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世界胃肠病学杂志（英文版）
世界胃肠病学杂志（英文版）

潘伯荣

周刊

1007-9327

wjg@wjgnet.com

010-85381901-628

100025

北京市朝阳区东四环中路62号楼远洋国际中心D座903室

世界胃肠病学杂志（英文版）/Journal World Journal of GastroenterologyCSCDCSTPCDSCI
查看更多>>主要报道和刊登国内外、特别是我国消化病学者具有创造性的、有较高学术水平的基础和临床研究论文、研究快报等. 对具有中国特色的研究论文, 如食管癌、胃癌、肝癌、大肠癌、病毒性肝炎、幽门螺杆菌、中医中药、中西医结合和基于作者自己研究工作为主的综述性论文, 将优先发表. 读者对象为基础研究或临床研究的消化专业工作者。
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    Comparative genomic study of gastric epithelial cells co-cultured with Helicobacter pylori

    Fen WangLi-Dan LuoJian-Hua PanLi-Hua Huang...
    7212-7224页
    查看更多>>摘要：AIM:To identify genes potentially involved in Helicobacter pylori (H.pylori)-induced gastric carcinogenesis.METHODS:GES-1 cells were co-cultured with H.pylori strains isolated from patients with gastric carcinoma (GC,n =10) or chronic gastritis (CG,n =10) for in vitro proliferation and apoptosis assays to identify the most and least virulent strains.These two strains were cagA-genotyped and used for further in vivo carcinogenic virulence assays by infecting Mongolian gerbils for 52 wk,respectively; a broth free of H.pylori was lavaged as control.Genomic profiles of GES-1 cells cocultured with the most and least virulent strains were determined by microarray analysis.The most differentially expressed genes were further verified using quantitative real-time polymerase chain reaction in GES-1 cells infected with the most and least virulent strains,and by immunohistochemistry in H.pylori positive CG,precancerous diseases,and GC biopsy specimens in an independent experiment.RESULTS:GC-derived H.pylori strains induced a potent proliferative effect in GES-1 cells in co-culture,whereas CG-derived strains did not.The most (from a GC patient) and least (from a CG patient) virulent strains were cagA-positive and negative,respectively.At week 52,CG,atrophy,metaplasia,dysplasia,and GC were observed in 90.0％,80.0％,80.0％,90％,and 60.0％,respectively,of the animals lavaged with the most virulent strain.However,only mild CG was observed in 90％ of the animals lavaged with the least virulent strain.On microarray analysis,800 differentially expressed genes (49 up-and 751 down-regulated),involving those associated with cell cycle regulation,cell apoptosis,cytoskeleton,immune response,and substance and energy metabolisms,were identified in cells co-cultured with the most virulent strain as compared with those co-cultured with the least virulent strain.The six most differentially expressed genes (with a betweenness centrality of 0.1-0.2) were identified among the significant differential gene profile network,including JUN,KRAS,BRCA1,SMAD2,TRAF1,and HDAC6.Quantitative real-time polymerase chain reaction analyses verified that HDAC6 and TRFA1 mRNA expressions were significantly more up-regulated in GES-1 cells cocultured with the most virulent strain than in those cocultured with the least virulent strain.Immunohistochemistry of gastric mucosal specimens from H.pyloripositive patients with CG,intestinal metaplasia (IM),dysplasia,and GC showed that moderately positive and strongly positive HDAC6 expression was detected in 21.7％ of CG patients,30.0％ of IM patients,54.5％ of dysplasia patients,and 77.8％ of GC patients (P ＜0.001).The up-regulation of TRAF1 expressions was detected in 34.8％,53.3％,72.7％,and 88.9％ specimens of CG,IM,dysplasia,and GC,respectively (P ＜0.001).CONCLUSION:The overexpression of HDAC6 and TRAF1 in GES-1 cells co-cultured with the GC-derived strain and in H.pylori-positive dysplasia and GC suggests that HDAC6 and TRAF1 may be involved in H.pyloriinduced gastric carcinogenesis.
      原文链接:
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    • NSTL
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    • 维普

