scholarly journals Outcome of TACE treatment in HIV infected patients with hepatocellular carcinoma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lingxiang Kong ◽  
Guo Wei ◽  
Tao Lv ◽  
Li Jiang ◽  
Jian Yang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prognostic Factors ◽  
Surgical Treatment ◽  
Supportive Therapy ◽  
Control Group ◽  
Hiv Patients ◽  
Immunodeficiency Virus ◽  
Serum Alpha Fetoprotein ◽  
One Year ◽  
Tace Treatment

AbstractThe surgical treatment and transcatheter arterial chemoembolization (TACE) rate of human immunodeficiency virus (HIV)-infected hepatocellular carcinoma (HCC) patients is relatively low in West China. For various reasons, most patients do not receive timely surgical treatment. Upon transfer to an infectious disease centralized hospital, they were already classified in the Barcelona Clinic Liver Cancer (BCLC)-B stage. A total of 2249 BCLC-B HCC patients were analyzed. The eligible population was divided into three groups for analysis of survival and prognostic factors; These were 21 HIV infected (HIV+) HCC patients treated with TACE (TACE+), 1293 non-HIV-infected (HIV−) HCC patients treated with TACE, and 150 HIV− HCC patients who only receive medication (TACE−) as a second control group. After 1:2 matching, 1- and 2-year survival of HIV+ TACE+ and HIV− TACE+ groups was 64.3% and 76.5% (P = 0.453) and 45.5% vs. 50.0% (P = 0.790) respectively. We also compared one and two-year survival between HIV+ TACE+ and HIV− TACE−. One-year overall survival was 64.3% vs. 45.7% (P = 0.097) and 2-year survival was 45.5% vs. 7.1% (P = 0.004). Multivariate analysis showed that the most important prognostic factors for survival were serum alpha-fetoprotein (AFP) and Child–Pugh score and tumor size, while HIV status had no significant effect on prognosis statistically. CD4 levels below 200 may increase the risk of opportunistic infection after surgery, but after anti-infection and systematic supportive therapy, it has no effect on survival. HIV+ patients should have the same treatment opportunities as HIV− patients. If the patient's immune status permits, we suggest that early TACE treatment should be administered to BCLC-B HCC patients, regardless of HIV infection.

Analysis of surgical treatment and prognostic factors for hepatocellular carcinoma with portal vein tumor thrombus

2017 ◽  
Vol 6 (1) ◽  
pp. 247-253
Author(s):  
Jingyu Cao ◽  
Zusen Wang ◽  
Shengkun Wu ◽  
Yao Yu ◽  
Chengzhan Zhu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prognostic Factors ◽  
Surgical Treatment ◽  
Portal Vein ◽  
Tumor Thrombus ◽  
Portal Vein Tumor Thrombus

scholarly journals Modifiable Prognostic Factors of Hepatocellular Carcinoma in Patients with Non-Surgical Treatment

PLoS ONE ◽  
2015 ◽  
Vol 10 (12) ◽  
pp. e0144893 ◽  
Author(s):  
Jen-Hao Yeh ◽  
Chao-Hung Hung ◽  
Jing-Houng Wang ◽  
Chien-Hung Chen ◽  
Kwong-Ming Kee ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prognostic Factors ◽  
Surgical Treatment ◽  
Non Surgical Treatment

scholarly journals Diagnostic accuracy of the 1,3-beta-d-glucan test and lactate dehydrogenase for pneumocystis pneumonia in non-HIV patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ruixue Sun ◽  
Dan Lv ◽  
Meng Xiao ◽  
Li Zhang ◽  
Jun Xu ◽  
...  
Keyword(s):  
Lactate Dehydrogenase ◽  
Diagnostic Procedures ◽  
Serum Levels ◽  
Pneumocystis Pneumonia ◽  
Control Group ◽  
Hiv Patients ◽  
Exclusion Criteria ◽  
Immunodeficiency Virus ◽  
Methenamine Silver ◽  
Polymerase Chain

