TACE and TKI-based combination therapy shows promise for unresectable hepatocellular carcinoma (uHCC), but inter-patient heterogeneity requires reliable biomarkers for personalized management. We developed a deep learning model to predict objective response and progression-free survival (PFS) in HBV-related uHCC. We retrospectively analyzed 243 patients, partitioned into training (clinical n = 168; radiomics n = 106) and test (n = 75) datasets. Three models were constructed: a Clinical Model (C-Model), a Machine Learning Radiomics Model (ML-Model) utilizing 1,479 CT features, and a Deep Learning Model (DL-Model) based on ResNet-50. Model interpretability was addressed via Grad-CAM. Performance was evaluated using AUC and Kaplan-Meier analysis. In the test dataset, the DL-Model achieved a superior AUC of 0.851 (95% CI: 0.747-0.954), significantly outperforming the C-Model (AUC = 0.586, P < 0.05) and exceeding the ML-Model (AUC = 0.709). Survival analysis showed the DL-Model was the only framework capable of robust prognostic stratification; predicted responders had significantly prolonged PFS (P = 0.011). Grad-CAM analysis revealed a spatial dichotomy: responders exhibited focal, centralized tumor activation, whereas non-responders showed multifocal, peripheral activation patterns. The DL-Model provides a reliable, interpretable tool for predicting tumor response and PFS in uHCC patients receiving TACE and TKI-based therapy. The Grad-CAM visualization offers spatial insights into tumor heterogeneity, facilitating personalized treatment adjustments.

The combination of immune checkpoint inhibitors (ICIs) with anti-angiogenic agents has demonstrated efficacy in the clinical treatment of advanced hepatocellular carcinoma (HCC). This study seeks to elucidate the underlying mechanisms that contribute to the enhanced therapeutic effects of apatinib when administered in conjunction with ICIs for the treatment of advanced HCC. The effects of apatinib on the viability, clonal formation, and apoptosis of HCC cells were evaluated through in vitro experiments. Meanwhile, in vivo experiments were conducted to substantiate these findings and further investigate the synergistic effects of apatinib with PD-1 inhibitors on the immune microenvironment, particularly by activating the signal transducer and activator of transcription 1 (STAT1)/natural killer (NK) cell axis. In vitro experiments demonstrated that apatinib significantly suppressed HCC cell viability, colony formation capacity, and induced apoptosis. In tumor-bearing mouse models, the combination of apatinib with PD-1 inhibitors showed superior tumor growth inhibition compared to monotherapy (combination group exhibited the smallest tumor volume and 100% survival rate vs. 0% in PBS group, p < 0.001). Western blot and immunohistochemical analyses revealed STAT1/NK axis activation through combination therapy (upregulated STAT1 expression with increased CD8+T cell and NK cell infiltration, p < 0.001). In the mechanism discussion, STAT1-overexpressing Hepa1-6 cells confirmed the antitumor effect of STAT1 in the combination therapy. Subsequently, we validated our findings using the STAT1 inhibitor fludarabine or the NK cell-depleting agent Asialo GM1. Furthermore, combination therapy remodeled the tumor microenvironment by reducing CA IX (hypoxia marker), CD31 (angiogenesis marker), and α-SMA (stromal activation marker) expression (p < 0.05). Apatinib enhances the efficacy and responsiveness of PD-1 inhibition via the STAT1/NK axis, while the combination therapy remodels the tumor microenvironment to potentiate anti-tumor effects.