    Magnetic resonance-based total liver volume and magnetic resonance-diffusion weighted imaging for staging liver fibrosis in mini-pigs

    Hang LiTian-Wu ChenXiao-Li ChenXiao-Ming Zhang...
    7225-7233页
    查看更多>>摘要：AIM:TO determine whether and how magnetic resonance imaging (MRI)-based total liver volume (TLV) and diffusion weighted imaging (DWI) could predict liver fibrosis.METHODS:Sixteen experimental mature mini-pigs (6 males,10 females),weighing between 20.0 and 24.0 kg were prospectively used to model liver fibrosis induced by intraperitoneal injection of 40％ CCl4 dissolved in fat emulsion twice a week for 16 wk,and by feeding 40％ CCl4 mixed with maize flour twice daily for the subsequent 5 wk.All the survival animals underwent percutaneous liver biopsy and DWI using b =300,500 and 800 s/mm2 followed by abdominal gadolinium-enhanced MRI at the 0,5th,9th,16th and 21st weekend after beginning of the modeling.TLV was obtained on enhanced MRI,and apparent diffusion coefficient (ADC) was obtained on DWI.Hepatic tissue specimens were stained with hematoxylin and Masson's trichrome staining for staging liver fibrosis.Pathological specimens were scored using the human METAVIR classification system.Statistical analyses were performed to determine whether and how the TLV and ADC could be used to predict the stage of liver fibrosis.RESULTS:TLV increased from stage 0 to 2 and decreased from stage 3 (r =0.211; P ＜ 0.001).There was a difference in TLV between stage 0-1 and 2-4 (P =0.03) whereas no difference between stage 0-2 and 3-4 (P =0.71).TLV could predict stage ≥ 2 [area under receiver operating characteristic curve (AUC) =0.682].There was a decrease in ADC values with increasing stage of fibrosis for b =300,500 and 800s/mm2 (r =-0.418,-0.535 and-0.622,respectively;all P ＜ 0.001).Differences were found between stage 0-1 and 2-4 in ADC values for b =300,500 and 800 s/mm2,and between stage 0-2 and 3-4 for b =500 or 800 s/mm2 (all P ＜ 0.05).For predicting stage ≥ 2 and ≥ 3,AUC was 0.803 and 0.847 for b =500 s/mm2,and 0.848 and 0.887 for b =800 s/mm2,respectively.CONCLUSION:ADC for b =500 or 800 s/mm2 could be better than TLV and ADC for b =300 s/mm2 to predict fibrosis stage ≥ 2 or ≥ 3.
      原文链接:
    • NETL
    • NSTL
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    Adult-to-adult living donor liver transplantation for acute liver failure in China