AbstractWe evaluated the serum levels of (1–3)-beta-d-glucan (BG) and lactate dehydrogenase (LDH) as a tool to support pneumocystis pneumonia (PCP) diagnostic procedures in non-HIV patients. We retrospectively collected non-HIV (human immunodeficiency virus) patients presenting clinical features of PCP between April 1st, 2013, and December 31st, 2018. A total of 225 included patients were tested for Pneumocystis jirovecii by polymerase chain reaction (PCR) and methenamine silver staining. Based on different exclusion criteria, 179 cases were included in the BG group, and 196 cases were included in the LDH group. In each group, cases with positive immunofluorescence (IF) microscopy and PCR were considered proven PCP, while cases with only positive PCR were considered probable PCP. Fifty patients with negative IF and PCR results and proven to be non-PCP infection were chosen randomly as the control group. The cut-off levels of BG and LDH to distinguish non-PCP from probable PCP were 110 pg/mL and 296 U/L with 88% sensitivity and 86% specificity, and 66% sensitivity and 88% specificity, respectively. The cut-off levels of BG and LDH to distinguish non-PCP from proven PCP were 285.8 pg/mL and 379 U/L with 92% sensitivity and 96% specificity, and 85% sensitivity and 77% specificity, respectively. The cut-off levels of BG and LDH to distinguish non-PCP from proven/probable PCP were 144.1 pg/mL and 363 U/L with 90% sensitivity, 86% specificity and 80% sensitivity, 76% specificity respectively. BG and LDH are reliable indicators for detecting P. jirovecii infection in HIV-uninfected immunocompromised patients.

scholarly journals Gambaran Ketahanan Hidup (Kesintasan) Satu Tahun Pasien Koinfeksi TB-HIV Berdasarkan Waktu Awal Pengobatan Antiretroval (ARV) pada Fase Lanjut di Rumah Sakit Penyakit Infeksi (RSPI) Prof. Dr. Sulianti Saroso Periode Januari 2011-Mei 2014

2017 ◽  
Vol 3 (2) ◽  
pp. 11
Author(s):  
Siti Maemun ◽  
Syahrizal Syarif ◽  
Adria Rusli ◽  
Renti Mahkota
Keyword(s):  
Human Immunodeficiency Virus ◽  
Antiretroviral Treatment ◽  
Antiretroviral Drugs ◽  
Initial Time ◽  
Hiv Patients ◽  
Intensive Phase ◽  
Probability Of Survival ◽  
Immunodeficiency Virus ◽  
One Year ◽  
Hiv Aids

AbstrakLatar Belakang : Human Immunodeficiency Virus (HIV) merupakan jenis retrovirus yang menginfeksi sistem kekebalan tubuh manusia yang menyebabkan Acquired Immunodefiency Syndrome (AIDS),. Kehadiran kuman TB menyebabkan progresivitas kasus ko-infeksi TB-HIV bertambah buruk sehingga mengancam jiwa penderitanya. Penelitian ini bertujuan untuk mengetahui gambaran kesintasan satu tahun pasien ko-infeksi TB-HIV berdasarkan waktu awal pengobatan ARV.Metode : Penelitian ini menggunakan desain kohort retrospektif di RSPI Prof. Dr. Sulianti Saroso tahun 2013-2015. Sumber data yang digunakan berasal dari penelusuran pada register pra ARV dan ARV, Form TB 01, buku monitoring ARV, monitoring farmasi ARV, pelacakan ikhtisar ARV dan status rekam medis. Pengumpulan data melibatkan petugas Pokja HIV/AIDS dan dokter (validasi diagnosa dan kovariat) yang di blind atas hipotesis penelitian.Hasil : Probabilitas ketahanan hidup kumulatif satu tahun pasien ko-infeksi TB-HIV yang mendapatkan awal pengobatan ARV di RSPI Prof. Dr. Sulianti Saroso periode Januari 2011-Mei 2014 adalah 81,5%. Probabilitas ketahanan hidup pasien TB-HIV berdasarkan waktu awal menunjukan bahwa ketahanan hidup satu tahun pada pasien yang mendapatkan pengobatan ARV pada fase intensif adalah 89,1% dan pada pasien yang mendapatkan pengobatan ARV pada fase lanjut adalah 74,5%.Kesimpulan : Pasien ko-infeksi TB-HIV yang mendapatkan ARV pada fase intensif cenderung memiliki probalitas ketahanan hidup yang lebih besar di tahun pertama dibandingkan pasien ko-infeksi TB-HIV yang mendapatkan ARV pada fase lanjut. Abstract Background : Human Immunodeficiency Virus (HIV) is a type of retrovirus that infects the human immune system that causes Acquired Immunodefiency Syndrome (AIDS). The presence of TB germs cause progression of cases of co-infection of TB-HIV getting worse so threatening sufferers. This study aims to reveal the one-year survival rate of patients co-infected TB-HIV based on time start of antiretroviral treatment.Methods : This study used a retrospective cohort design in RSPI Prof. Dr. Sulianti Saroso years 2013-2015. The data used comes from searches on the register of pre ARV and ARV form, TB Form, the book ARV monitoring, monitoring of pharmaceutical drugs, ARV overview and status tracking of medical records. The data collection involves the officer HIV / AIDS and the doctor (validation diagnosis and covariates) were in blind on the research hypothesis. Results : The cumulative probability of survival for one year patients co-infected TB-HIV get antiretroviral treatment early in RSPI Prof. Dr. Sulianti Saroso period January 2011-May 2014 was 81.5%. The probability of survival for patients of TB-HIV based on the initial time showed that one-year survival in patients receiving antiretroviral treatment in the intensive phase was 89.1% and in patients receiving antiretroviral treatment in advanced phases was 74.5%.Conclusion : Co-infected TB-HIV patients get antiretroviral drugs in the intensive phase tend to have a probability of survival is greater in the first year compared to co-infection TB-HIV patients get antiretroviral drugs in the advanced phase