Background:Patients with Barcelona Clinic Liver Cancer (BCLC) stage 0/A hepatocellular carcinoma (HCC) represent the guideline-recommended population for liver resection; however, treatment strategies for early recurrence after resection remain debated. This study aimed to analyze prognostic factors for survival after recurrence (SAR) in patients with early recurrence following R0 resection of BCLC stage 0/A HCC and to develop evidence-based treatment recommendations integrating time to recurrence (TTR) and BCLC stage at recurrence. Methods:We conducted a retrospective review of 544 patients with early recurrence after R0 resection of BCLC stage 0/A HCC at a tertiary hepatopancreatobiliary academic hospital. Curative treatments included repeat liver resection and ablation, while non-curative treatments comprised transarterial chemoembolization and systemic therapy. Kaplan-Meier methods were applied to estimate SAR, and independent prognostic factors were identified with multivariable Cox regression analysis. Results:The median SAR was 39.4 months, with 1-year, 3-year, and 5-year SAR rates of 81.8%, 52.6%, and 39.0%, respectively. Patients receiving curative treatments demonstrated significantly improved SAR compared with those undergoing non-curative therapies (P < 0.001). Multivariable analysis identified TTR, alpha-fetoprotein level, albumin level, BCLC stage at recurrence, treatment modality, and microvascular invasion in initial tumors as independent prognostic factors for SAR. Subgroup analysis showed that integrating TTR and BCLC stage effectively guided treatment allocation: for BCLC stage A or C disease, treatment should follow current BCLC guidelines, whereas for stage B disease, curative therapy conferred survival benefit when TTR was >6 months but offered no benefit when TTR was ≤6 months. Conclusions:Curative treatments remain an effective option for selected patients with early-recurrent HCC. Treatment allocation based on TTR and BCLC stage at recurrence may optimize outcomes for this population.

The primary objective of neoantigen vaccines is to elicit a robust anti-tumor immune response by generating neoantigen-specific T cells that can eradicate tumor cells. Despite substantial advancements in personalized neoantigen prediction using next-generation sequencing, machine learning, and mass spectrometry, challenges remain in efficiently expanding neoantigen-specific T cell populations in vivo. This challenge impedes the widespread clinical application of neoantigen vaccines. Nanovector-based neoantigen delivery systems have emerged as a promising solutions to this challenge. These nanovectors offer several advantages, such as enhanced stability, targeted intracellular delivery, sustained release, and improved antigen-presenting cell (APC) activation. Notably, they effectively deliver various neoantigen vaccine formulations (DC cell-based, synthetic long peptide (SLP)-based or DNA/mRNA-based) to APCs or T cells, thereby activating both CD4+ T and CD8+ T cells. This ultimately induces a specific anti-tumor immune response. This review focuses on recent innovations in neoantigen vaccine delivery vectors. We aim to identify optimal design parameters for vectors tailored to different neoantigen vaccine types, with an emphasis on enhancing the tumor microenvironment and stimulating the production of neoantigen-specific cytotoxic T cells. By maximizing the potential of these delivery systems, we aim to accelerate the clinical translation of neoantigen nanovaccines and advance cancer immunotherapy.

Hepatocellular carcinoma (HCC) is one of the deadliest cancers in the world. Exploring the underlying molecular mechanisms of HCC, such as those involving small ubiquitin-related modifier (SUMO) and its targets, is worthwhile. A total of 12 HCC tissue samples were collected for immunohistochemistry. The interaction between SUMO1 and OSR1 was confirmed by co-IP and immunofluorescence (IF). The expression (qPCR and Western blot), cytological function (CCK-8, clone formation and transwell assays) of OSR1 was further investigated in HepG2 cells. The anti-tumor function of OSR1 was also verified in the nude mouse xenograft model. Western blot analysis revealed the underlying downstream signaling pathway of SUMO1-modified OSR1 in HCC. Up-regulated co-expression of SUMO1-OSR1 was observed in the HepG2 cells. Through the cytological experiments and a nude mouse xenograft model, we found that OSR1 is a tumor suppressor gene that inhibits the proliferation and invasion of the HepG2 cells in vitro. Intriguingly, SUMO1-OE antagonized OSR1-mediated β-catenin regulation: in nuclei, SUMO1-OE enhanced β-catenin expression, counteracting OSR1-OE-induced suppression, whereas in the cytoplasm, SUMO1-OE inhibited β-catenin accumulation and attenuated OSR1-OE-driven promotion. Hypoxia reversed these effects, suggesting an oxygen-sensitive interplay between SUMO1 and OSR1. In conclusion, OSR1 is a tumor suppressor in HCC via attenuation of the Wnt/β-catenin pathway. SUMO1 modifies OSR1, suppressing the Wnt/β-catenin signaling pathway and promoting the occurrence and development of HCC; this effect of which could be enhanced by hypoxia.