    Ding YuanFei LiuYong-Gang WeiBo Li...
    7234-7241页
    查看更多>>摘要：AIM:To investigate the long-term outcome of recipients and donors of adult-to-adult living-donor liver transplantation (AALDLT) for acute liver failure (ALF).METHODS:Between January 2005 and March 2010,170 living donor liver transplantations were performed at West China Hospital of Sichuan University.All living liver donor was voluntary and provided informed consent.Twenty ALF patients underwent AALDLT for rapid deterioration of liver function.ALF was defined based on the criteria of the American Association for the Study of Liver Diseases,including evidence of coagulation abnormality [international normalized ratio (INR) ≥ 1.5] and degree of mental alteration without pre-existing cirrhosis and with an illness of ＜ 26 wk duration.We reviewed the clinical indications,operative procedure and prognosis of AALDTL performed on patients with ALF and corresponding living donors.The potential factors of recipient with ALF and corresponding donor outcome were respectively investigated using multivariate analysis.Survival rates after operation were analyzed using the Kaplan-Meier method.Receiver operator characteristic (ROC) curve analysis was undertaken to identify the threshold of potential risk factors.RESULTS:The causes of ALF were hepatitis B (n =18),drug-induced (n =1) and indeterminate (n =1).The score of the model for end-stage liver disease was 37.1 ± 8.6,and the waiting duration of recipients was 5 ± 4 d.The graft types included right lobe (n=17) and dual graft (n =3).The mean graft weight was 623.3 ± 111.3 g,which corresponded to graft-to-recipient weight ratio of 0.95％ ± 0.14％.The segment Ⅴor Ⅷ hepatic vein was reconstructed in 11 right-lobe grafts.The 1-year and 3-year recipient's survival and graft survival rates were 65％ (13 of 20).Postoperative results of total bilirubin,INR and creatinine showed obvious improvements in the survived patients.However,the creatinine level of the deaths was increased postoperatively and became more aggravated compared with the level of the survived recipients.Multivariate analysis showed that waiting duration was independently correlated with increased mortality (P =0.014).Furthermore,ROC curve revealed the cut-off value of waiting time was 5 d (P =0.011,area under the curve =0.791) for determining the mortality.The short-term creatinine level with different recipient's waiting duration was described.The recipients with waiting duration ≥ 5 d showed the worse renal function and higher mortality than those with waiting duration ＜ 5 d (66.7％ vs 9.1％,P =0.017).In addition,all donors had no residual morbidity.Furthermore,univariate analysis did not show that short assessment time induced the high morbidity (P =0.573).CONCLUSION:Timely AALDLT for patients with ALF greatly improves the recipient survival.However,further systemic review is needed to investigate the optimal treatment strategy for ALF.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Highlights for α-fetoprotein in determining prognosis and treatment monitoring for hepatocellular carcinoma

    Xin-Sen XuKai QuChang LiuYue-Lang Zhang...
    7242-7250页
    查看更多>>摘要：AIM:To explore the prognostic value in the monitoring of treatment efficacy of serial α-fetoprotein (AFP) in hepatocellular carcinoma (HCC) patients.METHODS:We searched MEDLINE,EMBASE and COCHRANE LIBRARY through April 21,2012,to find qualifying articles.Our overall search strategy induded terms for HCC,AFP,treatment response,and prognosis.Literature was limited to English-language,human studies.Studies reporting cumulative survival rates were summarized qualitatively.For the prognostic meta-analysis,we undertook a series of meta-analyses that summarised the Cox proportional hazard ratios (HRs) by assuming a random effects model.With regards to the correlation of AFP change with radiologic response,the categorical dichotomous variables were assessed using Poisson relative risks (RRs),which were incorporated into the random effects model meta-analysis of accuracy prediction.Between-study heterogeneity was estimated by use of the I2 statistic.Publication bias was evaluated using the Begg funnel plot and Egger plot.Sensitivity analyses were conducted first by separating systemic treatment estimates from locoregional therapy estimates,evaluating different AFP response cut-off point effects,and exploring the impact of different study sizes.RESULTS:Of 142 titles identified in our original search,11 articles (12 clinical studies) met our criteria.Six studies investigated outcome in a total of 464 cases who underwent systemic treatment,and six studies investigated outcome in a total of 510 patients who received locoregional therapy.A random-effects model metaanalysis showed that AFP response was associated with an mortality HR of 0.55 (95％CI,0.47-0.65) across HCC in overall survival (OS) and 0.50 (95％CI,0.38-0.65) in progression-free survival.Restricting analysis to the six eligible analyses of systemic treatment,the pooled HRs were 0.64 (95％CI,0.53-0.77) for OS.Limiting analysis to the six analyses of locoregional therapy,the pooled HRs for OS was 0.39 (95％CI,0.29-0.53).We showed a larger pooled HR in the 50％ definition studies (HR,0.67,95％CI,0.55-0.83) compared with that from the 20％ definition studies (HR,0.41,95％CI,0.32-0.53).Restricting analysis to the four studies including over 100 patients individually,the pooled HR was 0.65 (95％CI,0.54-0.79),with a pooled HR for OS of 0.35 (95％CI,0.23-0.46) in the studies of less than 100 patients.As to radiological imaging,43.1％ (155/360) of the patients in the AFP response group presented with a radiological overall response,while the response rate decreased to 11.5％ (36/313) in the patients from the AFP nonresponse group.The RR of having no overall response was significantly lower in the AFP response group than the AFP nonresponse group (RR,0.67;95％CI,0.61-0.75).In terms of disease control rate,86.9％ (287/330) in the AFP response group and 51.0％ (153/300) in the AFP nonresponse group showed successful disease control,respectively.The RR of disease control failure,similarly,was significantly lower in the AFP response group (RR,0.37; 95％CI,0.23-0.58).But these findings could be overestimates because of publication and reporting bias.CONCLUSION:HCC patients presenting with an AFP response are at decreased risk of mortality.In addition,patients with an AFP response also present with a higher overall response rate and disease control rate.
      原文链接:
    • NETL
    • NSTL
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    Single nucleotide polymorphisms in the CDH17 gene of colorectal carcinoma

