Hepatic cancer

肝癌
  • 文章类型: Journal Article
    目的:电化学疗法,临床建立用于治疗(皮下)皮肤肿瘤,已在欧洲标准电化学疗法操作程序(ESOPE)的框架内标准化。由于化疗药物的常见副作用,最近的进展集中在非细胞毒性药物上,像钙,诱导细胞死亡(钙电穿孔)。因此,这项研究旨在确定博来霉素或顺铂的电化学疗法的疗效,或使用ESOPE方案在体外对人肝细胞癌细胞(HepG2)进行钙电穿孔。
    方法:在化疗药物博来霉素或顺铂(0-20µM)进行电化学化疗后,用MTT(3-(4,5-二甲基噻唑-2-基)-2,5-二苯基四唑溴化物)测定HepG2细胞活力,或钙电穿孔后(0-20mM),使用ESOPE方案(8个矩形脉冲,1000V/cm,100µs)与非电穿孔药物治疗相比。
    结果:电穿孔样品中细胞活力显著降低,与未电穿孔的对照相比(差异27-75%)。博来霉素和钙电穿孔的电化学疗法,达到(几乎)完全细胞死亡(-1±3%和2.5±2%),在2.5µM和2.5mM的最低浓度下,分别。用2.5µM顺铂进行电化学治疗,显着降低细胞活力仅68%(±7%)。
    结论:博来霉素或顺铂的电化学疗法,与单独的非电穿孔药物处理相比,使用ESOPE方案,或钙电穿孔在体外降低HepG2细胞活力方面更有效。当比较电化学时,HepG2细胞对博莱霉素比顺铂更敏感,浓度相似。钙电穿孔与博来霉素的电化学疗法具有相同的效果,但钙可能具有更好的安全性和一些治疗优势。
    OBJECTIVE: Electrochemotherapy, clinically established for treating (sub)cutaneous tumors, has been standardized in the framework of the European Standard Operating Procedure on Electrochemotherapy (ESOPE). Due to common side effects of chemotherapeutic drugs, recent advances focus on non-cytotoxic agents, like calcium, to induce cell death (calcium electroporation). Therefore, this study aims to determine the efficacy of electrochemotherapy with bleomycin or cisplatin, or calcium electroporation on human hepatocellular carcinoma cells (HepG2) in vitro using the ESOPE protocol.
    METHODS: HepG2 cell viability was measured with a MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay after electrochemotherapy with the chemotherapeutic drugs bleomycin or cisplatin (0-20 µM), or after calcium electroporation (0-20 mM), to determine its efficacy on HepG2 cells in vitro using the ESOPE protocol (8 rectangular pulses, 1000 V/cm, 100 µs) compared to non-electroporated drug treatment.
    RESULTS: Cell viability was significantly lower in electroporated samples, compared to their non-electroporated controls (27-75% difference). Electrochemotherapy with bleomycin and calcium electroporation, reached (almost) complete cell death (- 1 ± 3% and 2.5 ± 2%), in the lowest concentration of 2.5 µM and 2.5 mM, respectively. Electrochemotherapy with 2.5 µM cisplatin, significantly decreased cell viability to only 68% (± 7%).
    CONCLUSIONS: Electrochemotherapy with bleomycin or cisplatin, or calcium electroporation were more effective in reducing the HepG2 cell viability in vitro using the ESOPE protocol compared to the non-electroporated drug treatments alone. When comparing electrochemotherapy, HepG2 cells are more sensitive to bleomycin than cisplatin, in similar concentrations. Calcium electroporation has the same effectiveness as electrochemotherapy with bleomycin, but calcium potentially has a better safety profile and several treatment advantages.
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  • 文章类型: Case Reports
    肝细胞癌(HCC)是Budd-Chiari综合征(BCS)的极为罕见的长期并发症,可能是由于长期静脉充血引起纤维化而发生的。肝硬化和随后的肝细胞发育不良或间变。这种并发症在小儿BCS中甚至更罕见,需要早期诊断以获得良好的预后。BCS的良性再生结节难以与HCC的恶性结节区分,从而使串行成像对BCS中HCC的早期诊断不那么敏感。由于这种并发症的罕见性,在监测慢性小儿BCS时不存在像成人这样的监测指南。除了放射学监测外,每月6个月的血清甲胎蛋白监测可提高早期检测BCS中HCC转化的敏感性,也应该是儿科BCS的前进方向。我们描述了一名儿科患者,在BCS随访25个月后出现晚期HCC。
    Hepatocellular carcinoma (HCC) is an extremely rare long-term complication of Budd-Chiari syndrome (BCS) which may occur due to long-term venous congestion causing fibrosis, cirrhosis and subsequent hepatocellular dysplasia or anaplasia. This complication is even rarer in paediatric BCS and warrants early diagnosis for a favourable prognosis. Benign regenerative nodules seen with BCS are difficult to differentiate from malignant nodular lesion of HCC, thereby making serial imaging less sensitive for early diagnosis of HCC in BCS. Surveillance guidelines like adults do not exist in monitoring chronic paediatric BCS due to rarity of this complication. Six monthly serum alpha-fetoprotein monitoring in addition to radiological surveillance improves the sensitivity of early detection of HCC transformation in BCS and should be the way ahead in paediatric BCS as well. We describe a paediatric patient who presented with advanced HCC after 25-month follow-up for BCS.