Inflammation is implicated in tumorigenesis and has been reported as an important prognostic factor in cancers. In this study, we aimed to develop and validate a novel inflammation score (IFS) system based on 12 inflammatory markers and explore its impact on intrahepatic cholangiocarcinoma (ICC) survival after hepatectomy. Clinical data of 446 ICC patients undergoing surgical treatment were collected from the Primary Liver Cancer Big Data, and then served as a training cohort to establish the IFS. Furthermore, an internal validation cohort including 175 patients was used as internal validation cohort of the IFS. A survival tree analysis was used to divide ICC patients into three groups (low-, median-, and high- IFS-score groups) according to different IFS values. Kaplan-Meier (KM) curves were used to compare the overall survival (OS) and recurrence-free survival (RFS) rates among three different groups. Cox regression analyses were applied to explore the independent risk factors influencing OS and RFS. In the training cohort, 149 patients were in the low-IFS-score group, 187 in the median-IFS-score group, and 110 in the high-IFS-score group. KM curves showed that the high-IFS-score group had worse OS and RFS rates than those of the low- and median-IFS-score groups (P < 0.001) in both the training and validation cohorts. Moreover, multivariable Cox analyses identified high IFS as an independent risk factor for OS and RFS in the training cohort. The area under the curve values for OS prediction of IFS were 0.703 and 0.664 in the training and validation cohorts, respectively, which were higher than those of the American Joint Committee on Cancer (AJCC) 7th edition TNM stage, AJCC 8th edition TNM stage, and the Child-Pugh score. Our results revealed the IFS was an independent risk factor for OS and RFS in patients with ICC after hepatectomy and could serve as an effective prognostic prediction system in daily clinical practice.

Objective:To analyze and predict the clinical efficacy of rigid choledochoscopic percutaneous transhepatic biliary fistulation (PTBF) lithotripsy for the treatment of hepatolithiasis.Methods:Databases including PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang were searched for literatures from January 1, 1990 to March 1, 2022 on rigid choledochoscopic PTBF lithotripsy for hepatolithiasis studies. The primary outcomes including the final clearance rate, recurrence rate and overall postoperative complication rate, were analyzed by the random effects model in meta analysis and Bayesian network. The Markov Chain Monte Carlo was used for evaluation and prediction.Results:Fifteen articles were ultimately included, involving 1 296 patients, of which 1 008 patients were clearly shown to have complex intrahepatic bile duct stones in the literature [divided into two groups, the percutaneous transhepatic one-step biliary fistulation (PTOBF) stone removal group ( n=568) and the percutaneous transhepatic two-step biliary fistulation (PTTBF) stone removal group ( n=440)]. The results of Bayesian single-arm meta-analysis showed that the final clearance rate, recurrence rate and overall postoperative complication rate of PTOBF for hepatolithiasis were 84.19% (95% HPD: 79.08%-88.93%), 15.79% (95% HPD: 11.01%-21.07%) and 10.85% (95% HPD: 7.93%-14.21%). For complex hepatolithiasis, the final clearance rate, recurrence rate and overall postoperative complication rate of PTOBF were 82.58% (95% HPD: 75.46%-88.83%), 17.99% (95% HPD: 11.51%-25.45%), 10.34% (95% HPD: 6.42%-15.40%). For PTTBF, they were respectively 73.56% (95% HPD: 65.67%-80.30%), 29.48% (95% HPD: 23.13%-36.01%), 11.42% (95% HPD: 6.18%-17.67%). In comparison to PTTBF, the patients treated with PTOBF has a higher clearance rate ( OR=1.74, 95% CI: 1.17-2.60) and a lower recurrence rate ( OR=0.56, 95% CI: 0.37-0.84)but the overall complication rate did not improve ( OR=1.03, 95% CI: 0.66-1.62). Conclusions:Rigid choledochoscopic PTBF lithotripsy for hepatolithiasis is safe, effective and feasible. For complex hepatolithiasis, PTOBF has a higher clearance rate and a lower recurrence rate.

