Congenital intrahepatic portosystemic venous shunt（CPSVS）, a rare vascular malformation, has been described in both children and adults and can lead to severe neurophysiological complications. However, a standard therapeutic protocol for CPSVS has not been elucidated. With the advantage of minimally invasive techniques,transcatheter embolization has been used to treat CPSVS. The condition is challenging to manage, especially in patients with large or multiple shunts, through which rapid blood flow can cause ectopic embolism. Here, we describe a case of CPSVS with a large shunt that was successfully treated with balloon-occluded retrograde transvenous obliteration with interlocking detachable coils.

Increasing evidence shows that circular RNAs (circRNAs) play a regulatory role in cancer. In the present study, we aimed to investigate the characteristics and effects of hsa circ 0026134 in hepatocellular carcinoma (HCC). We investigated hsa circ 0026134 expression in 20 pairs of clinical tissues from HCC patients; expression of hsa circ 0026134 in different cell lines; effect of hsa_circ_0026134 on proliferation and invasion of HCC cell lines; and the regulatory mechanisms and interactions among hsa_circ_0026134, miR-127-5p, tripartite motif-containing protein 25 (TRIM25) and insulin-like growth factor 2 mRNA-binding protein 3 (IGF2BP3). hsa_circ_0026134 expression was increased in HCC samples and cell lines. Down-regulation of hsa_circ_0026134 attenuated HCC cell proliferation and metastatic properties. Micro (mi)RNA (miR)-127-5p was sponged by hsa_circ_0026134. Rescue experiments indicated that inhibition of miR-127-5p expression promoted cell proliferation and invasion even after hsa_circ_0026134 silencing. TRIM25 and IGF2BP3 were targets of miR-127-5p. Overexpression of TRIM25 or IGF2BP3 promoted cell proliferation and invasion in cells overexpressing miR-127-5p. Down-regulation of hsa_circ_0026134 suppressed TRIM25- and IGF2BP3-mediated HCC cell proliferation and invasion via promotion of miR-127-5p expression, which have been confirmed by luciferase reporter assay. The present study provides a new treatment target for HCC.

Hepatocellular carcinoma (HCC), the most common primary tumor of the liver, has a poor prognosis and shows rapid progression. MicroRNAs (miRNAs) play important roles in carcinogenesis and tumor progression. Regulators of G-protein signaling (RGS) are critical for defining G-protein-dependent signal fidelity. RGS17 plays an important role in the regulation of cancer cell proliferation, migration and invasion. Here, we showed that miR-199 was downregulated in a hepatocarcinoma cell line. Overexpression of miR-199 significantly suppressed HCC cell proliferation, migration, and invasion in vitro. RGS17 overexpression promoted HCC cell proliferation, migration, and invasion, and reversed the miR-199 mediated inhibition of proliferation, migration, and invasion. Dual-fluorescence reporter experiments confirmed that miR-199 downregulated RGS17 by direct interaction with the 3'-UTR of RGS17 mRNA. In vivo studies showed that miR-199 overexpression significantly inhibited the growth of tumors. Taken together, the results suggested that miR-199 inhibited tumor growth and metastasis by targeting RGS17.

Objective:To investigate the safety and efficacy of radiofrequency ablation combined with transarterial chemoembolization in patients with specially located small hepatocellular carcinoma. Materials and Methods:Between March 2014 and March 2017, a total of 26 patients with 26 lesions (10 perivascular, 6 subdiaphragmatic, 5 subcapsular, 5 perivascular, and subdiaphragmatic location; mean diameter 2.12 (0.62) cm), who received radiofrequency ablation–transarterial chemoembolization treatment, were retrospectively analyzed. Local tumor response was assessed by computed tomography/magnetic resonance imaging 1 month after the procedure. Tumor-free survival was also assessed according to the modified Response Evaluation Criteria in Solid Tumors. Complications were evaluated according to the National Cancer Institute's Common Terminology Criteria for Adverse Events (version 4.0). Results:Complete response was achieved in all patients 1 month after the procedure. During a median follow-up duration of 16.76 months (95% confidence interval: 7.78-25.73 months), local tumor recurrence occurred in 2 patients and new intrahepatic lesions developed in 7 patients. The 1-, 2-, and 3-year cumulative local tumor progression rates were 3.84%, 7.69%, and 7.69%, respectively. The median tumor-free survival duration was 21.96 months (95% confidence interval: 17.58-26.34 months). The 1-, 2-, and 3-year tumor-free survival rates were 67.4%, 46.1%, and 39.3%, respectively. Conclusion:The radiofrequency ablation–transarterial chemoembolization combination therapy appears to be safe and effective and might be a treatment option for specially located small hepatocellular carcinoma lesions that have a risk of incomplete ablation or major complications.