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  • 文章类型: Journal Article
    由于肝癌的发病率和死亡率在全球范围内持续增长,有必要开发仿生肿瘤模型,用于药物开发和肿瘤治疗。细胞球体作为一种出色的简单3D模型,可以弥合2D细胞培养和活组织之间的差距。在这项研究中,我们提出了一种基于生物甲基丙烯酸酯明胶(GelMA)水凝胶的微平台,用于肝细胞球体的大量生成和耐药性的下游研究。通过微成型制造策略,可以在标准24培养孔板中轻松实现具有可调阵列的微图案化GelMA水凝胶微孔芯片(GHM芯片)。制造的GHM芯片在限定的形貌内诱导多细胞自组装行为,并进一步形成球状结构。通过调节细胞接种密度和设计微孔尺寸,均匀的肝癌球体与可调直径在一个简单的获得,稳定可控。此外,通过从GHM芯片中无损回收球体,完成了抗癌药物的筛选化疗研究。除此之外,回收的功能性球体在肿瘤生物学等生物医学领域具有潜在的应用价值,药理学,和组织微工程。最后,拟议的GHM芯片并入标准细胞培养板,具有易于制造和操作的特性,可能是癌症研究应用的有效培养微平台。
    Since hepatic cancer incidence and mortality continue to grow worldwide, it is necessary to develop the biomimetic tumor models for drug development and tumor therapeutics. Cellular spheroids as an excellent simple 3D model can bridge the gap between 2D cell culture and live tissue. In this study, we proposed a biological methacrylated gelatin (GelMA) hydrogel-based microplatform for the massive generation of hepatocellular spheroids and downstream investigation of drug resistance. Micropatterned GelMA hydrogel microwell chip (GHM-chip) with tunable array was easily achieved in standard 24-culture well plates through the micro-molding fabrication strategy. The fabricated GHM-chip induced multicellular self-assembly behavior within the defined topography and further formed spheroidal structure. By regulating cell seeding density and designing microwell size, uniform hepatic cancer spheroids with tunable diameters were obtained in a simplicity, stability and controllable manner. In addition, the screening chemotherapy study of anti-cancer drug was completed through non-destructive recovery of spheroids from the GHM-chip. Beyond that, the recovered functional spheroids have potential application value in various biomedical fields such as tumor biology, pharmacology, and tissue microengineering. Finally, the proposed GHM-chip incorporated into standard cell culture plates with easy to manufacture and operate properties, may be an efficient culture microplatform for cancer research applications.
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  • 文章类型: Journal Article
    观察性研究和临床试验表明,免疫细胞之间存在关联,炎症因子,血清代谢物,还有肝癌.然而,这些因素与肝癌之间的因果关系仍有待确定。
    为了探索免疫细胞之间的因果关系,炎症因子,血清代谢物,还有肝癌.
    本研究利用公开的遗传数据(GWAS)采用孟德尔双样本随机化(MR)来分析731个免疫细胞性状之间的因果关系,91个炎症因子,1400种血清代谢物,还有肝癌.主要分析使用逆方差加权(IVW)MR,进行额外的敏感性测试,以评估因果关系的有效性。
    对异质性和水平多效性进行校正后,在探索免疫细胞群与肝癌之间的因果关系时,我们发现终末分化CD4-CD8-T细胞%T细胞与肝癌呈负相关,作为保护因素,而效应记忆CD4-CD8-T细胞%CD4-CD8-T细胞与肝癌呈正相关,作为一个风险因素。在研究炎症因子与肝癌之间的因果关系时,C-C基序趋化因子19水平与肝癌呈正相关,代表一个风险因素,而白细胞介素-10水平与肝癌呈负相关,作为保护因素。关于血清代谢物与肝癌之间的因果关系,(N(1)N(8))-乙酰亚精胺水平与肝癌呈负相关,作为保护因素,而1-(1-烯基-棕榈酰)-GPC(p-16:0)水平与肝癌呈正相关,作为一个风险因素。
    我们的MR分析表明免疫细胞之间的因果关系,炎症因子,血清代谢物,还有肝癌.然而,需要进一步验证来评估这些免疫细胞的潜力,炎症因子,和血清代谢物作为肝癌的预防或治疗靶标。
    UNASSIGNED: Observational studies and clinical trials suggest associations between immune cells, inflammatory factors, serum metabolites, and hepatic cancer. However, the causal relationships between these factors and hepatic cancer remain to be established.