INTRODUCTION:Natural killer cells can attack cancer cells without prior sensitization, but their clinical benefit is limited owing to their poor selectivity that is caused by the lack of specific receptors to target tumor cells. In this study, we aimed to endow NK cells with the ability to specifically target glypican-3+ tumor cells without producing cell damage or genetic alterations, and further evaluated their therapeutic efficiency.METHODS:NK cells were modified with a Gpc3 DNA aptamer on the cell surface via metabolic glycoengineering to endow NK cells with specific targeting ability. Then, the G-NK cells were evaluated for their specific targeting properties, cytotoxicity and secretion of cytokines in vitro. Finally, we investigated the therapeutic efficiency of G-NK cells against glypican-3+ tumor cells in vivo.RESULTS:Compared with NK cells modified with a random aptamer mutation and unmodified NK cells, G-NK cells induced significant apoptosis/necrosis of GPC3+ tumor cells and secreted cytokines to preserve the intense cytotoxic activities. Moreover, G-NK cells significantly suppressed tumor growth in HepG2 tumor-bearing mice due to the enhanced enrichment of G-NK cells at the tumor site.CONCLUSIONS:The proposed strategy endows NK cells with a tumor-specific targeting ability to enhance adoptive therapeutic efficiency in GPC3+ hepatocellular carcinoma.

Purpose:The influence of resection margin (RM) width on the prognosis of solitary hepatocellular carcinoma (HCC) following anatomical resection (AR) has yet to be determined. Therefore, we conducted a real-world study to identify the optimal RM width and assess its impact on the outcomes of solitary HCC patients undergoing AR.Methods:The data pertaining to patients diagnosed with solitary HCC who underwent AR between December 2012 and December 2015 were retrospectively collected. The optimal cutoff value for the width of the RM was determined using X-tile software. The Kaplan-Meier method was utilized to compare the overall survival (OS) and disease-free survival (DFS) between the narrow and wide RM groups. Additionally, propensity score matching (PSM) was performed to minimize potential bias in the data.Results:Of the 1033 patients who met the inclusion criteria, 293 (28.4%) were categorized into the narrow RM group (≤4 mm) and 740 (71.6%) into the wide RM group (> 4mm). Before and after PSM, there were no significant differences in OS and DFS between the two groups (before PSM: OS, HR=0.78, P=0.071; DFS, HR=0.95, P=0.620; after PSM: OS, HR=0.77, P=0.150; DFS, HR=0.90, P=0.470). Multivariate analysis demonstrated that RM width was not an independent risk factor for DFS and OS both before and after PSM (all P>0.05). However, subgroup analyses revealed that patients with ALBI grade 1, absence of cirrhosis, and AJCC stage II significantly benefited from wide RM in OS (all P< 0.05). Similarly, patients without HBV infection and absence of cirrhosis also exhibited significant benefits from wide RM in DFS (both P< 0.05).Conclusion:In patients with solitary HCC undergoing AR, the width of the RM does not appear to have a significant impact on their prognosis. However, in certain selected patients, a wider RM may confer benefits.

Purpose This study aimed to assess the efficacy and safety of adjuvant transarterial chemoembolization (TACE) plus tyrosine kinase inhibitor (TKI) treatment in patients with hepatocellular carcinoma (HCC) with a high risk of early recurrence after curative resection. Patients and Methods Patients from multiple centres were divided into postoperative adjuvant TACE with (n=57) or without (n=142) TKI administration groups. The disease-free survival (DFS) curve was depicted by the Kaplan–Meier method, and the difference between the two groups was tested using the log rank test. Univariate and multivariate Cox analyses were performed to identify independent risk factors for DFS. Additionally, three propensity score analyses were performed to minimise the potential confounding factors to facilitate a more reliable conclusion. Adverse events (AEs) were assessed according to the Common Terminology Criteria for Adverse Events, version 4.0. Results The 1-and 2-year DFS rates of the TACE plus TKI treatment group were 45.5% and 34.9%, respectively, which were significantly better than those of the TACE alone group (26.8% and 18.3%, respectively). Multivariate analysis identified adjuvant TACE plus TKI treatment as an independent prognostic factor for DFS (hazard ratio: 0.611, 95% confidence interval: 0.408–0.915, P=0.017). Further analysis based on the various propensity score methods yielded similar results. Subgroup analysis showed that patients with tumour diameter ≥5 cm, tumour number <3, absence of hepatic vein tumour thrombus and bile duct tumour thrombus, ruptured tumours, and stage IIIB could benefit more from TACE plus TKI treatment (all P<0.05). Some patients (33.33%) experienced grade ≥3 AEs in the TACE plus TKI group. Conclusion TACE plus TKI treatment can reduce the incidence of early recurrence with tolerable adverse events in HCC patients at high risk of recurrence after hepatectomy and may be an appropriate option in postoperative anti-recurrence treatment.

