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| 1 | 肝癌转化治疗中国专家共识(2021版)显示文摘中国肝癌病人的总体生存较差,重要原因是首诊时中晚期肝癌病人的比例很高。随着系统治疗的进步,中晚期肝癌的疗效已显著改善,部分病人可能通过手术切除而获根治。此外,系统治疗与局部治疗的结合,进一步提高肿瘤缩小、降期的机会,因此,转化率较高的新型、多模式综合治疗已成为中晚期肝癌病人获得长期生存的主要途径。本专家共识凝聚了中国专家在肝癌转化治疗领域的经验,提出了转化治疗的策略和实施过程需要解决的问题,并推动该领域研究和临床实践奠定了基础。 | 中国抗癌协会肝癌专业委员会转化治疗协作组 樊嘉 | 2021 | 中华消化外科杂志2021，20，6： | 83 |
| 2 | 肝癌转化治疗中国专家共识(2021版)显示文摘国内许多研究中心已积累了肝癌转化治疗经验。初步研究结果显示,转化治疗是改善中晚期肝癌病人生存的重要途径。但转化治疗及其相关领域仍存在许多亟待解决的临床和科学问题。为了总结既往经验、梳理问题,由中国抗癌协会肝癌专业委员会转化治疗协作组发起,基于国内外该领域研究获得的初步经验和研究结果,结合符合我国国情的临床实践,制订《肝癌转化治疗中国专家共识(2021版)》。 | 中国抗癌协会肝癌专业委员会转化治疗协作组 樊嘉 秦叔逵 沈锋 蔡秀军 滕皋军 蔡建强 周俭 陈敏山 李强 刘连新 王伟林 梁廷波 张必翔 孙惠川 谢青 荚卫东 赵明 刘秀峰 毕新宇 黎功 白雪莉 纪元 徐立 王征 朱小东 | 2021 | 中国实用外科杂志2021，41，6： | 82 |
| 3 | TACE联合索拉非尼治疗大肝癌的疗效与安全性分析显示文摘目的评价经动脉化疗栓塞(TACE)联合索拉非尼治疗大肝癌的疗效与安全性。方法回顾分析中山大学附属第一医院2008年7月至2012年6月收治的79例大肝癌(直径〉10cm)患者的临床资料,分为3组,24例行TACE联合索拉非尼治疗(T+S组),35例行单纯TACE治疗(T组),20例单纯服用索拉非尼治疗(s组)。结果T+S组、T组、S组中位生存期(MST)分别为15、10、5个月(P=0.000);3组的中位肿瘤进展时间(TTP)分别为6.0、3.0、2.5个月(P=0.000),T+S组与S组的索拉非尼相关不良反应的发生率差异无统计学意义(P〉0.05),主要为手足皮肤反应、腹泻和脱发,无4级以上的严重不良反应。T+S组与T组的介入治疗相关并发症发生率差异无统计学意义(P〉0.05),主要为轻度的黄疸、腹水和腹股沟血肿。结论TACE联合索拉非尼治疗大肝癌安全性和耐受性良好,可有效控制肿瘤进展,延长患者生存期。 | 张应强 杨建勇 王于 黄勇慧 范文哲 李家平 | 2013 | 中华医学杂志2013，93，13： | 15 |
| 4 | 增强CT检查在鉴别肝细胞癌患者肾上腺腺瘤与转移瘤的诊断价值显示文摘目的:分析肝脏三期动态增强CT检査在鉴别肝细胞癌(HCC)患者肾上腺腺瘤与转移瘤的诊断价值。方法:回顾性分析2013年3月至2015年10月期间在我院行肝脏CT动态增强三期扫描并诊断为HCC的患者资料。其中,HCC合并肾上腺结节的89名患者中共发现94个肾上腺结节。记录第一次发现肾上腺结节时的患者性别及年龄,肾上腺结节的最大径,平扫及增强后各期的CT值。测量及计算绝对流空比值(APW)、相对流空比值(RPW)、延迟期强化比值(RER)。两组数据进行独立样本t检验及ROC分析比较诊断准确性。结果:肾上腺腺瘤的平均最大径(2.09±0.98cm)明显小于转移瘤的平均最大径(4.54±2.02cm),P<0.01.肾上腺腺瘤的平扫CT值(7.52±14.62HU),明显低于肾上腺转移瘤的平扫CT值(41.08±7.28HU)(P<0.01)。19例乏脂性腺瘤与转移瘤鉴别诊断的准确性分别为43%(APW值)、64.6%(RPW值)、100%(RER值)。RER值的ROC曲线下面积为1.0。结论:肝脏三期增强CT扫描可以鉴别HCC患者的肾上腺腺瘤与转移瘤。在乏脂性腺瘤与转移瘤鉴别方面,RER值显示了最高的诊断价值。 | 金日明 李倩倩 李妍卓 陈栋 蔡权宇 | 2019 | 中国医学计算机成像杂志2019，25，3： | 12 |
| 5 | Diagnostic value for extrahepatic metastases of hepatocellular carcinoma in positron emission tomography/computed tomography scan显示文摘AIM: To evaluated the value of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) scan in diagnosis of hepatocellular carcinoma (HCC) and extrahepatic metastases. METHODS: A total of 138 patients with HCC who had both conventional imaging modalities and 18F-FDG PET/CT scan done between November 2006 and March 2011 were enrolled. Diagnostic value of each imaging modality for detection of extrahepatic metastases was evaluated. Clinical