdominal hernias
Chao GUO ; Shupeng HUANG ; Tong YANG ; Fan WANG ; Yongsheng ZHOU ; Hua LIANG ; Jiaping ZHANG
Chinese Journal of Plastic Surgery 2023;39(12):1353-1356
In December 2021, a male patient with a large-scale tissue defect in the lower abdomen and multiple abdominal wall hernias caused by a serious traffic accident was admitted to the Department of Plastic Surgery, the First Affiliated Hospital of Army Medical University. The tensor fascia lata myocutaneous flap combined with anterolateral thigh flap was used to repair abdominal wall sunken deformity and abdominal wall hernia successfully. Five months of follow-up showed satisfactory appearance with no recurrence of abdominal wall hernia.
4.Repair of a severe defect of the lower abdomen with multiple abdominal hernias
Chao GUO ; Shupeng HUANG ; Tong YANG ; Fan WANG ; Yongsheng ZHOU ; Hua LIANG ; Jiaping ZHANG
Chinese Journal of Plastic Surgery 2023;39(12):1353-1356
In December 2021, a male patient with a large-scale tissue defect in the lower abdomen and multiple abdominal wall hernias caused by a serious traffic accident was admitted to the Department of Plastic Surgery, the First Affiliated Hospital of Army Medical University. The tensor fascia lata myocutaneous flap combined with anterolateral thigh flap was used to repair abdominal wall sunken deformity and abdominal wall hernia successfully. Five months of follow-up showed satisfactory appearance with no recurrence of abdominal wall hernia.