Hepatocellular carcinoma (HCC), the most common primary tumor of the liver, has a poor prognosis, rapid progression. The aim of the current study was to establish a stable lentiviral expression vector for enhanced green fluorescent protein (EGFP) and to evaluate biological characteristics on HCC growth and migration following transfection of HCC cells with EGFP. McA-RH7777 cells were transfected with EGFP overexpression lentiviral vector. Cell activity and mobility were monitored with a Cell-IQ Analyzer. Transwell assays were performed to detect invasiveness and flow cytometry was performed for cell cycle analysis. A subcutaneous tumor rat model was established to analyze the stability of fluorescent protein expression. The result suggested no significant differences between wild-type and EGFP-overexpressing McA-RH7777 cells with regards to cell proliferation, activity, mobility, invasiveness and cell cycle. Green fluorescence was detected over 108 days of culturing. The subcutaneous tumor rat model demonstrated that EGFP expression had no influence on tumor growth and long-term expression was stable. The stable EGFP expression of the HCC transplanted tumor rat model may share biological characteristics with human liver cancer. The model established in the current study may be suitable for various applications, including research focusing on liver cancer metastasis and recurrence, interventional therapy, imaging diagnosis and drug screenings.

Purpose: To evaluate short-term and long-term effectiveness of interventional treatment for hepatic artery thrombosis (HAT).Materials and Methods: From March 2003 to October 2015, 34 patients (32 male and 2 female; mean age, 45 y; range 7-64 y) with HAT were identified 0-21d (mean 6.5 d +/- 6.0) after liver transplantation and underwent interventional treatments. Technical success, clinical success, complications, hepatic artery patency, and survival time were assessed.Results: All 34 patients underwent urokinase thrombolytic treatment. The mean dosage of urokinase was 1,250,000 U +/- 1,000,000 (range, 350,000-9,000,000 U). Thrombolysis treatment required 5-120 h (mean 50 h +/- 31) for completion. In 21 patients, stents were also implanted during thrombolytic treatment. In 3 patients with splenic artery steal syndrome, proximal splenic artery embolization was performed during thrombolytic treatment. The technical and clinical success rate was 91% (31/34), with treatment failure in 3 children. Hemorrhage was observed in 11 cases. Local necrotic foci in the transplanted liver were found on CT in 5 patients. Complications associated with the interventional procedures occurred in 2 patients. Patency rates of the hepatic artery at 1 y, 2 y, 3 y, and 5 y were 96%, 93%, 83%, and 83%. Overall survival rate at 1 y, 2 y, 3 y, and 5 y were 82%, 73%, 57%, and 57%.Conclusions: Interventional treatment can achieve satisfactory short-term and long-term effectiveness for adult HAT.

We aim to investigate the safety and efficacy of microwave ablation (MWA) combined with attenuated Salmonella typhimurium strain VNP20009 in treating hepatocellular carcinoma. Portions of tumor tissues were orthotopically implanted in the livers of 40 male rats weighed 150~200 g to establish tumor models. Three weeks later, the rats were randomly divided into four groups: (A) MWA plus VNP20009 group; (B) MWA group; (C) VNP20009 group; and (D) control group. Incomplete MWA was performed (20~30 W, 1~2 min) after the hepatic carcinoma was properly exposed. VNP20009 (about 1×107 cfu) was directly injected into the tumor immediately. MRI scans were performed to assess the tumor responses 7 and 14 days later, respectively. Micro CT was used to observe the lung metastases. After the animals were sacrificed or died, the tumors were cut off for the purpose of pathological and immunohistochemical analyses. The results showed that the mean tumor volumes of MWA plus VNP20009 group on the 7th and 14th day post treatment were obviously smaller than those of other groups (P < 0.05). Lung metastases rates were 20%, 60%, 30% and 100% in MWA plus VNP20009 group, MWA group, VNP20009 group and control group, respectively. The median survival of the rats in MWA plus VNP20009 group was distinctly longer than those in other groups (P < 0.05). In summary, MWA combined with VNP20009 produced better effects than MWA or VNP20009 alone in treating hepatic carcinoma. This strategy might have potential ability to decrease lung metastases and prolong the overall survival.