factors and tumor characteristics including PET imaging were analyzed as indicative factors for metastases by univariate and multivariate methods. RESULTS: The accuracy of chest CT was significantly superior compared with the accuracy of PET imaging for detecting lung metastases. The detection rate of metastatic pulmonary nodule ≥ 1 cm was 12/13 (92.3%), when < 1 cm was 2/10 (20%) in PET imaging. The accuracy of PET imaging was significantly superior compared with the accuracy of bone scan for detecting bone metastases. In multivariate analy- sis, increased tumor size (≥ 5 cm) (P = 0.042) and increased average standardized uptake value (SUV) uptake (P = 0.028) were predictive factors for extrahepatic metastases. Isometabolic HCC in PET imaging was inversely correlated in multivariate analysis (P = 0.035). According to the receiver operating characteristic curve, the optimal cutoff of average SUV to predict extrahepatic metastases was 3.4. CONCLUSION: 18F-FDG PET/CT scan is invaluable for detection of lung metastases larger than 1 cm and bone metastases. Primary HCC having larger than 5 cm and increased average SUV uptake more than 3.4 should be considered for extrahepatic metastases. | Ji Eun Lee Jae Young Jang Soung Won Jeong Sae Hwan Lee Sang Gyune Kim Sang-Woo Cha Young Seok Kim Young Deok Cho Hong Soo Kim Boo Sung Kim So Young Jin Deuk Lin Choi | 2012 | World Journal of Gastroenterology2012，18，23： | 10 |
| 6 | 原发性肝癌骨转移的临床病理特征及预后因素分析显示文摘目的 探讨原发性肝癌骨转移患者的临床病理特征和预后因素.方法 回顾分析天津医科大学肿瘤医院2005年1月至2014年6月间收治的80例原发性肝癌骨转移患者的临床资料,描述原发灶和骨转移灶的临床病理特征,并分析相关预后因素.生存分析采用Kaplan-Meier法,单因素分析采用Log-rank法,多因素分析采用Cox回归模型.结果 患者中位生存期4.7(95% CI3.4~6.0)个月,6、12、24个月生存率分别为42.5%、17.5%、2.5%.单因素分析显示,Child-Pugh分级(P<0.01)、ECOG评分(P=0.014)、胆碱酯酶(P=0.002)、总胆红素(P=0.006)、腹水(P =0.003)、TACE治疗(P<0.01)是影响预后的相关因素.多因素分析显示,Child-Pugh分级(P<0.01)、TACE治疗(P<0.01)是独立预后因素.结论 肝癌合并骨转移预后差,积极局部TACE联合药物保肝治疗可改善患者预后. | 国永飞 郭志 于海鹏 孙元元 杨雪玲 张炜浩 | 2015 | 中华医学杂志2015，95，41： | 9 |
| 7 | 肝细胞癌肝移植术后复发和转移的研究:单中心经验显示文摘目的研究肝细胞癌肝移植术后复发和转移的临床特点及治疗方法。方法回顾分析2003年1月至2005年11月收治的95例肝细胞癌肝移植术后肝癌复发转移病例的临床资料。结果在随访期内,42例(43.2%)患者被诊断为肝癌复发。复发部位最多见于移植肝(32例)、肺(21例)、骨(7例)。单因素分析结果显示,肿瘤大小、肿瘤分布、肝硬化背景、术前甲胎蛋白浓度、组织学分期、大血管侵犯6项因素对肝移植术后生存和(或)肝癌复发有明显影响。多因素分析结果显示,肿瘤分布、组织学分期、大血管侵犯是影响术后总体生存率和肝癌复发率的独立危险因素。肝癌复发后的介入治疗及内放疗可延缓肿瘤进展,选择合适病例行复发灶手术切除可最大限度地改善预后。结论合理选择接受肝移植的肝癌患者可能可以大幅度降低移植术后肝癌的复发率。在现阶段,外科治疗应是目前移植术后复发性肝癌的首选治疗手段。 | 郑树森 陈峻 王伟林 张珉 沈岩 吴健 徐骁 严盛 | 2008 | 中华外科杂志2008，46，21： | 9 |