目的:分析仑伐替尼治疗晚期肝癌的临床效果.方法:选择我院92例晚期肝癌患者,根据住院号尾号奇数与偶数进行分组,每组各46例.对照组患者接受FOLFOX4方案治疗,试验组患者在此基础上使用仑伐替尼治疗.比较两组患者AFP、CA199、CA125肿瘤标志物指标、OS、PFS、治疗总有效率以及不良反应发生率.结果:两组患者治疗前AFP、CA199、CA125肿瘤标志物指标水平无明显差异(P>0.05);试验组患者治疗后AFP、CA199、CA125肿瘤标志物指标水平均低于对照组,差异具有统计学意义(P<0.05).试验组患者无进展生存期、总生存期更长,试验组患者治疗总有效率更高,不良反应发生率更低(P<0.05).结论:对晚期肝癌患者在常规化疗方案的基础上使用仑伐替尼治疗可以提高疗效,安全性良好.

Modulating interactions between immune effector cells and tumor cells in vivo using a bispecific aptamer (Ap) is a promising strategy for cancer immunotherapy. However, it remains a technical challenge owing to the complex and dynamic internal environment accompanied by severe degradation. Herein, by using a Y-shaped DNA scaffold, a bispecific and stabilized Y-type Ap is designed to redirect natural killer (NK) cells to enhance adoptive immunotherapy of hepatocellular carcinoma (HCC) solid tumors. Y-type Ap is constituted by the HCC-specific Ap TLS11a linked with the CD16-specific Ap through a Y-shaped DNA scaffold. Owing to the rigid structure, Y-type Ap shows high stability in 10% serum for over 72 h and resistance to denaturation by 8 M urea. Additionally, the Y-type Ap exhibits more potent avidity to bind with NK cells and tumor cells both in vitro and in vivo, resulting in higher cytokine secretion and excellent antitumor efficiency. Collectively, this study offers a translational platform for constructing stable bispecific Ap, offering considerable potential to enhance adoptive immunotherapy of solid tumors.

目的:以晚期胆管癌患者为研究对象,总结三维适形放疗联合5-氟尿嘧啶化疗方法的临床治疗效果.方法:选择2018年1月—2019年6月间收治的52例晚期胆管癌患者,按照入院顺序对患者分组后,对照组患者26例,单纯接受5-氟尿嘧啶化疗治疗,实验组患者则接受5-氟尿嘧啶化疗+三维适形放疗治疗,统计治疗效果,并对两组患者实施为期18个月的随访,评估预后.结果:两组患者的治疗总有效率显示,实验组晚期胆管癌患者达到了76.92％,显著高于对照组的50.00％,数据差异显著(χ2值=5.839,P=0.036);两组患者的随访结果显示,在治疗后的18个月内,实验组患者的并发症例数、再入院例数、死亡例数分别为12(46.15％)、9(34.62％)、7(26.92％),显著优于对照组的20(76.92％)、15(57.69％)、14(53.84％),数据差异具有统计学意义(χ2值=4.293/0.018、6.772/0.032、8.593/0.022).且两组患者的OS与FPS比较,实验组为(11.75±2.16)月、(8.52±1.77)月,优于对照组的(9.59±3.29)月、(5.97±1.69)月,数据差异显著(P<0.05).结论:在晚期胆管癌患者临床治疗中,采用三维适形放疗联合5-氟尿嘧啶化疗治疗方法能够取得满意效果,与常规治疗方法相比,联合治疗模式的临床总有效率更高,患者预后更理想.