    Ren-Yin ChenJuan-Juan CaoJuan ChenJian-Ping Yang...
    7251-7261页
    查看更多>>摘要：AIM:To investigate the relationship between c.343A＞G and c.2216A＞C polymorphism sites in the CDH17 gene and colorectal carcinoma.METHODS:Ninety-three non-consanguineous colorectal carcinoma patients admitted to the Department of Oncology at the First Affiliated Hospital of Zhengzhou University were included in this study.Ninety-three peripheral venous blood samples,of approximately one milliliter from each patient,were collected between December 2009 and August 2010.The genomic DNA of these peripheral venous blood samples were extTacted and purified using a Fermentas Genomic DNA Purification Kit (Fermentas,CA) according to the manufacturer's protocol.The single nucleotide polymorphisms (SNPs) of the liver-intestine cadherin (CDH17) gene c.343A＞G and c.2216A＞C were determined by the polymerase chain reaction-single strand conformation polymorphism method (PCR-SSCP) in 93 peripheral venous blood sampies from patients suffering with colorectal carcinoma.Typical samples that showed different migration bands in SSCP were confirmed by sequencing.Directed DNA sequencing was used to check the correctness of the genotype results from the PCR-SSCP method.RESULTS:There was a significant association between the c.2216 A＞C SNPs of the CDH17 gene and the tumor-node-metastasis (TNM) grade,as well as with lymph node status,in 93 peripheral venous blood sampies from colorectal carcinoma patients.The genotype frequencies of A/C,A/A,and C/C were 12.90％,33.33％ and 53.76％,respectively.There was a significant correlation between lymph node metastasis,TNM grade,and the genotype distribution (P ＜ 0.05).The C/C genotype raised the risk of lymph node metastasis and the TNM grade.There was a significant difference in the TNM grade and lymph node metastasis between the A/A and C/C genotypes (P =0.003 and P =0.013,respectively).Patients with colorectal carcinoma carrying the C allele tended to have a higher risk of lymph node metastasis and have a higher TNM grade.The difference between the TNM grades,as well as the lymph node metastasis of the two alleles,was statistically significant (P ＜ 0.01).CONCLUSION:The SNPs of the CDH17 gene c.2216 A＞C might be clinically important in the prognosis of colorectal carcinoma.
      原文链接:
    • NETL
    • NSTL
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    • 维普

    Notch2 regulates matrix metallopeptidase 9 via PI3K/AKT signaling in human gastric carcinoma cell MKN-45