| 8 | 索拉非尼治疗19例晚期原发性肝癌临床疗效观察显示文摘目的:观察索托非尼治疗19例晚期原发性肝癌患者的疗效及不良反应。方法19例无法手术切除的晚期原发性肝癌患者口服索拉非尼400 mg,2次/d,至出现不可耐受的不良反应或连续两次评价为疾病进展时停药,观察疗效和不良反应。结果在服药后3个月观察,获得 PR 1例(5.3%),SD 10例(52.6%),PD8例(42.1%),42.9%(6/14)患者 AFP 明显降低,而50.0%(7/14)呈不同程度的增加;随访3~22(8.5)个月,16例(84.2%)患者死亡,3例(16%)患者仍继续服药,中位疾病进展时间(TTP)为5.1个月(1.5~15.0个月),中位总生存期(OS)为6.5个月(3.0-22.0个月);16例(84.2%)患者出现手足皮肤硬化、麻木,7例(36.8%)出现皮疹和脱发,10例(52.6%)血压升高,15例(78.9%)发生胃肠道不良反应,2例(10.5%)发生骨髓抑制,8例(42.1%)出现腹泻。结论索拉非尼治疗晚期原发性肝癌患者有一定的疗效,多数不良反应可以耐受,服药期间患者的生活质量保持稳定。 | 芦东徽 郝文胜 费振乐 胡宗涛 | 2014 | 实用肝脏病杂志2014，17，3： | 8 |
| 9 | ^(18)F-FDG PET/CT对腹部增强CT术前评估肝癌远处转移的价值显示文摘目的探讨^(18)F-FDG PET/CT对腹部增强CT术前评估肝癌远处转移的价值。方法回顾性分析63例肝癌患者的临床资料,以最终病理或随访结果为准,探讨^(18) F-FDG PET/CT对腹部增强CT术前评估肝癌远处转移方面的增益价值。结果增强CT结合^(18)F-FDG PET/CT诊断肝癌远处转移的灵敏度、特异度和准确度分别为83.3%(20/24)、100%(39/39)、93.7%(59/63),显著优于增强CT的41.7%(10/24)、100%(39/39)、77.8%(49/63),差异有统计学意义(χ~2=8.88,P=0.003;χ~2=6.48,P=0.011)。53例腹部增强CT未检出远处转移,经^(18) F-FDGPET/CT检查发现10例存在远处转移(4例骨转移,3例肺转移,1例肾上腺转移,1例网膜转移,1例肺转移同时伴锁骨上淋巴结转移)。增强CT检出远处转移的10例患者,结合^(18) FFDG PET/CT后,发现1例转移灶超出增强CT检出范围(多处骨转移及左侧肾上腺转移灶)。结论 ^(18) F-FDG PET/CT术前评估肝癌远处转移及转移范围具有独特价值,肝癌患者术前应考虑^(18)F-FDG PET/CT检查以准确评价肿瘤分期,指导治疗。 | 邓家琦 付文广 雷正明 陈跃 蔡亮 李秋 蒋禹 | 2016 | 重庆医学2016，45，13： | 7 |
| 10 | 31例肝癌脑转移患者的临床特点及预后影响因素显示文摘目的:探讨肝癌脑转移患者的临床特点和预后影响因素。方法回顾性分析31例肝癌脑转移患者的临床资料,对预后影响影响因素进行单因素和多因素生存分析。结果31例肝癌患者诊断为脑转移,肝癌脑转移的发生率为0.61%。诊断肝癌脑转移时患者的平均年龄为48.5岁,其中男性患者26例。从诊断肝癌到脑转移的平均时间间隔为14个月,肝癌脑转移患者的中位生存时间为10周。单因素分析显示,脑部放疗、颅内转移瘤数目、卡氏评分、独立递归分级指数( RPA)分级和Child-pugh分级与患者的预后均有关(均P<0.05)。 Cox多因素分析显示,RPA分级和脑部放疗为影响患者预后的独立因素(均P<0.05)。结论肝癌脑转移患者生存时间短,预后差。但对于RPA分级低的患者,积极地进行脑部放疗可延长患者的生存时间。 | 张瑞丽 张华 张仑 肖蕾 孙岩娜 杨颖 包永星 | 2016 | 中华肿瘤杂志2016，38，4： | 7 |
| 11 | 肝癌术后病人癌症复发恐惧现状及其影响因素显示文摘目的:探讨肝癌术后病人癌症复发恐惧现状,并分析其影响因素。方法:采用一般资料问卷、癌症病人恐惧疾病进展简化量表(FoP-Q-SF)、疾病不确定感量表(MUIS)、简易应对方式问卷(SCSQ)对武汉市某三级甲等综合性医院行肝癌切除术病人343例进行问卷调查。结果:肝癌术后病人FoP-Q-SF总分为(30.33±6.36)分,其中生理健康维度得分为(16.18±3.39)分,社会家庭维度得分为(14.15±3.64)分,超出正常水平(≥34分)104例(30.3%)。MUIS总分为(55.89±6.08)分;SCSQ中积极应对得分为(15.40±6.06)分,消极应对得分为(9.46±2.71)分。多元线性回归分析显示,年龄、病程、肿瘤直径、肿瘤数目、肝炎病史及不可预测、积极应对得分为肝癌术后病人癌症复发恐惧的主要影响因素(P<0.05)。结论:肝癌术后病人癌症复发恐惧水平较高,医护人员应对病人采取个性化的疾病相关健康教育,帮助病人降低疾病不确定感,指导病人实施积极有效的应对方式,提高病人面对癌症的信心和能力,以降低癌症复发恐惧水平。 | 胡正楠 汪晖 李蓉蓉 王冰花 胡凯利 罗鸿萍 陈伟勋 | 2022 | 护理研究2022，36，19： | 6 |