    UNASSIGNED: To explore the causal relationships between immune cells, inflammatory factors, serum metabolites, and hepatic cancer.
    UNASSIGNED: This study employed comprehensive two-sample Mendelian randomization (MR) utilizing publicly available genetic data (GWAS) to analyze causal relationships between 731 immune cell traits, 91 inflammatory factors, 1400 serum metabolites, and hepatic cancer. The primary analysis used inverse variance-weighted (IVW) MR, with additional sensitivity tests to assess the validity of causal relationships.
    UNASSIGNED: After correction for heterogeneity and horizontal pleiotropy, in exploring the causal relationships between immune cell groups and hepatic cancer, we found that Terminally Differentiated CD4-CD8- T cell %T cell was negatively associated with hepatic cancer, serving as a protective factor, while Effector Memory CD4-CD8- T cell %CD4-CD8- T cell was positively associated with hepatic cancer, acting as a risk factor. In investigating the causal relationships between inflammatory factors and hepatic cancer, C-C motif chemokine 19 levels were positively associated with hepatic cancer, representing a risk factor, while Interleukin-10 levels were negatively associated with hepatic cancer, acting as a protective factor. Regarding the causal relationships between serum metabolites and hepatic cancer, (N(1) + N(8))-acetylspermidine levels were negatively associated with hepatic cancer, serving as a protective factor, while 1-(1-enyl-palmitoyl)-GPC (p-16:0) levels were positively associated with hepatic cancer, acting as a risk factor.
    UNASSIGNED: Our MR analysis indicates causal relationships between immune cells, inflammatory factors, serum metabolites, and hepatic cancer. However, further validation is needed to assess the potential of these immune cells, inflammatory factors, and serum metabolites as preventive or therapeutic targets for hepatic cancer.
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  • 文章类型: Journal Article
    芦笋属以其药理活性和民族药理学应用而闻名。在民间医学中,它用于治疗多种疾病,如糖尿病,炎症,和风湿病。这项工作旨在研究芦笋根和地上部分提取物作为细胞毒性和抗炎的潜力,并研究其化学特征。GC分析和Folin-Ciocalteu和重量分析法分别用于估算脂质体,酚醛,和皂苷含量。使用两种细胞系(MCF-7和HepG2)进行MTT测定,以通过监测一氧化氮释放水平和NF-κB基因表达来研究使用TNF-α刺激的MCF-7细胞的细胞毒性和抗炎活性。初步的植物化学调查表明,两个提取部分同样富含皂苷,黄酮类化合物,碳水化合物和/或糖苷,和甾醇和/或三萜。棕榈酸和β谷甾醇代表主要的饱和脂肪酸和甾醇,分别。对于DCM提取物(IC50为26.13μg/ml),记录了对MCF-7细胞的显著细胞毒活性。所有测试的提取物均显示NO释放和NF-κB基因表达的显着降低,因此具有潜在的抗炎活性。A.densiflorusmeyeri被认为是一个很好的候选人作为食品补充剂保护免受恶性肿瘤。
    Genus Asparagus is well known for its pharmacological activities and ethnopharmacological applications.  In folk medicine, it is used in the management of several diseases such as diabetes, inflammations, and rheumatism. This work aimed to investigate the potential of Asparagus densiflorus meyeri root & aerial parts extracts as cytotoxic and anti-inflammatory and the investigation of their chemical profile. GC analysis & Folin-Ciocalteu and gravimetric methods were used respectively to estimate the lipoidal, phenolic, and saponin contents. MTT assay was conducted using two cell lines (MCF-7 & HepG2) to investigate the cytotoxic and anti-inflammatory activity using TNF-α stimulated MCF-7 cells through monitoring the level of nitric oxide release and NF-κB gene expression. Preliminary phytochemical investigation indicated that both extracted parts are equally rich in saponins, flavonoids, carbohydrates and/or glycosides, and sterols and/or triterpenes. Palmitic acid and β sitosterol represented the major saturated fatty acids and sterol, respectively. A significant cytotoxic activity against MCF-7 cells was recorded for DCM extract (IC50 26.13 μg/ml). All tested extracts showed a significant decrease in NO release and NF-κB gene expression thus it possesses a potential anti-inflammatory activity. A. densiflorus meyeri is considered a good candidate as a food supplement for protection from malignancy.