Objective:To explore the effect of interference on expression of signal transducer and activator of transcription 3 (STAT3) by small interfering RNA (siRNA) on biological function of cholangiocarcinoma.Methods:Cholangiocarcinoma cell lines human cholangiocarcinoma cells1 (HUCCT1) and human cholangiocarcinoma cell (RBE) were cultured, siRNA-710, siRNA-551 and siRNA-2021 were constructed, Lipo 3000 transfection reagent was used to transfect siRNA into cholangiocarcinoma cells. The interference effect of siRNA on STAT3 expression was detected by polymerase chain reaction (PCR) and Western blotting, and siRNA-551 was selected for subsequent experiments. After 48 h of siRNA-551 transfection on cholangiocarcinoma cells, cell proliferation was tested by cell counting kit-8 (CCK-8) assay, apoptosis rate examined by flow cytometry, and the expression levels of interleukin-6 (IL-6) and vascular endothelial growth factor (VEGF) were detected by Western blotting. One-way ANOVA of variance was used to analyze experimental results.Results:SiRNA-551 can significantly reduce the expression of STAT3 mRNA and protein in cholangiocarcinoma cells. After HUTT1 and RBE cholangiocarcinoma cells transfection with siRNA-551, the proliferation of cholangiocarcinoma cells in the STAT3 interference group [(74.49±0.96)%, (91.08±5.32)%] was lower than that of the blank control group [(100.00±5.52)%, (100.00±2.82)%, F=62.20, 6.57, P<0.05] and NC group [(90.99±1.87)%, (99.74±4.71)%, F=184.57, 4.45, P<0.05], The difference was statistically significant; the apoptosis rate of the interference group [(15.68±1.79)%, (11.30±0.67)%] was higher than that of the blank control group [(6.97±0.76)%, (6.12±0.37)%, F=60.01, 138.40, P<0.05] and NC group [(9.21±0.63)%, (6.22±0.21)%, F=34.77, 155.96, P<0.05], The difference was statistically significant; After HUCCT1 cholangiocarcinoma cells transfection with siRNA-551, The expression of IL-6 and VEGF protein in the interference group (0.23±0.07, 0.16±0.02) was low in the blank control group (0.62±0.34, 0.35±0.15, F=3.78, 4.90, P<0.05) and NC group (0.59±0.07, 0.47±0.39, F=37.46, 2.11, P<0.05), The difference was statistically significant; After RBE cholangiocarcinoma cells transfection with siRNA-551, the proliferation of cholangiocarcinoma cells in the STAT3 interference group (0.22±0.11, 0.80±0.08) was lower than that of the blank control group (0.51±0.11, 1.89±0.13, F=11.39, 151.69, P<0.05) and NC group (0.60±0.34, 1.46±0.48, F=3.39, 140.20, P<0.05), The difference was statistically significant. Conclusion:Interfering the expression of STAT3 in cholangiocarcinoma cells by siRNA has a tumor suppressor effect.

目的 探讨巨块型肝癌行精准肝切除的可行性、安全性.方法 对医院肝胆外科2014年3月至2016年3月收治的43例巨块型肝癌患者采用精准肝切除手术.回顾性分析患者术前评估、术中情况、术后恢复及术后1年、2年生存率等.结果 43例患者的肿瘤平均直径为13.2 cm,术前肝功能Child-Pugh分级均为A级、吲哚青绿15 min滞留率均小于10％;41例剩余肝体积/标准肝体积>35％,2例剩余肝体积/标准肝体积为35％.43例巨块型肝癌患者均成功实施精准肝切除手术,平均手术时间为245 min,平均出血量188 mL,围术期输血8例(均为血浆),输血量为600～1800 mL.4例发生术后并发症,其中小肝综合征1例,予积极保肝、支持治疗后治愈;术后胆汁漏1例,予冲洗引流及抗感染治疗后治愈;胸腔积液2例,穿刺置管引流后治愈.术后平均住院日为12.6 d.术后1年、2年生存率分别为65.1％、48.8％.结论 只要严格掌握适应证,巨块型肝癌患者采用精准肝切除手术是安全可行的,具有术后并发症少、肝功能恢复快、住院时间短的优点.