| 12 | 肝癌合并肝外转移的外科治疗现状显示文摘随着诊断及筛查技术的不断进步,肝癌合并肝外转移的发现率逐年增加,其治疗较为困难且预后较差。目前尚无统一的肝癌合并肝外转移的治疗标准,各类指南仅建议行靶向治疗、系统化疗或最佳支持治疗,对于外科手术在肝癌合并肝外转移治疗中的价值并未具体描述。多项研究的结果表明,多数肝癌合并肝外转移患者死于肝内肿瘤进展所致的肝功能衰竭,而非肝外转移,对肝内原发肿瘤可切除但早期即发生肝外转移的患者,切除肝内原发灶可带来生存获益。对于转移灶切除在治疗肝癌合并肝外转移中的作用目前争议较大,多数学者认为对于肝癌肺转移的患者,在肝内原发病灶切除或控制良好的情况下进行有选择的外科手术治疗是有益的,对于淋巴结转移、骨转移、肾上腺转移、脑转移灶的手术切除并未显示出明显的生存获益,仅在需要缓解症状及改善生活质量时予以考虑。因此,肝癌即使出现肝外转移仍不可忽视外科手术的作用,对于部分严格筛选的患者外科手术加个体化的综合治疗仍可带来生存获益。 | 毛凯 王捷 | 2019 | 中华外科杂志2019，57，6： | 6 |
| 13 | Hepatic arterial infusion chemotherapy in hepatocellular carcinoma with portal vein tumor thrombosis显示文摘AIM: To evaluate the prognostic factors and efficacy of hepatic arterial infusion chemotherapy in hepatocellular carcinoma with portal vein tumor thrombosis. METHODS: Fifty hepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT) were treated using hepatic arterial infusion chemotherapy (HAIC) via a subcutaneously implanted port. The epirubicin-cisplatin-5-fluorouracil (ECF) chemotherapeutic regimen consisted of 35 mg/m 2 epirubicin on day 1, 60 mg/m 2 cisplatin for 2 h on day 2, and 500 mg/m 2 5-fluorouracil for 5 h on days 1-3. The treatments were repeated every 3 or 4 wk. RESULTS: Three (6%) of the 50 patients achieved a complete response (CR), 13 (26%) showed partial responses (PR), and 22 (44%) had stable disease (SD).The median survival and time to progression were 7 and 2 mo, respectively. After 2 cycles of HAIC, CR was achieved in 1 patient (2%), PR in 10 patients (20%) and SD in 26 patients (52%). Significant pre-treatment prognostic factors were a tumor volume of < 400 cm 3 (P = 0.01) and normal levels of protein induced by vitamin K absence or antagonist (PIVKA)-Ⅱ (P = 0.022). After 2 cycles of treatment, disease control (CR + PR + SD) (P = 0.001), PVTT response (P = 0.003) and α-fetoprotein reduction of over 50% (P = 0.02) were independent factors for survival. Objective response (CR + PR), disease control, PVTT response, and combination therapy during the HAIC were also significant prognostic factors. Adverse events were tolerable and successfully managed. CONCLUSION: HAIC may be an effective treatment modality for advanced HCC with PVTT in patients with tumors < 400 cm 3 and good prognostic factors. | Do Seon Song Si Hyun Bae Myeong Jun Song Sung Won Lee Hee Yeon Kim Young Joon Lee Jung Suk Oh Ho Jong Chun Hae Giu Lee Jong Young Choi Seung Kew Yoon | 2013 | World Journal of Gastroenterology2013，19，29： | 5 |