MicroRNAs (miRNAs), which are suppressors of gene expression, participate in diverse biological functions and in carcinogenesis. Aberrant expression of miR-519 has been confirmed in various human cancer tissues and cells, and it represses HuR translation without influencing HuR mRNA level. However, the role of miR-519 in hepatocellular carcinoma (HCC) has yet to be elucidated. Here, we analyzed the miR-519 expression in HCC tissues and cell lines using qRT-PCR. We observed that miR-519 was dramatically downregulated in HCC clinical specimens and cell lines as compared to normal tissues and cells. In addition, enhanced expression of miR-519 resulted in the inhibition of cell growth through suppressing proliferation and promoting apoptosis, and repression of cell invasion. Importantly, we found that miR-519 potently repressed HuR expression through suppressing translation without affecting HuR mRNA level. Meanwhile, our results demonstrated that HuR protein level in the cancer tissues was inversely correlated with miR-519 expression in 25 HCC patients. Furthermore, overexpression of HuR abrogates the suppressive effects of miR-519 upregulation on HCC cell growth and invasion. Taken together, our findings suggested that miR-519 might functions as a tumor suppressor via inhibiting HuR expression in the development of progression of HCC, and implicated the potential application of miR-519 in HCC treatment.

Background: The purpose of this study was to retrospectively evaluate the therapeutic efficacy and safety of ultrasound-guided percutaneous microwave ablation (MWA) combined with synchronous transcatheter arterial chemoembolization (TACE) in patients with colorectal liver metastases (CRLM).Patients and methods: A retrospective analysis was performed in 30 patients who were treated with ultrasound- guided percutaneous MWA combined with synchronous TACE for colorectal cancer liver metastases from November 2011 to December 2014 in Zhongshan Hospital, Fudan University. The response of the tumor to treatment was evaluated by follow-up computed tomography and/or magnetic resonance imaging. Local tumor control, procedure-related complications, and long-term survival data were analyzed.Results: A total of 30 patients with 43 tumors ranging in size from 1.4 cm to 10.0 cm were analyzed. The patients' mean age was 61.6 +/- 10.3 years (range, 44.0-78.0 years). The median follow-up time was 26.5 +/- 10.4 months (range, 13.3-50.6 months). The complete ablation rate was 81.4% (35/43 lesions) for CRLM. Complete response was achieved in eight cases (26.7%), and partial response was achieved in 17 cases (56.7%) 1 month after the procedure. The objective response rate (complete response + partial response) was 83.4%. Progression-free survival and overall survival were 5.0 months and 11.0 months, respectively. The 12-month and 24-month survival rates were 46.7% and 25.4%, respectively. A total of 22 patients succumbed during follow-up due to tumor progression. No major complications or perioperative mortalities were recorded.Conclusion: Ultrasound-guided percutaneous MWA combined with synchronous TACE therapy is a safe and effective modality for patients with CRLM.