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  • 文章类型: Case Reports
    腺样囊性癌(ACC)是一种罕见的唾液腺肿瘤,以远处转移为特征。主要是肺和骨骼。孤立的肝转移是不寻常的。我们介绍了一名患有下颌下腺ACC(pT1N0)的女性,该女性接受了下颌下腺根治性切除术和选择性颈部清扫术。术前影像学发现肝脏病变,特征提示血管瘤。术后两年,监测CT颈部/躯干显示左肝叶病变的大小增加。随后的MR肝脏和US引导活检证实病变为转移性ACC。患者接受了成功的左肝外侧部分切除术。肝切除后2.5年,她仍然无病。文献检索显示只有四个其他类似的案例。该报告强调,即使唾液腺的早期ACCs也可能出现同步孤立性肝转移,可以通过根治性手术有效治疗。
    Adenoid cystic carcinoma (ACC) is a rare tumour of the salivary glands characterised by distant metastases, mainly to lungs and bone. Isolated metastasis to the liver is unusual. We present the case of a woman with an ACC of the submandibular gland (pT1N0) who underwent radical submandibular gland excision and selective neck dissection. Preoperative imaging identified a liver lesion with features suggestive of a haemangioma. Two-year postoperatively, a surveillance CT neck/trunk showed an increase in size of the left liver lobe lesion. Subsequent MR liver and US-guided biopsy confirmed the lesion to be metastatic ACC. The patient underwent a successful left lateral liver sectionectomy. She remains disease-free 2.5 years after her liver resection. A literature search revealed only four other similar cases. This report highlights that even early-stage ACCs of the salivary gland may present with synchronous solitary liver metastasis which can be effectively treated with curative surgery.
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  • 文章类型: Journal Article
    背景:肝细胞癌(HCC)在癌症发病率方面全球排名第六,死亡率排名第三。不幸的是,超过70%的肝癌患者放弃了治愈性手术或肝移植的机会,由于体检不足,身体状况差,诊断后器官的可用性有限。临床指南认可经动脉化疗栓塞(TACE)作为中晚期HCC的一线治疗。冷冻消融(CRA)是一种新兴的局部消融疗法,越来越多地用于HCC管理。最近的研究表明,CRA与TACE的结合提供了互补和协同作用,有可能提高长期生存率。然而,对于等于或超过5cm的HCC病变,TACE+CRA联合治疗比TACE单独治疗的优越性需要进一步研究.
    目的:比较TACE联合CRA与单纯TACE治疗直径≥5cmHCC的疗效和安全性。
    方法:PubMed,EMBASE,科克伦图书馆,CNKI,万方,和VIP数据库进行检索,以检索截至2022年7月所有关于TACE和CRA的相关研究。采用RevMan5.3软件进行Meta分析。
    结果:根据纳入和排除标准进行筛选后,包括6篇文章,包括2项随机对照试验和4项非随机对照试验,共有575例患者纳入荟萃分析.结果表明,客观反应率[优势比(OR)=2.56,95%置信区间(CI):1.66-3.96,P<0.0001),疾病控制率(OR=3.03,95CI:1.88-4.89,P<0.00001),1年生存率(OR=3.79,95CI:2.50-5.76,P<0.00001),2年生存率(OR=2.34,95CI:1.43-3.85,P=0.0008),3年生存率(OR=3.34,95CI:1.61~6.94,P=0.001)均优于对照组;术后甲胎蛋白值降低(OR=295.53,95CI:250.22~340.85,P<0.0001),术后CD4值升高(OR=10.59,95CI:8.78~12.40,P<0.00001),术后CD8值下降(OR=6.47,95CI:4.44~8.50,P<0.00001)也明显高于单纯TACE治疗组。
    结论:与单纯TACE治疗相比,TACE+CRA联合治疗不仅能改善直径≥5cm的HCC患者的免疫功能,而且还提高了治疗效果和长期生存率,不会增加并发症的风险。因此,对于直径≥5cm的HCC患者,TACE+CRA联合治疗可能是更推荐的治疗方法。
    BACKGROUND: Hepatocellular carcinoma (HCC) ranks sixth globally in cancer incidence and third in mortality rates. Unfortunately, over 70% of HCC patients forego the opportunity for curative surgery or liver transplantation due to inadequate physical examinations, poor physical condition, and limited organ availability upon diagnosis. Clinical guidelines endorse transarterial chemoembolization (TACE) as the frontline treatment for intermediate to advanced-stage HCC. Cryoablation (CRA) is an emerging local ablative therapy increasingly used in HCC management. Recent studies suggest that combining CRA with TACE offers complementary and synergistic effects, potentially improving long-term survival rates. However, the superiority of combined TACE + CRA therapy over TACE alone for HCC lesions equal to or exceeding 5 cm requires further investigation.