| 14 | 肝脏恶性肿瘤合并肝外转移的外科治疗显示文摘随着疾病筛查手段及影像学检查的发展,肝癌合并肝外转移的检出率逐年增加,手术切除率亦逐年增加。肝癌合并肝外转移尚无统一的治疗标准。本文汇集国内肝脏外科领域4位著名专家及其团队,结合各自中心临床经验,从不同角度探讨肝癌合并肝外转移行外科治疗的合理性。耿小平教授认为:肝癌合并肝外转移虽属进展期肝癌,但在严格控制适应证的前提下选择部分患者尝试联合外科手术的综合治疗有望获得较好预后;对部分少见肝脏恶性肿瘤则可在综合治疗的基础上对肝外转移病灶宜行更为积极的外科治疗。周俭教授认为:合并肝外转移的原发性肝癌行肝内病灶切除应以是否切实延长患者生存时间为前提。其主张依据患者具体情况选择个体化治疗方案及联合多种方式的综合治疗使患者生存获益,必要的肝内病灶切除是一种积极可行的治疗策略。王捷教授分享其团队的2例肝癌合并肝外转移患者的诊断与治疗过程,建议原发性肝癌即使出现肝外转移仍不可忽视外科手术的作用。对于部分严格筛选的患者,尤其是肝内原发病灶可切除但早期即发生肝外转移的患者,肝内原发病灶切除可带来生存获益。周伟平教授认为:肝癌合并肝外转移患者选择手术应格外慎重,应优先考虑能否提高患者生存率,在肝外转移病灶得到有效控制或完全坏死的情况下,行肝脏原发病灶切除术仍然是目前的主流观点。 | 耿小平 周俭 王征 王捷 毛凯 周伟平 赵翎皓 | 2019 | 中华消化外科杂志2019，18，4： | 5 |
| 15 | TACE与索拉非尼在晚期肝癌治疗中的疗效比较显示文摘目的 比较肝动脉栓塞化疗(TACE)和索拉非尼在晚期肝细胞癌治疗中的疗效.方法 回顾性分析确诊为晚期肝细胞癌(按巴塞罗那标准ECOG评分1-2,Child A/B级,和/或有大血管侵犯或肝外转移)的89例患者的临床资料.其中30例既往接受了TACE治疗,59例患者接受了索拉非尼治疗.观察比较TACE治疗与索拉非尼治疗肿瘤出现恶化的时间和总生存时间.结果 接受TACE治疗的患者随访时长的中位数为7.3个月(95% CI:4.0~10.6),病人接受TACE治疗的中位数为(3±2)次;接受索拉非尼治疗时长的中位数为4.3个月(95%CI:2.9~5.8),肿瘤出现恶化时间的中位数在TACE组与索拉非尼组间差异无显著性(P=0.128).总生存时间的中位数在索拉非尼组中为7.38个月(95% CI:5.2~9.56),TACE组中为8.59个月(95% CI:5.5~11.58,P=0.0164),提示TACE组优于索拉非尼组.结论 在晚期肝癌患者(BCLC:C期)中,TACE呈现出了积极的疗效,且略优于索拉非尼. | 李明非 杨远 曾勇 甘险峰 李刚 | 2015 | 西部医学2015，27，9： | 5 |
| 16 | Efficacy of surgical resection in management of isolated extrahepatic metastases of hepatocellular carcinoma显示文摘AIM:To clarify the benefit of surgical excision for patients with extrahepatic metastases of hepatocellular carcinoma(HCC). METHODS:We retrospectively reviewed the medical records of 140 patients with pathologically proven extrahepatic metastases of HCC and evaluated the outcomes of those who had undergone surgical resection(SR)for extrahepatic metastatic lesions.Prognoses made on the basis of extrahepatic metastatic sites were also examined. RESULTS:The survival rates of patients who underwent SR of extrahepatic metastases were significantly better than those of patients who did not receive SR. For the SR group,1-and 3-year survival rates were 24%and 7%,respectively,while for the non-resection group,the survival rates were 8%and 0%,respec- tively(P<0.0001).Survival rates related to metastatic sites were also significantly superior after SR of extrahepatic metastases:median survivals were 32 mo with lung metastasis,10 mo with bone metastasis,6.1 mo with brain metastasis. CONCLUSION:SR can provide survival benefits forpatients with 1 or 2 isolated extrahepatic metastases and who concurrently exhibit good hepatic functional reserve and general performance status as well as successful treatment of intrahepatic HCC. | Kun-Ming Chan Ming-Chin Yu Ting-Jung Wu Chen-Fang Lee Tse-Ching Chen Wei-Chen Lee Miin-Fu Chen | 2009 | World Journal of Gastroenterology2009，15，43： | 4 |