scholarly journals β-Catenin Expression and Its Association with Prognostic Factors in Hepatocellular Carcinoma: A Study on Alpha-fetoprotein, Histologic Grade, and Microvascular Invasion

2021 ◽  
Vol 9 (A) ◽  
pp. 887-893
Author(s):  
Nur Rahadiani ◽  
Ignasia Andhini Retnowulan ◽  
Marini Stephanie ◽  
Diah Rini Handjari ◽  
Ening Krisnuhoni
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prognostic Factors ◽  
Primary Liver Cancer ◽  
Microvascular Invasion ◽  
Alpha Fetoprotein ◽  
Histologic Grade ◽  
Molecular Characteristics ◽  
High Recurrence Rate ◽  
Cellular Processes ◽  
Serum Alpha Fetoprotein

Background. Hepatocellular carcinoma (HCC), the most common primary liver cancer. In addition to its high incidence, the disease burden is high due to its poor prognosis and high recurrence rate. Some of the currently known clinicopathologic prognostic factors include alpha-fetoprotein (AFP) level, histologic grade, and microvascular invasion. At the molecular level, β-catenin is one of the most common driver mutation found in HCC. The Wnt/β-catenin pathway regulates cellular processes related to initiation, growth, survival, migration, differentiation, and apoptosis. Although the underlying pathogenesis of hepatocarcinogenesis is known, clinical application warrants a greater understanding of the molecular characteristics and tumor phenotype, especially for determining the prognosis. This study aims to analyze the expression of β-catenin and its association with AFP, histologic grade, and microvascular invasion. Materials and methods. Thirty-five samples of surgically resected HCCs at Cipto Mangunkusumo National Referral Hospital were examined. Diagnoses were made based on histopathological and immunohistochemical findings followed by β-catenin staining. β-catenin expression was analyzed to determine difference between variables. Results and conclusions. Here we show that β-catenin expression is significantly associated with low serum alpha-fetoprotein and well to moderate differentiation Implications. Strong nuclear β-catenin expression implies better prognosis in HCC.

scholarly journals Analysis of the Clinicopathological Features and Prognosis of Pregnancy with Gastric Cancer: A Case-Control Study

2020 ◽  
Author(s):  
Ying Han ◽  
Junli Lu ◽  
Lei Zhu ◽  
Cuiqin Sang ◽  
ShuZhen Wang
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factors ◽  
Abdominal Mass ◽  
Supportive Therapy ◽  
Tumor Stage ◽  
Clinicopathological Features ◽  
Control Group ◽  
Advanced Stage ◽  
Curative Gastrectomy ◽  
Cancer In Pregnancy

