Ｔｈｅ ｔｈｅｒａｐｅｕｔｉｃ ｒｅｓｕｌｔｓ ｏｆ ３６ ｃａｓｅｓ ｏｆ ｇａｓｔｒｉｃ ｃａｎｃｅｒ ｗｉｔｈ ｈｅｐａｔｉｃ ｍｅｔａｓｔａｓｅｓ ｃｏｎｆｉｒｍｅｄ ｂｙ ｏｐｅｒａｔｉｏｎ ａｎｄ ｐａｔｈｏｌｏｇｉｃａｌ ｅｘａｍｉｎａｔｉｏｎ ａｒｅ ｒｅｐｏｒｔｅｄ．Ｉｔ ｓｕｇｇｅｓｔｓ ｔｈａｔ ｏｐｅｒａｔｉｏｎｓ ｓｈｏｕｌｄ ｎｏｔ ｂｅ ｇｉｖｅｎ ｕｐ ｅｖｅｎ ｈｅｐａｔｉｃ ｍｅｔａｓｔａｓｅｓ ｈａｖｅ ｏｃｃｕｒｅｄ．Ｒａｄｉｃａｌ ｒｅｓｅｃｔｉｏｎ ｏｆ ｐｒｉｍａｒｙ ｃａｎｃｅｒ ｃｏｎｃｏｍｉｔａｎｔ ｗｉｔｈ ｔｒｅａｔｍｅｎｔ ｏｆ ｍｅｔａｓｔａｓｉｓ ａｎｄ ｏｔｈｅｒ ｐｒｏｃｅｄｕｒｅｄ ｃｏｕｌｄ ｒｅｌｉｅｖｅ ｓｙｍｐｔｏｍｓ，ｐｒｏｍｏｔｅ ｓｕｒｉｖａｌ ｄｕｒａｔｉｏｎ ａｎｄ ｑｕａｌｉｔｙ．Ｐｒｏｃｅｄｕｒｅｄ ｆｏｒ ｔｒｅａｔｉｎｇ ｐｒｉｍａｒｙ ｈｅｐａｔｉｃ ｃａｎｃｅｒ ａｒｅ ａｌｓｏ ｕｓｅｆｕｌ ａｓ ｗｅｌｌ ａｓ ｍｅｔａｓｔａｔｉｃ ｈｅｐａｔｉｃ ｃａｎｃｅｒ．
ObjectiveTo summarize the papers about the molecular mechanisms of liver metastasis from colorectal cancer in recent years and in order to provide assistance for the diagnosis and treatment of liver metastases from colorectal cancer.MethodThe relevant literatures at home and abroad in recent years about the molecular mechanisms of liver metastasis from colorectal cancer were reviewed.ResultsThe molecular mechanism of liver metastasis from colorectal cancer is complicated. For example, microRNA-192 could inhibit liver metastasis from colorectal cancer through multiple targets, however microRNA-181a could promote liver metastasis from colorectal cancer. TGF-β inhibits liver metastasis from colorectal cancer by inhibiting cell proliferation and Smad-dependent signaling to induce apoptosis. Elevated CEA level not only help in the diagnosis of colorectal cancer, but also as a prognostic indicator for colorectal cancer patients. CEA could promote liver metastasis by affecting the survival of colorectal cancer cells in vessels, changeing the liver microenvironment, and affecting the adhesion and survival of circulating tumor cells in the liver.ConclusionsThe molecular mechanism of liver metastasis of colorectal cancer has not been fully elucidated. Through in-depth study of the mechanism of liver metastasis of colorectal cancer, it can provide molecular targets for targeted therapy in patients with liver metastases from colorectal cancer, such as bevacizumab, cetuximab, panitumab and so on. Detecting the change of serological markers in patients with colorectal cancer can help diagnose, judge recurrence, prognosis and metastasis.
Objective To analyze the relationship between Glasgow prognostic score （GPS）， liver metastasis， and prognosis of rectal caner. Methods Clinical data of 223 patients with rectal cancer who underwent operation in Chinese PLA General Hospital from Jun. 2005 to Dec. 2011 were retrospectively analyzed， and the relationship between preoperative GPS score， liver metastasis， and prognosis of rectal cancer were analyzed. Results Preoperative GPS score of patients with rectal cancer was related to invasion depth （P＜0.001）， vascular or lymphatic invasion （P＜0.001）， liver metastasis （P＜0.001）， TNM stage （P＜0.001）， levels of carcinoembryonic antigen （P=0.009）， levels of CA19-9（P＜0.001）， and levels of CA724 （P＜0.001）. Multivariate analysis results revealed that differentiation of tumor （poorly：OR=10.688）， vascular or lymphatic invasion （OR=4.918）， lymph node metastasis （OR=3.359）， and preoperative GPS score （score 2：OR=15.907） were related to liver metastasis；age （RR=2.121）， differentiation of tumor （poorly：RR=2.846）， invasion depth （RR=1.754）， TNM stage （stageⅡ：RR=7.447， stageⅢ：RR=9.030， stage Ⅳ：RR=13.325）， and preoperative GPS score （score 2：RR=2.471） were the independently prognostic factors of rectal cancer. The preo- perative GPS score were related with both liver metastasis and prognosis of rectal cancer. Conclusion Preoperative GPS score is associated with liver metastasis of rectal cancer， and it is considered to be a useful predictor of postoperative prognosis in rectal cancer.