    Ling-Yun GuoYu-Min LiLiang QiaoTao Liu...
    7262-7270页
    查看更多>>摘要：AIM:To clarify the role of activated Notch2 in the invasiveness of gastric cancer.METHODS:To investigate the invasiveness of silencing Notch2 gene expression,we established a Notch2 small interfering RNA (siRNA) transfected cell line using the MKN-45 gastric cancer cell line.After the successful transfection confirmed by real-time reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting,migration and invasion assays were employed to evaluate the aggressiveness of the gastric cancer.RT-PCR and Western blottings were employed to confirm the down-regulation of Notch2 and to evaluate the expression of epithelial mesenchymal transition-related gene matrix metallopeptidase 9 (MMPg),Akt,p-Akt.To confirm the relationship between PI3K-Akt and MMP9,the PI3K inhibitor LY294002 was used to treat MKN-45 cells.RESULTS:Notch2 expression was dramatically decreased after Notch2 siRNA transfection (100.00％ ±9.74％ vs 11.61％ ± 3.85％,P ＜ 0.01 by qRT-PCR).There was also a marked reduction of Notch target gene Hes1 (100.00％ ± 4.74％ vs 61.61％ ± 3.58％,P ＜ 0.05)at the mRNA,indicating an inhibition of Notch signaling.Inhibition of Notch signaling was also confirmed by the marked reduction of Notch2 intracellular domain at the protein levels (100.00％ ± 9.74％ vs 65.61％ ± 7.58％,P ＜ 0.05).Down-regulation of Notch2 by siRNA enhanced tumor cell invasion (100.00％ ± 21.64％ vs 162.22％ ± 16.84％,P ＜ 0.05) and expression of MMP9 (1.56 fold,P ＜ 0.05),and activated the pro-MMP9 protein to its active form (1.48 fold,P ＜ 0.05).There was no significant difference in the protein levels of Akt between the two groups (100.00％ ± 10.87％ vs 96.61％ ± 7.33％,P ＞ 0.05),while down-regulation of Notch2 elevated p-Akt expression (100.00％ ± 9.87％ vs 154.61％ ± 13.10％,P ＜ 0.05).Furthermore,p-Akt and MMP9 was down-regulated in response to the inhibitor LY294002 (p-Akt 100.00％ ± 8.87％ vs 58.27％ ± 5.01％,P ＜ 0.05; MMP9 100.00％ ± 9.17％ vs 50.03％ ± 4.88％,P ＜ 0.05).CONCLUSION:Notch2 may negatively regulate cell invasion by inhibiting the PI3K-Akt signaling pathway in gastric cancer.
      原文链接:
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    • NSTL
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    Impact of intestinal ischemia/reperfusion and lymph drainage on distant organs in rats

    Gui-Zhen HeKai-Guo ZhouRui ZhangYu-Kang Wang...
    7271-7278页
    查看更多>>摘要：AIM:To investigate the impact of intestinal ischemia/reperfusion (I/R) injury and lymph drainage on distant organs in rats.METHODS:Thirty-two Sprague-Dawley male rats,weighing 280-320 g,were randomly divided into blank,sham,I/R,and ischemia/reperfusion and drainage (I/R + D)groups (n =8).All rats were subjected to 60 min ischemia by clamping the superior mesenteric artery,followed by 120 min reperfusion.The rats in the I/R + D group received intestinal lymph drainage for 180 min.In the sham group,the abdominal cavity was opened for 180 min,but the rats received no treatment.The blank group served as a normal and untreated control.A chromogenic limulus assay kit was used for quantitative detection of serum endotoxin.The serum concentrations of tumor necrosis factor-α (TNF-α),interleukin (IL)-6,IL-1β,soluble cell adhesion molecules (sICAM-1),and high mobility group protein box 1 (HMGB1) were determined with an enzyme-linked immunosorbent assay kit.Histological evaluations of the intestine,liver,kidney,and lung were performed by hematoxylin and eosin staining and immunohistochemistry.HMGB1 protein expression was assayed by westem blot analysis.RESULTS:The serum levels of endotoxin and HMGB1 in the I/R and I/R + D groups were significantly higher than those in the sham group (endotoxin,I/R and I/R +D vs sham:0.033 ± 0.004 EU/mL,0.024 ± 0.003 EU/mL vs 0.017 ± 0.009 EU/mL,respectively,P ＜ 0.05; HMGB1,I/R and I/R + D vs sham:5.473 ± 0.963 EU/mL,4.906 ± 0.552 EU/mL vs 0.476 ± 0.406 EU/mL,respectively,P ＜ 0.05).In addition,endotoxin and HMGB1 were significantly lower in the I/R + D group compared to the I/R group (P ＜ 0.05).The serum inflammatory factors IL-6,IL-1β,and sICAM-1 in the I/R and I/R + D groups were significantly higher than those in the sham group (IL-6,I/R and I/R + D vs sham:41.773-9.753 pg/ml,19.204 ± 4.136 pg/mL Vs 11.566 ± 2.973 pg/ml,respectively,P ＜ 0.05; IL-1β,I/R and I/R + D vs sham:144.646 ± 29.378 pg/mL,65.829 ± 10.888 pg/mL vs 38.178 ± 7.157 pg/mL,respectively,P ＜ 0.05; sICAM-1,I/R and I/R +D vs sham:97.360 ± 12.714 ng/mL,48.401 ± 6.547 ng/mL w 33.073 ± 5.957 ng/mL,respectively; P ＜ 0.05).The serum TNF-α in the I/R group were significantly higher than in the sham group (45.863 ± 11.553 pg/mL vs 18.863 ± 6.679 pg/mL,respectively,P ＜ 0.05).These factors were significantly lower in the I/R + D group compared to the I/R group (P ＜ 0.05).The HMGB1 immunohistochemical staining results showed no staining or apparent injury in the blank group,and slight staining at the top of the microvillus was detected in the sham group.In the I/R group,both the top of villi and the basement membrane were stained for HMGB1 in most areas,and injury in the I/R + D group was less than that in the I/R group.HMGB1 expression in the liver,kidney,and lung of rats in the I/R + D group was significantly lower than the rats in the I/R group (P ＜ 0.05).CONCLUSION:Lymph drainage could block the "gutlymph" pathway,improve intestinal barrier function,and attenuate distant organ injury incurred by intestinal I/R.
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    Clinical features and risk factors of acute hepatitis E with severe jaundice