Objective To study the expression of zinfingeE-box bingdinghomeobox 1 (ZEB1) and microRN(niRNA, miR) in hepatocellulacarcinom(HCC) cell line MHCC97-H, and to furthereveal the relationship between ZEB1 and miR-200 in epithelial-mesenchymal transitionof HCC.MethodReal-time fluorescenquantitative polymerase chain reaction (FQ-PCR) waused to detecthe expression of ZEB1, E-cadherin and miR-200 in normal livecell line L-02 and MHCC97-H.The ZEB1 of MHCC97-H and L-02 cellwaknocked outhrough the shorhairpin RN(shRNA) lentiviral particletransfection of L-02 and MHCC97-H cells.FQ-PCwaused to detecthe expression of ZEB1,E-cadherin and miR-200 family in shRNL-02 and shRNA-MHCC97-H.ResultThe expression levelof ZEB1 and miR-200in MHCC97 cells-H were 1.268 1 ±0.120 1 and 484.368 1 ±99.804 1 respectively, which were significantly highethan those in L-02 cell(1.000 0 ± 0.050 7 and 220.196 8 ± 62.021 0 rcspectively) (P ＜ 0.05).The expression level of E-cadherin in MHCC97-H cellwa0.443 9 ± 0.090 1, signifycantly lowethan in L-02 cell(1.000 0 ± 0.051 1) (P ＜ 0.05).There wanegative correlation between the expression level of ZEB1 and E-cadherin in MHCC97-H cell(=-1.00).The shRNlentiviruwasuccessfully transfected into L-02 celland MHCC97-H cellrespectively.The expression level of ZEB1 in the two groupwa0.573 2 ±0.103 1, and 0.494 3 ± 0.092 1respectively, which were significantly reduced (P ＜0.05).The expression level of E-cadherin in the two groupwa1.190 2 ± 0.112 1 and 1.459 3-± 0.121 3 respectively.The expression levelof miR-200a, miR-200and miR-200in L-02 cellwere 3.040 7 ±0.113 3,2.201 3 ±0.120 8 and 1.665 1 ±0.121 7 respectively, and those in MHCC97-H cellwere 2.857 1 ± 0.113 5,3.789 1 ± 0.112 9 and 6.129 3 ± 0.182 4 respectively.They were all significantly increased (P ＜ 0.05).Conclusion The expression level of ZEB1 in MHCC97-H cellwanegatively correlated with thaof E-cadherin.They are regulated each othebetween ZEB1 and miR-200 family in MHCC97-H cells,which may play an importanrole in the proliferation, invasion and metastasiprocesof tumocells.

目的:探讨射频消融术治疗小肝癌的术后并发症及治疗效果.方法:对34例肝癌患者共37个肝恶性肿瘤行超声引导下射频消融术治疗,肿瘤直径为2.3～4.0 cm.术后所有患者均进行定期随访、复查.结果:37个癌灶射频消融治疗均获得成功.其中有3例患者术后出现并发症,肝功能衰竭1例,大量腹水2例,经治疗后均好转出院.在4～20个月随访中有2例复发,均再次予行射频消融治疗,术后均恢复顺利、出院；术后6,12,20个月生存率分别是100％,94.1％,91.2％.结论:射频消融术做为一种微创治疗方法,操作简单,创伤小,术后并发症少、恢复快,对小肝癌的治疗效果好.

Objective To explore the feasibility and safety of hand-assisted laparoscopic surgery(HALS) in complicated liver and spleen surgery.Methods HALS was used in 202 cases including 94 cases of hepatectomy,29 cases of splenectomy,28 cases of modified Sugiura procedure,4 cases of combined hepatectomyand splenectomy,41 cases of combined hepatectomy and choledocholithotomy,one case of combinedhepatectomy and total hysterectomy and 5 cases of combined splenectomy with choledocholithotomy.Results HALS was successful in all of the 202 cases.Mean surgical time was(138±12) minutes.Mean blood loss was(179±34) mL.No serious postoperative complications occurred.The mean postoperative hospitalstay was(9.2±1.1) days.Conclusions HALS is feasible and safe in complicatedliver and spleen surgery for strictly selected patients.It offers to patients significant benefits such as decreased operative difficultyand trauma to the abdominal wall,shortened operative time,and effective control of hemorrhage.

Objective The study the feasibility and safety of hand-assisted laparoscopic surgery(HALS) in complicated hepatecto-spleen surgery.Methods The handport incision and the first trocar were placed appropriately accoding to lesion's location and operative demand.HALS was used in 172 cases including 81 cases of hepatectomy,21 cases of splenectomy,28 cases of modified Sugiura procedure,4 cases of combined hepatectomy with splenectomy,34 cases of combined hepatectomy with choledocholithotomy,one case of combined hepatectomy with total hysterectomy and 3 cases of combined splenectomy with choledocholithotomy.Results HALS were all successful in 172 cases.Mean surgical time was 135 minutes.Mean blood loss was 148 ml.No serious postoperative complications occurred. The mean postoperative hospital stay was 9.12 days.Conclusions HALS is feasible and safe in complicated hepatecto-spleen surgery for strictly selected patients.It offers significant benefits to patients such as reduced operative difficulty and trauma to the abdo minal wall,shortened operative time and applied immediate hemostasis.