Objective To investigate the influence of cationic liposomemediated endostatin gene on colorectal cancer liver metastasis. Methods Animal model for colorectal carcinoma liver metastasis were established. The plasmid expressing endostatin genelipofectAMINE were injected in vein. Results After cationic liposomemediated endostatin gene were injected in vein, the incidence of liver metastasis and mean numbers of liver tumors were decreased, survival time of animal was significantly longer. Conclusion Intravenous injection of cationic liposomemediated endostatin gene can control the development of colorectal cancer liver metastasis effectively.
Objective To explore the research progress in molecular mechanisms, clinical diagnosis and treatment of single cell sequencing (SCS) techniques in the progression of colorectal cancer liver metastasis (CRLM). Method The literatures on SCS in CRLM at home and abroad in recent years were reviewed. Results SCS technology could perform high-throughput sequencing on the genetic information of different cell subsets at the single-cell level, which was helpful to explore the molecular mechanism of action in the occurrence, development, metastasis, immune escape and drug resistance of colorectal cancer liver metastasis. Thus making the clinical diagnosis, treatment, and prognosis of colorectal cancer more accurate. Conclusion SCS technology, as an emerging sequencing technology, can provide us with updated ideas and more perspectives to explore the occurrence and development of tumors and the prevention and treatment of tumors.
ObjectiveTo evaluate the clinical application and the efficacy of contrast enhanced ultrasonography (CEUS)guided percutaneous radiofrequency ablation (RFA) in patients with liver metastases. MethodsTotal 136 patients with 219 liver metastatic tumors, which were detected by CEUS before RFA therapy, were analyzed retrospectively. The diamter of tumors was (3.2±1.2) cm. Among them, the largest tumor more than 3 cm in diameter were found in 48.5% (66 patients), and 57.4% (78 patients) were with solitary metastasis. Enhanced CT and (or) MRI, and laboratory tests were applied to evaluate the outcomes after RFA treatment by regular followup. ResultsTumors were not detected by conventional ultrasonography in two cases, and 47.0% (63/134) of the patients with the largest tumor were 0.3 cm larger by CEUS than by conventional ultrasonography. More 40 tumors were detected in 18.4% (25/136) patients by CEUS. Followup ranged from 3 to 68 months (median time of 12 months). Early tumor necrosis rate one month after therapy was 98.2% (215/219 tumors). The incidence of local recurrence, new intrahepatic metastasis, and extrahepatic metastasis was 16.9% (23/136), 38.2% (52/136), and 8.8% (12/136), respectively. Local recurrence and new intrahepatic metastasis happened 2-25 months (median time of 6 months) after treatment. Local recurrence rates of the largest tumors ≥ 3 cm and tumor lt; 3 cm was 22.7% and 11.4%， respectively (P=0.079). The rate of new intrahepatic metastasis for the solitary metastasis cases was significantly lower than that for multiple metastases cases (25.6% versus 55.2%, P=0.000). The 1, 2, 3year survival rates were 82.5%, 64.3%, and 50.1%, and the 1, 2, 3year local recurrence free survival rates were 67.7%, 53.8%, and 38.3%, respetively. Patients with solitary metastasis survived longer than that with multiple metastases (P=0.034). ConclusionPatients with liver metastases treated by CEUSguided percutaneous RFA can get better survival rate, and CEUS is of much value for clinic application.
ObjectiveTo examine long-term survival, morbidity, and mortality following hepatic resection for gastric cancer hepatic metastases and to identify prognostic factors that affect survival. MethodsA systematic literature search of EMbase, PubMed, Web of Science, The Cochrane Library (Issue 2, 2015), CBM, WanFang Data, and CNKI was undertaken for studies that evaluated the role of hepatic resection for gastric cancer hepatic metastases. Two reviewers independently screened studies based on inclusion and exclusion criteria, extracted data, and evaluated risk of bias of included studies. RevMan 5.3 software was used for meta-analysis. ResultsThirty-nine studies were included, of which, eight studies were included in meta-analysis. The median sample size was 21 (range 10 to 64). Procedures were associated with a median 30-day morbidity of 24% (0% to 47%) and mortality of 0% (0% to 30%). The median 1-year, 3-year, and 5-year survival rates were 68%, 31%, and 27%, respectively. Meta-analysis result of 8 cohort studies showed hepatic resection of hepatic metastases was associated with a significantly improved overall survival at 1-year and 2-year follow-up (RR=0.47, 95%CI 0.3 to 0.58, P < 0.000 01; RR=0.70, 95%CI 0.63 to 0.79, P < 0.000 01). ConclusionsPatients with hepatic metastasis from gastric cancer may benefit from hepatic resection. More trials are needed to confirm this finding because of the limited included studies and their low quality.
ObjectiveTo summarize current treatment methods and research advances of liver metastasis in patients with gastrointestinal stromal tumor (GIST).MethodThe related literatures about treatment of liver metastasis in patients with GIST were collected and reviewed.ResultsGIST often occurred liver metastasis, which seriously affected the prognosis of patients. In the era of tyrosine kinase inhibitors (TKI) treatment, radical resection combined with TKI was the first choice. In addition, radiofrequency ablation and interventional therapy could be selected according to the patient’s condition.ConclusionsComplete resection of tumor and TKI treatment can improve the prognosis and survival rate of GIST patients with liver metastasis. GIST patients with liver metastasis need multi-disciplinary and multi-mode combined treatment.