    Bin XuHai-Bin YuWei HuiJia-Li He...
    7279-7284页
    查看更多>>摘要：AIM:To compares the clinical features of patients infected with hepatitis E virus (HEV) with or without severe jaundice.In addition,the risk factors for HEV infection with severe jaundice were investigated.METHODS:We enrolled 235 patients with HEV into a cross-sectional study using multi-stage sampling to select the study group.Patients with possible acute hepatitis E showing elevated liver enzyme levels were screened for HEV infection using serologic and molecular tools.HEV infection was documented by HEV antibodies and by the detection of HEV-RNA in serum.We used x2 analysis,Fisher's exact test,and Student's t test where appropriate in this study.Significant predictors in the univariate analysis were then included in a forward,stepwise multiple logistic regression model.RESULTS:No significant differences in symptoms,alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase,or hepatitis B virus surface antigen between the two groups were observed.HEV infected patients with severe jaundice had significantly lower peak serum levels of γ-glutamyl-transpeptidase (GGT) (median:170.31 U/L vs 237.96 U/L,P =0.007),significantly lower ALB levels (33.84 g/L vs 36.89 g/L,P =0.000),significantly lower acetylcholine esterase (CHE) levels (4500.93 U/L vs 5815.28 U/L,P =0.000) and significantly higher total bile acid (TBA) levels (275.56 μmol/L vs 147.03 μmol/L,P =0.000) than those without severe jaundice.The median of the lowest point time tended to be lower in patients with severe jaundice (81.64％ vs 96.12％,P =0.000).HEV infected patients with severe jaundice had a significantly higher viral load (median:134 vs 112,P =0.025) than those without severe jaundice.HEV infected patients with severe jaundice showed a trend toward longer median hospital stay (38.17 d vs 18.36 d,P =0.073).Multivariate logistic regression indicated that there were significant differences in age,sex,viral load,GGT,albumin,TBA,CHE,prothrombin index,alcohol overconsumption,and duration of admission between patients infected with acute hepatitis E with and without severe jaundice.CONCLUSION:Acute hepatitis E patients may naturally present with severe jaundice.
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    • NSTL
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    Growth-inhibitory effects of MOB2 on human hepatic carcinoma cell line SMMC-7721