Purpose: To evaluate the safety and efficacy of microwave (MW) ablation combined with transarterial chemoembolization in a single stage for the treatment of large (>= 5 cm) hepatocellular carcinoma (HCC).Materials and Methods: From March 2013 to January 2015, 66 patients (54 men and 12 women; mean age, 54 y; range, 29-83 y) with 72 large HCC lesions were included in this study. Eighteen (27.3%) had Barcelona Clinic Liver Cancer class B disease, and 48 (72.7%) had class C disease. Seventy-nine percent of patients (n = 52) had hepatitis B virus infection. The average tumor size was 9.0 cm +/- 3.9, ranging from 5 to 19 cm. MW ablation was performed under ultrasound guidance, immediately followed by chemoembolization. Local tumor response, progression-free survival (PFS), and overall survival (OS) were assessed.Results: The technique was successfully performed in all patients. Complete response (CR) was achieved in 28 cases (42.4%), and partial response (PR) was achieved in 34 cases (51.5%) at 1 month after the procedure. The objective response rate (ie, CR plus PR) was 93.9%. Median PFS and OS times were 9 months and 21 months, respectively. The 6-, 12-, and 18-month OS rates were 93.9%, 85.3%, and 66.6%, respectively. Hemorrhage was detected in three patients and arteriovenous fistula in two patients after MW ablation; all were promptly treated with embolization. There were no liver abscesses, bile-duct injuries, or other major procedure related complications.Conclusions: MW ablation immediately followed by chemoembolization is safe and effective in the treatment of large HCC lesions.

Purpose To conduct a single-center, open-label, randomized, controlled trial to compare the effectiveness and safety of (a) ginsenoside Rg3 combined with transcatheter arterial chemoembolization (TACE) and (b) TACE alone in patients with advanced hepatocellular carcinoma (HCC). Materials and Methods This trial was approved by the Fudan University Zhongshan Hospital ethics committee and was registered with the Chinese Clinical Trial Registry (ChiCTR-TRC-11001643). After informed consent was obtained, 228 patients with advanced HCC (Barcelona Clinic Liver Cancer stage C) were randomly assigned to receive an Rg3 capsule and undergo TACE (n = 152; mean age ± standard deviation, 52.4 years ± 11.8; 84.2% men) or undergo TACE alone (n = 76; mean age, 52.4 years ± 10.4; 82.9% men). TACE was performed by using iodized oil with epirubicin and gelatin sponge after oxaliplatin and 5-fluorouracil were infused. The primary end point was overall survival. Secondary end points included time to progression, time to untreatable progression, disease control rate, and safety. Data were compared with the log-rank test, and survival curves were generated with the Kaplan-Meier method. Results Median overall survival was 13.2 months (95% confidence interval [CI]: 11.15, 15.26) in the TACE with Rg3 group and 10.1 months (95% CI: 9.14, 11.06) in the control group (hazard ratio, 0.63 [95% CI: 0.46, 0.85]; P = .002). Median time to progression (4.3 vs 3.2 months, respectively; P = .151) and median time to untreatable progression (8.3 vs 7.3 months, respectively; P = .063) were similar in the two groups. Disease control rate was 69.7% in the TACE with Rg3 group versus 51.3% in the control group (P = .012). Constipation and epistaxis were more frequent in the Rg3 with TACE group (P < .05). Importantly, Rg3 alleviated some TACE-related adverse syndromes and blood anomalies. Conclusion In patients with advanced HCC and adequate liver function, the combination of TACE and ginsenoside Rg3 may prolong overall survival when compared with TACE alone. (©) RSNA, 2016.

Aim To retrospectively evaluate the safety and efficacy of ultrasound-guided percutaneous microwave ablation (MWA) combined with simultaneous transarterial chemoembolization (TACE) in the treatment of patients with advanced intrahepatic cholangiocarcinoma (ICC). Methods All patients treated with ultrasound-guided percutaneous MWA combined with simultaneous TACE for advanced ICC at our institution were included. Posttreatment contrast-enhanced computed tomography and/or magnetic resonance imaging were retrieved and reviewed for tumor response to the treatment. Routine laboratory studies, including hematology and liver function tests were collected and analyzed. Procedure-related complications were reviewed and survival rates were analyzed. Results From January 2011 to December 2014, a total of 26 advanced ICC patients were treated at our single institute with ultrasound-guided percutaneous MWA combined with simultaneous TACE. There were 15 males and eleven females with an average age of 57.9±10.4 years (range, 43–75 years). Of 26 patients, 20 (76.9%) patients were newly diagnosed advanced ICC without any treatment, and six (23.1%) were recurrent and treated with surgical resection of the original tumor. The complete ablation rate was 92.3% (36/39 lesions) for advanced ICC. There were no major complications observed. There was no death directly from the treatment. Median progression-free survival and overall survival were 6.2 and 19.5 months, respectively. The 6-, 12-, and 24-month survival rates were 88.5%, 69.2%, and 61.5%, respectively. Conclusion The study suggests that ultrasound-guided percutaneous MWA combined with simultaneous TACE therapy can be performed safely in all patients with advanced ICC. The complete ablation rate was high and there was no major complication. The overall 24-month survival was 61.5%.

