Experimental Study of Hepatic Artery Infusion of Vascular Endothelial Growth Factor Receptor (VEGFR)-2As2O3 Nanospheres for Targeted Therapy of Implanted Hep G2 Liver Cancer in Rats

This study assesses the effect of VEGFR-2/As2O3 invisible nanospheres on treating liver cancer. The following groups were set: Group I: blank control group (hepatic artery perfusion 0.9% saline 0.5 ml), group II: VEGFR-2/As2O3 nanospheres injection via tail vein, group III: hepatic artery perfusion of VEGFR-2/As2O3 nanospheres. The effect of hepatic artery infusion of VEGFR-2/As2O3 nanospheres on cell proliferation, apoptosis and colony forming ability was evaluated by MTT method, flow cytometry and colony formation experiment. Tumor xenotransplantation was established to observe the effect of hepatic artery infusion of VEGFR-2/As2O3 nanospheres on liver cancer. The in vivo and in vitro experiments both confirmed that hepatic artery perfusion of VEGFR-2/As2O3 nanospheres can inhibit the proliferation of liver cancer cells, promote cell apoptosis and inhibit cell migration, thereby enhancing the therapeutic effect. The hepatic artery perfusion of VEGFR-2As2O3 nanospheres may be used as a targeted research and development direction for the treatment of liver cancer, providing a new and efficient targeted drug for the interventionaltreatment of liver cancer.

Role of portal color Doppler ultrasonography as noninvasive predictive tool for esophageal varices in cirrhotic patients

Background Esophageal varices (EV) is the most common apprehensive complication of portal hypertension in patients with cirrhotic liver. Guidelines recommend Upper gastro-intestinal endoscopic screening for EV in patients with newly diagnosed chronic cirrhosis (Imperiale et al. in Hepatology 45(4):870–878, 2007). Yet, it is invasive, time consuming and costly. To avoid unnecessary endoscopy, some studies have suggested Doppler ultrasound examination as simple, and noninvasive tool in prediction and assessment of severity of EV (Agha et al. in Dig Dis Sci 54(3):654–660, 2009). Our study was to assess the role of different Doppler indices of portal vein, hepatic and splenic arteries as a noninvasive tool for prediction of esophageal varices in cirrhotic patients. Results This prospective case control study was conducted on 100 cirrhotic liver patients and 100 of healthy volunteers as control group. Patients were subjected to clinical examination, upper gastrointestinal tract endoscopy, abdominal ultrasonography with duplex Doppler evaluation of different portal Doppler hemodynamic indices were done for each patient. The results revealed that portal vein diameter, hepatic artery pulsatility index, portal hypertensive index, portal vein flow velocity, portal congestion index have high sensitivity for prediction of EV. However, Splenic artery resistance index, hepatic artery resistance index HARI, liver vascular index and platelet count/spleen diameter have less sensitivity for prediction of EV. Conclusion Measuring the portal hemodynamic indices can help physicians as noninvasive predictors of EV in cirrhotic patients to restrict the need for unnecessary endoscopic screening especially when endoscopic facilities are limited.

Efficacy of Hepatic Arterial Infusion Chemotherapy and Radiofrequency Ablation against Hepatocellular Carcinoma Refractory to Transarterial Chemoembolization and Vascular Variation: A Case Study

Transarterial chemoembolization is often the first-line treatment for multiple hepatocellular carcinomas. However, hepatic arterial infusion chemotherapy is a treatment option for hepatocellular carcinoma refractory to multiple sessions of transarterial chemoembolization. Hepatic arterial infusion chemotherapy requires implantation of an appropriate port into the hepatic artery. However, it may be impossible to implant a port due to hepatic artery variation. We report a case of hepatocellular carcinoma refractory to transarterial chemoembolization and hepatic artery variation treated successfully with hepatic arterial infusion chemotherapy and radiofrequency ablation with complete response after implantation of ports in both liver lobes.