| 17 | Chinese expert consensus on conversion therapy for hepatocellular carcinoma(2021 edition)显示文摘Recent advances in systemic and locoregional treatments for patients with unresectable or advanced hepatocellular carcinoma(HCC)have resulted in improved response rates.This has provided an opportunity for selected patients with initially unresectable HCC to achieve adequate tumor downstaging to undergo surgical resection,a‘conversion therapy’strategy.However,conversion therapy is a new approach to the treatment of HCC and its practice and treatment protocols are still being developed.Review the evidence for conversion therapy in HCC and develop consensus statements to guide clinical practice.Evidence review:Many research centers in China have accumulated significant experience implementing HCC conversion therapy.Preliminary findings and data have shown that conversion therapy represents an important strategy to maximize the survival of selected patients with intermediate stage to advanced HCC;however,there are still many urgent clinical and scientific challenges for this therapeutic strategy and its related fields.In order to summarize and learn from past experience and review current challenges,the Chinese Expert Consensus on Conversion Therapy for Hepatocellular Carcinoma(2021 Edition)was developed based on a review of preliminary experience and clinical data from Chinese and non-Chinese studies in this field and combined with recommendations for clinical practice.Sixteen consensus statements on the implementation of conversion therapy for HCC were developed.The statements generated in this review are based on a review of clinical evidence and real clinical experience and will help guide future progress in conversion therapy for patients with HCC. | Hui-Chuan Sun Jian Zhou Zheng Wang Xiufeng Liu Qing Xie Weidong Jia Ming Zhao Xinyu Bi Gong Li Xueli Bai Yuan Ji Li Xu Xiao-Dong Zhu Dousheng Bai Yajin Chen Yongjun Chen Chaoliu Dai Rongping Guo Wenzhi Guo Chunyi Hao Tao Huang Zhiyong Huang Deyu Li Gang Li Tao Li Xiangcheng Li Guangming Li Xiao Liang Jingfeng Liu Fubao Liu Shichun Lu Zheng Lu Weifu Lv Yilei Mao Guoliang Shao Yinghong Shi Tianqiang Song Guang Tan Yunqiang Tang Kaishan Tao Chidan Wan Guangyi Wang Lu Wang Shunxiang Wang Tianfu Wen Baocai Xing Bangde Xiang Sheng Yan Dinghua Yang Guowen