BACKGROUND:The aim of this study was to determine the therapeutic efficacy and safety of transarterial chemoembolization (TACE) with gemcitabine and oxaliplatin in patients with advanced biliary tract cancer (BTC).METHODS:We retrospectively analyzed the outcomes for 65 patients with advanced BTC treated by TACE with gemcitabine 1,000 mg/m(2) and oxaliplatin 100 mg/m(2). Follow-up laboratory tests and computed tomography or magnetic resonance imaging were performed routinely to evaluate the response of the tumor to treatment. All patients were assessed for adverse effects.RESULTS:Of the 65 patients, 19 (29.2%) achieved a partial response, 36 (55.4%) showed stable disease, and ten (15.4%) showed progressive disease. The overall response rate was 29.2%. At the end of this study, five patients were still alive. The median overall survival was 12.0 months (95% confidence interval 8.5-15.5). There were no serious complications after TACE.CONCLUSION:The disease control rate and overall survival in this retrospective study were consistent with those in previous reports. TACE with gemcitabine and oxaliplatin was well tolerated and highly effective in patients with advanced BTC.

Ubiquitin specific peptidase 7 (UPS7) has a critical role in the development and progression of cancer, at least in part, through its regulation of p53 protein stability. However, its molecular determinants remain to be elucidated. In the present study, it was identified that microRNA‑205 (miR‑205) may negatively regulate UPS7 protein levels through targeting its 3'‑untranslated region in hepatocellular carcinoma (HCC) cells. As a result, miR‑205 mimics inhibited USP7 protein levels while antisense miR‑205 enhanced USP7 protein levels, thereby modulating the p53 signaling pathway and cell proliferation levels. In conclusion, the data presents a novel molecule for the dysregulated expression of USP7 in HCC, which may assist in elucidating mechanisms underlying the tumorigenesis of HCC.

The obstruction of hepatic arterial blood flow results in tumor tissue hypoxia and elevated expression of hypoxia-inducible factor-1alpha (HIF-1α). Our study evaluated whether lentivirus-mediated short interference RNA against HIF-1α inhibits proliferation, invasion, and migration of hepatocellular carcinoma (HCC) cells under hypoxia. RNA interference knockdown of HIF-1α was achieved by HIF-1α-directed lentiviral shRNA, in a rat HCC cell line cultured under hypoxia condition for varying length of times. The expression levels of HIF-1α and vascular endothelial growth factor were examined using reverse transcription polymerase chain reaction and western blot analyses. Cell proliferation, migration, and invasion were measured by cell viability, transwell migration, and invasion assays, respectively. Inhibition of HIF-1α expression by shRNA suppressed vascular endothelial growth factor mRNA and protein levels under both normoxia and hypoxia. It also suppressed cell migration and invasion, which were enhanced under hypoxic conditions. RNAi knockdown of HIF-1α further suppressed hypoxia-mediated inhibition of the cell proliferation. These data suggest that shRNA of HIF-1α could antagonize the hypoxia-mediated increase in hepatic cancer cell migration and invasion, and synergize with hypoxia to inhibit the cell proliferation in HCC cells.