Abstract BackgroundTo summarize the clinicopathological features and prognostic factors of pregnancy with gastric cancer.MethodsThe clinical data of pregnant patients with gastric cancer diagnosed and treated in our hospital from 2009.1 to 2019.12 were analyzed. Two sex-, age-, and stage- matched controls for each case were identified from the medical data. Clinical characteristics, pathological features and prognosis were summarized.ResultsThe median overall survival time of the pregnancy with gastric cancer and the control group were 8.0 months and 11.0 months, respectively (P = 0.05). The advanced stage was associated with poor prognostic factors. Pregnancy with gastric cancer was associated with a longer time from diagnosis to treatment (19.0 days vs 9.0 days, p = 0.012). The median age was 32 years old (26.0ཞ41.0 years old). The diagnosed time of prengnancy week was 9.0 ~ 37.0 weeks. Of 22 patients, 4 patients had gastric cancer family history. Abdominal pain (6/22, 27.3%) was the most common presentation, and other symptoms were nausea and/or vomiting (3/22, 13.6%), nonspecific dyspepsia (3 cases, 13.6%), and melena (1 case, 4.5%). Other 9 patients (41.0%) were identified with metastatic features, including abdominal distention, ascites, abdominal mass, and jaundice. 5 cases(22.7%) received curative gastrectomy, 5 patients (22.7%) received chemotherapy,and other 12 patients (54.6%) received supportive therapy. ConclusionsThe prognosis of patients with gastric cancer in pregnancy is very poor, and patients often cannot be diagnosed in time. The tumor differentiation is poor with advanced stage, always progresses rapidly with high mortality. And the tumor stage was the significant factor influecing the prognosis.

Increased levels of typically fetal bile acid species in patients with hepatocellular carcinoma

2001 ◽  
Vol 100 (5) ◽  
pp. 499-508 ◽  
Author(s):  
Mohamad Y. EL-MIR ◽  
Maria D. BADIA ◽  
Nazaret LUENGO ◽  
Maria J. MONTE ◽  
Jose J. G. MARIN
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Liver Metastasis ◽  
Viral Hepatitis ◽  
Chronic Viral Hepatitis ◽  
Control Group ◽  
Serum Alpha Fetoprotein ◽  
Liver Neoplasia ◽  
Urine And Serum ◽  
Serum And Urine

The aim of this work was to investigate the reappearance during liver neoplasia of bile acids (BAs) species, which are unusual in healthy adults, but common in fetuses. Serum and urine samples were collected from patients with hepatocellular carcinoma (HCC; n = 27), and for comparative purposes, with liver cirrhosis (n = 49), liver metastasis (n = 19), chronic viral hepatitis (n = 11) and healthy volunteer (control group; n = 26) groups. BAs were identified and measured by GC–MS. Hypercholanaemia was found in all groups of patients. In HCC, this was characterized by a marked increase in the chenodeoxycholate/cholate ratio in both serum and urine. Although increased levels of BAs, with hydroxylations at unusual positions, and oxo-BAs were found in HCC, these were not significantly different from those observed in other groups. However, BAs with a flat structure, i.e. Δ4-unsaturated- and 5α- or allo-BAs, which were almost absent in healthy subjects, were markedly increased in the serum and urine of HCC patients. They were also detected, although in much lower amounts, in liver metastasis and liver cirrhosis, but not in viral hepatitis. Flat-BAs were better detected in urine than in serum. Urinary Δ4-unsaturated-BA output was significantly lower in patients with small tumours (< 3 cm) compared with those with higher size tumours. No correlation between flat-BA output into urine and serum alpha-fetoprotein or total BAs was found. These results suggest that Δ4- and/or allo-BAs are particularly elevated in patients with HCC, which may be a potentially useful complementary, rather than alternative, marker for early detection of liver neoplasia.