Yin Tao Yin Zhenyu Yin Zhengping Yu Bixiang Zhang Jialin Zhang Shuijun Zhang Ti Zhang Yamin Zhang Yubao Zhang Aibin Zhang Haitao Zhao Ledu Zhou Wu Zhang Zhenyu Zhu Shukui Qin Feng Shen Xiujun Cai Gaojun Teng Jianqiang Cai Minshan Chen Qiang Li Lianxin Liu Weilin Wang Tingbo Liang Jiahong Dong Xiaoping Chen Xuehao Wang Shusen Zheng Jia Fan 无 | 2022 | Hepatobiliary Surgery and Nutrition2022，11，2： | 4 |
| 18 | 原发性肝癌伴淋巴结转移的临床与CT评价显示文摘目的:探讨原发性肝癌(HCC)伴淋巴结转移的临床特点与CT应用价值。方法:收集我院HCC伴淋巴结转移57例作为研究组,回顾性分析其临床特点、CT表现。结果:HCC淋巴结转移CT表现为肝脏淋巴结引流区肿大的淋巴结,增强扫描无明显强化或轻度强化,转移部位以肝门、腹膜后最常见。结论:HCC淋巴结转移临床表现缺乏特异性,增强CT有助于提高的诊断率。 | 周鹏志 谭慧珍 黄越前 李博璋 江魁明 | 2011 | 中国医药导刊2011，13，6： | 4 |
| 19 | Features of extrahepatic metastasis after radiofrequency ablation for hepatocellular carcinoma显示文摘BACKGROUND Extrahepatic metastasis(EHM)of hepatocellular carcinoma(HCC)is associated with poor outcomes.However,the clinical features and risk factors of EHM of HCC after radiofrequency ablation(RFA)remain unclear.AIM To elucidate the characteristics and risk factors of EHM after RFA for HCC.METHODS From January 2008 to December 2017,we retrospectively enrolled 661 patients who underwent RFA as first-line treatment for HCC at 2 tertiary hospitals.The inclusion criteria were age≥18 years,a diagnosis of HCC,and treatment-naivety.Abdominal computed tomography(CT)or magnetic resonance imaging(MRI)and alpha-fetoprotein measurements were routinely performed at 1 mo after RFA and followed-up at intervals of 3-6 mo.Univariate analyses were performed using the chi-squared test or Student’s t-test,and univariate and multivariate analyses were performed via logistic regression,as appropriate.RESULTS EHM was diagnosed in 44 patients(6.7%)during a median follow-up period of 1204 days.The 10-year cumulative rate of HCC recurrence and EHM was 92.7%and 33.7%,respectively.Initial recurrence was most often intrahepatic,and the rate of extrahepatic recurrence at initial recurrence was only 1.2%.The median time to the diagnosis of EHM was 2.68 years,and 68.2%of patients developed EHM within 2 years of the first recurrence,regardless of recurrence-free survival and 75.0%of patients developed EHM within 5 years after first recurrence.EHM was mostly diagnosed via abdominal CT/MRI in 33(75.0%)and 38 of 44 patients(86.4%)with EHM had either positive abdominal CT scan results or serum AFP level elevation.In multivariate analysis,recurrence-free