    Jian-Jun LengHua-Min TanKe ChenWei-Gan Shen...
    7285-7289页
    查看更多>>摘要：AIM:To investigate the growth-inhibiting and apoptosis-inducing effects of the gene MOB2 on human hepatic carcinoma cell line SMMC-7721.METHODS:The full-length cDNA of the MOB2 gene was amplified from human umbilical vein endothelial cells.The correct full-length MOB2 cDNA was subdoned into the eukaryotic expression vector pEGFP-C1.After lipofection of the MOB2 gene into cancer cells,the levels of MOB2 protein in the cancer cells were detectecl by immunoblotting.To transfect the recombined plasmid vector pEGFP-CI-MOB2 into SMMC-7721 cells,the cells were cultured in Dulbecco's Modified Eagle's Medium with 10％ fetal calf serum and glutamine,and then mixed with liposomes,Lipofectamine 2000 and the plasmid vector pEGFP-CI-MOB2.RESULTS:We observed the growth and proliferation of SMMC-7721 cells containing pEGFP-CI-MOB2 and analyzed their apoptosis and growth cycle phases by flow cytometry.We successfully transfected the recombined plasmid vector pEGFP-CI-MOB2 into SHHC-7721 cells and screened for a single clone cell containing MOB2.After transfection,MOB2 enhanced growth suppression,induced apoptosis,increased the ratio of G0/G1,significantly inhibited the advance of cell cycle phase,and arrested cells in G0/G1 phase.CONCLUSION:MOB2 overexpression induces apoptosis and inhibits the growth of human hepatic cancer cells,which may be useful in gene therapy for hepatic carcinoma.
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    • NETL
    • NSTL
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    • 维普

    Ex-situ liver surgery without veno-venous bypass

    Ke-Ming ZhangXiong-Wei HuJia-Hong DongZhi-Xian Hong...
    7290-7295页
    查看更多>>摘要：AIM:To evaluate the results of hepatic resection with ex-situ hypothermic perfusion and without veno-venous bypass.METHODS:In 3 patients with liver tumor,the degree of the inferior vena cava and/or main hepatic vein involvement was verified when the liver was dissociated in the operation.It was impossible to resect the tumors by the routine hepatectomy,so the patients underwent ex-situ liver surgery,vein cava replacement and hepatic autotransplantation without veno-venous bypass.All surgical procedures were carried out or supervised by a senior surgeon.A retrospective analysis was performed for the prospectively collected data from patients with liver tumor undergoing ex-situ liver surgery,vein cava replacement and hepatic autotransplantation without veno-venous bypass.We also compared our data with the 9 cases of Pichlmayr's group.RESULTS:Three patients with liver tumor were analysed.The first case was a 60-year-old female with a huge haemangioma located in S1,S4,S5,S6,S7 and S8 of liver; the second was a 64-year-old man with cholangiocarcinoma in S1,S2,S3 and S4 and the third one was a 55-year-old man with a huge cholangiocarcinoma in S1,S5,S7 and S8.The operation time for the three patients were 6.6,6.4 and 7.3 h,respectively.The anhepatic phases were 3.8,2.8 and 4.0 h.The volume of blood loss during operation were 1200,3100,2000 mL in the three patients,respectively.The survival periods without recurrence were 22 and 17 mo in the first two cases.As for the third case complicated with postoperative hepatic vein outflow obstruction,emergency hepatic vein outflow extending operation and assistant living donor liver transplantation were performed the next day,and finally died of liver and renal failure on the third day.Operation time (6.7 ± 0.47h vs 13.7 ± 2.6 h) and anhepatic phase (3.5 ± 0.64 h vs 5.7 ± 1.7 h) were compared between Pichlmayr's group and our series (P =0.78).CONCLUSION:Ex-situ liver resection and liver autotransplantation has shown a potential for treatment of complicated hepatic neoplasms that are unresectable by traditional procedures.
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    • 维普