Background Ginsenoside Rg3 is a low toxic inhibitor of vascular endothelial growth factor (VEGF), which is implicated in angiogenesis in hepatocellular carcinoma (HCC). This single-centre, open-label, randomised, controlled trial evaluated the efficacy and safety of ginsenoside Rg3 plus transarterial chemoembolisation (TACE) in patients with advanced HCC. Methods Advanced HCC patients (Child-Pugh A) who had no prior systemic therapy were randomly assigned (2:1 ratio) to receive 20 mg twice daily orally (n = 152) combined with TACE or TACE alone (n = 76). The primary endpoint was overall survival (OS). Secondary endpoints included time to progression (TTP), time to untreatable progression (TTUP), disease control rate (DCR) based on modified Response Evaluation Criteria in Solid Tumors, and safety. Results Median overall survival was 13.2 months (95% confidence interval (CI) 11.15–15.26) in the TACE + Rg3 group compared with 10.1 months (95% CI 9.14–11.06) for those receiving TACE alone (hazard ratio (HR) 0.63 [95% CI 0.46–0.85], p = 0.002). Median TTP was 4.3 months (95% CI 3.32–5.28) in the TACE + Rg3 group compared with 3.2 months (95% CI 2.51–3.89) in the TACE group (HR 0.82 [95% CI 0.62–1.08], p = 0.151). Patients in the TACE + Rg3 group had longer median TTUP (8.3 months [95% CI 7.05–9.55]) than in the TACE group (7.3 months [95% CI 6.40–8.20]; HR 0.76 [95% CI 0.57–1.02], p = 0.063). The most frequently reported Rg3-related grade 3–4 adverse events in 152 patients were constipation (two [1.3%]) and hypertension (six [3.9%]). The incidence of ascites was lower in the TACE + Rg3 group than in the TACE group (23.7% versus 48.7%, p = 0.002), as was the incidence of anorexia [12.5% versus 44.7%, p = 0.000], fatigue (9.9% versus 50.0% p = 0.000), anaemia (36.8% versus 51.3%, p = 0.037), leukopenia (46.7% versus 76.3%, p = 0.000), thrombocytopenia (32.9% versus 50.0%, p = 0.012), and hyperbilirubinaemia (17.8% versus 34.2%, p = 0.028). Interpretation In patients with advanced HCC and sufficient liver function, median survival was nearly 3 months longer for patients treated with TACE and ginsenoside Rg3 than for those who received TACE only. Ginsenoside Rg3 is a low toxic inhibitor of vascular endothelial growth factor (VEGF), which is implicated in angiogenesis in hepatocellular carcinoma (HCC). This single-centre, open-label, randomised, controlled trial evaluated the efficacy and safety of ginsenoside Rg3 plus transarterial chemoembolisation (TACE) in patients with advanced HCC. Advanced HCC patients (Child-Pugh A) who had no prior systemic therapy were randomly assigned (2:1 ratio) to receive 20 mg twice daily orally (n = 152) combined with TACE or TACE alone (n = 76). The primary endpoint was overall survival (OS). Secondary endpoints included time to progression (TTP), time to untreatable progression (TTUP), disease control rate (DCR) based on modified Response Evaluation Criteria in Solid Tumors, and safety. Median overall survival was 13.2 months (95% confidence interval (CI) 11.15–15.26) in the TACE + Rg3 group compared with 10.1 months (95% CI 9.14–11.06) for those receiving TACE alone (hazard ratio (HR) 0.63 [95% CI 0.46–0.85], p = 0.002). Median TTP was 4.3 months (95% CI 3.32–5.28) in the TACE + Rg3 group compared with 3.2 months (95% CI 2.51–3.89) in the TACE group (HR 0.82 [95% CI 0.62–1.08], p = 0.151). Patients in the TACE + Rg3 group had longer median TTUP (8.3 months [95% CI 7.05–9.55]) than in the TACE group (7.3 months [95% CI 6.40–8.20]; HR 0.76 [95% CI 0.57–1.02], p = 0.063). The most frequently reported Rg3-related grade 3–4 adverse events in 152 patients were constipation (two [1.3%]) and hypertension (six [3.9%]). The incidence of ascites was lower in the TACE + Rg3 group than in the TACE group (23.7% versus 48.7%, p = 0.002), as was the incidence of anorexia [12.5% versus 44.7%, p = 0.000], fatigue (9.9% versus 50.0% p = 0.000), anaemia (36.8% versus 51.3%, p = 0.037), leukopenia (46.7% versus 76.3%, p = 0.000), thrombocytopenia (32.9% versus 50.0%, p = 0.012), and hyperbilirubinaemia (17.8% versus 34.2%, p = 0.028). In patients with advanced HCC and sufficient liver function, median survival was nearly 3 months longer for patients treated with TACE and ginsenoside Rg3 than for those who received TACE only.