High-risk factors affecting survival after transcatheter therapy with doxorubicin-eluting beads for unresectable hepatocellular carcinoma

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e15614-e15614
Author(s):  
J. K. West ◽  
R. Dhanasekaran ◽  
D. A. Kooby ◽  
C. A. Staley ◽  
J. Kauh ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Portal Vein ◽  
Serum Albumin ◽  
Portal Vein Thrombosis ◽  
Survival Rates ◽  
Transcatheter Therapy ◽  
Vein Thrombosis ◽  
One Year

e15614 Background: Transcatheter therapy with drug eluting beads (DEB) with Doxorubicin is a relatively new modality of palliative treatment of patients with unresectable HCC. It is important to identify prognostic factors which affect survival after treatment with DEB to enable optimal patient selection and to ensure maximal survival benefit. Methods: Fifty consecutive patients with unresectable HCC who were treated with transcatheter therapy with DEB between the period of 2005 and 2008 were studied. Kaplan Meier test was used to study survival. Categorical variables were compared with Log rank test and continuous variable with Cox proportional hazards method. Results: The survival rates at one year from first transcatheter therapy in patients belonging to Okuda stage I, II and III were 67%, 35% and 27% (p=0.043). The survival rates at one year from the first transcatheter therapy in Child Pugh Class A, B and C were 60%, 39% and 13% (p=0.003). Portal vein thrombosis was present in 24%(12/50). Median survivals in patients with and without portal vein thrombosis were 335 days(31–638) and 610 days(482–738)(p=0.285). The median survival in patients with tumor thrombus and bland thrombus were 169 days and 335 days(p=0.69). The median survival in patients with main portal vein thrombosis and branch portal vein thromboses were 316 days(135–497) and 550 days(202–897)(p=0.89).Pre- procedure albumin, bilirubin and MELD score were found to be prognostic factors on univariate analysis ( Table 1 ).On multivariate analysis, pre-procedure serum albumin and Okuda staging were found to be independent prognostic factors. Conclusions: On multivariate analysis, serum albumin and Okuda staging were found to independently influence survival of patients treated with Doxorubicin eluting beads for unresectable hepatocellular carcinoma. The presence of portal vein thrombosis did not affect the long term survival. [Table: see text] No significant financial relationships to disclose.

scholarly journals Comparison of Transcatheter Arterial Chemoembolization-Radiofrequency Ablation and Transcatheter Arterial Chemoembolization Alone for Advanced Hepatocellular Carcinoma with Macrovascular Invasion Using Propensity Score Analysis: A Retrospective Cohort Study

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Yao Liu ◽  
Yuxin Li ◽  
Fangyuan Gao ◽  
Qun Zhang ◽  
Xue Yang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Propensity Score ◽  
Transcatheter Arterial Chemoembolization ◽  
Propensity Score Analysis ◽  
Supportive Therapy ◽  
Control Group ◽  
Tumor Diameter ◽  
Advanced Hepatocellular Carcinoma ◽  
Arterial Chemoembolization

Background. To compare the efficacies of transcatheter arterial chemoembolization (TACE) with radiofrequency ablation (RFA) (TACE + RFA) and TACE alone in patients with hepatocellular carcinoma (HCC) and macrovascular invasion (MVI). Methods. In total, 664 patients having HCC with MVI were included. Of these patients, 141 were treated with TACE + RFA, 254 with TACE alone, and 269 with supportive therapy (control group). The overall survival (OS) was compared among these groups. Propensity score matching (PSM) was performed for balancing the characteristics of the three groups. Results. After one-to-one PSM, the 12-month OS rates were higher in the TACE and TACE + RFA groups than in the control group (p=0.0009 and p=0.0017, respectively). Furthermore, higher 12-month OS rates were observed in the TACE + RFA group than in the TACE group (p=0.0192). The 12-month OS rates of patients were remarkably higher in α-fetoprotein (AFP) < 400 ng/ml, tumor < 3, tumor diameter < 5 cm, or portal vein tumor thrombosis (PVTT) group who were treated with TACE + RFA than in those who were treated with TACE (p=0.0122, p=0.0090, p=0112, and p=0.0071, respectively). Conclusions. TACE + RFA provides a superior survival outcome than TACE alone in HCC patients, especially in AFP <400 ng/ml, tumor <3, tumor diameter <5 cm, or PVTT group.

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