survival<2 years,ablation zone/tumor size<2,and alpha-fetoprotein level>400 IU/mL were associated with a high EHM risk.CONCLUSION EHM occurs following multiple intrahepatic recurrences after RFA and combined contrast-enhanced abdominal CT and serum AFP were useful for surveillance.Patients especially with high-risk factors require close follow-up for EHM. | Jae H Yoon Young J Goo Chae-Jun Lim Sung K Choi Sung B Cho Sang S Shin Chung H Jun | 2020 | World Journal of Gastroenterology2020，26，32： | 3 |
| 20 | Surgical resection of a solitary para-aortic lymph node metastasis from hepatocellular carcinoma显示文摘Lymph node (LN) metastases from hepatocellular carcinoma (HCC) are considered uncommon. We describe the surgical resection of a solitary para-aortic LN metastasis from HCC. A 65-year-old Japanese man with B-type liver cirrhosis was admitted for the evaluation of a liver tumor. He had already undergone radiofrequency ablation, transcatheter arterial chemoembolization, and percutaneous ethanol injection therapy for HCC. Despite treatment, viable regions remained in segments 4 and 8. We performed a right paramedian sectionectomy with partial resection of the left paramedian section of the liver. Six months later, serum concentrations of alpha-fetoprotein (189 ng/mL) and PIVKA-2 (507 mAU/mL) increased. Enhanced com- puted tomography of the abdomen revealed a tumor (20 mm in diameter) on the right side of the abdominal aorta. Fluorine-18 fluorodeoxyglucose positron emission tomography revealed an increased standard uptake value. There was no evidence of recurrence in other regions. Esophagogastroduodenoscopy and colonoscopy revealed no malignant tumor in the gastrointestinal tract. Para-aortic LN metastasis from HCC was thus diagnosed. We performed lymphadenectomy. Histopathological examination revealed that the tumor was largely necrotic, with poorly differentiated HCC on its surface, which confirmed the suspected diagnosis. After 6 mo tumor marker levels were normal, with no evidence of recurrence. Our experience suggests that a solitary para-aortic LN metastasis from HCC can be treated surgically. | Junji Ueda Hiroshi Yoshida Yasuhiro Mamada Nobuhiko Taniai Sho Mineta Masato Yoshioka Youichi Kawano Tetsuya Shimizu Etsuko Hara Chiaki Kawamoto Keiko Kaneko Eiji Uchida | 2012 | World Journal of Gastroenterology2012，18，23： | 3 |
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