Aim To investigate whether ultrasound-guided RNA interference (RNAi) targeting hypoxia-inducible factor-1alpha (HIF-1α) can enhance the efficacy of transarterial chemoembolization (TACE) in treating hepatocellular carcinoma. Materials and methods Rats with orthotopic hepatocellular carcinoma were randomized to four groups and treated as follows: 1) control; 2) siHIF-1α; 3) TACE; 4) siHIF-1α+TACE. Lentivirus (4×108 transfection units) with or without small interfering RNA (siRNA) expression in 0.6 mL transduction reagent was injected into tumors using a standard 1 mL syringe under ultrasonic guidance. In the siHIF-1α+TACE and siHIF-1α groups, rats received siRNA-expressing lentivirus; the rats in the TACE and control groups received lentivirus without siRNA. TACE was performed by placing a microcatheter into the gastroduodenal artery. Results The median survival time, body weight, and tumor volume of the siHIF-1α+TACE group were better than those of the TACE, siHIF-1α, and control groups. A comparative analysis of the different treatment groups demonstrated that HIF-1α RNAi could downregulate the levels of HIF-1α and VEGF, inhibit tumor angiogenesis, and lessen metastases; all of these effects were enhanced by TACE. Conclusion HIF-1α RNAi, which was administered in vivo in liver tumors under ultrasound guidance, improved the efficacy of TACE in treating hepatocellular carcinoma in an animal model.

The aims of this study were to assess the effect of transarterial chemoembolization (TACE) on circulating tumor cells (CTCs) in the peripheral blood and right atrium of patients with HCC and to evaluate whether perioperative shedding of CTCs affects time to progression of HCC. Before and after TACE, peripheral and right atrial blood samples (7.5 mL) were collected from 42 patients with HCC. CTCs were enriched using EpCAM antibody-conjugated magnetic beads. The number of CTCs was 0-30 and 0-54 in peripheral blood before and after TACE, respectively (P=0.166), and 0-65 and 0-98 in the right atrium before and after TACE, respectively (P=0.102). The number of CTCs was significantly different between the two samples both before (P=0.007) and after (P=0.021) TACE. There was no difference in time to progression between patients with and without an increase in the number of CTCs after TACE in either sample (P>0.05 for both). There were more CTCs in right atrial blood than in peripheral blood. The numbers of CTCs in both samples remained unchanged after TACE. Shedding of tumor cells did not affect time to progression of disease in patients with HCC.

Arsenic trioxide (ATO) has been found effective in several types of cancer cells, including acute promyelocytic leukemia, and recently in hepatocellular carcinoma (HCC). In this study, we investigated the role of ATO in regulating the invasive activity of HCC after transarterial embolization (TAE).

Objective To evaluate the analgesic effect of dihydroetorphine(DHE) on postoperative pain in transarterial chemoembolization(TACE) therapy for patients with liver cancers. Methods A total of120 patients with hepatic cancer who was planed to receive interventional therapy were enrolled in this study.The patients were randomly divided into DHE group(n = 60) and control group(n = 60). Patients of the DHE group sublingually took 20 μg(or 40 μg if necessary) of DHE when TACE began,while no special medication was employed for patients of control group. Visual analogue scale(VAS) was used to quantitatively evaluate the scores of the base line(T0) and at 0-12 hours(T12),12-24 hours(T24) and 24-48 hours(T48) after the treatment. And Bruggrmann comfort scale(BCS) was used to evaluate the scores of subjective comfort level. The percentage of patients who asked for analgesic drug within 24 hours after TACE was calculated. Results After TACE the pain severity and pain-control extent of the DHE group were much better than those of the control group. The VSA scores and BCS scores of both T12 and T24 of the DHE group were significantly superior to those of the control group. No obvious drug-related untoward reactions or sideeffects occurred during and after the operation. Conclusion For controlling pain in TACE for liver cancer,the use of DHE is safe and effective.