    OBJECTIVE: To compare the efficacy and safety of TACE combined with CRA vs TACE alone in the treatment of HCC with a diameter of ≥ 5 cm.
    METHODS: PubMed, EMBASE, Cochrane Library, CNKI, Wanfang, and VIP databases were searched to retrieve all relevant studies on TACE and CRA up to July 2022. Meta-analysis was performed using RevMan 5.3 software.
    RESULTS: After screening according to the inclusion and exclusion criteria, 6 articles were included, including 2 randomized controlled trials and 4 nonrandomized controlled trials, with a total of 575 patients included in the meta-analysis. The results showed that the objective response rate [odds ratio (OR) = 2.56, 95% confidence interval (CI):1.66-3.96, P < 0.0001), disease control rate (OR = 3.03, 95%CI: 1.88-4.89, P < 0.00001), 1-year survival rate (OR = 3.79, 95%CI: 2.50-5.76, P < 0.00001), 2-year survival rate (OR = 2.34, 95%CI: 1.43-3.85, P = 0.0008), and 3-year survival rate (OR = 3.34, 95%CI: 1.61-6.94, P = 0.001) were all superior to those of the control group; the postoperative decrease in alpha-fetoprotein value (OR = 295.53, 95%CI: 250.22-340.85, P < 0.0001), the postoperative increase in CD4 value (OR = 10.59, 95%CI: 8.78-12.40, P < 0.00001), and the postoperative decrease in CD8 value (OR = 6.47, 95%CI: 4.44-8.50, P < 0.00001) were also significantly higher than those in the TACE-alone treatment group.
    CONCLUSIONS: Compared with TACE-alone treatment, TACE + CRA combined treatment not only improves the immune function of HCC patients with a diameter of ≥ 5 cm, but also enhances the therapeutic efficacy and long-term survival rate, without increasing the risk of complications. Therefore, TACE + CRA combined treatment may be a more recommended treatment for patients with HCC with a diameter of ≥ 5 cm.
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  • 文章类型: Journal Article
    背景:本研究系统地回顾了代谢功能障碍相关的脂肪变性肝病(MASLD)与肝癌发生发展之间的关系。先前的研究强调了MASLD是一种易感条件。目的:收集有关MASLD与肝癌关系的最新全球数据。方法:系统评价,其中包括对MASLD与肝癌发病率之间关系的研究分析,关注纤维化和MASLD严重程度作为癌症风险预测因子的作用。遵循评估纵向研究的标准方法框架,这篇综述收集了纤维化评分的信息,肝细胞癌(HCC)发病率,和其他类型的肝肿瘤。结果:最初共确定522项研究,其中6项研究适合本综述.他们共同揭示了MASLD中纤维化的阶段是死亡率和肝脏相关事件的重要独立预测因子。更高的纤维化分期与更高的风险相关。纵向数据显示,FIB-4评分的增加与发生HCC和肝硬化的风险更高有关。MASLD还与非肝癌的风险增加有关,例如男性的结直肠癌和女性的乳腺癌。发现MASLD的严重程度是胆道癌(BTC)的可改变的危险因素,糖尿病进一步放大了风险。此外,生活方式因素和合并症,比如吸烟和糖尿病,被确定为MASLD患者癌症风险的调节剂。结论:系统评价确定了MASLD与肝癌风险升高之间的关联,在肝纤维化的严重程度与HCC和其他肝肿瘤的发病率之间建立明确的联系。这支持了对MASLD患者进行肝癌筛查的必要性,特别是在存在晚期纤维化或其他风险调节因素的情况下。
    Background: This study systematically reviewed the association between metabolic-dysfunction-associated steatotic liver disease (MASLD) and the development of hepatic cancer. Previous research has highlighted MASLD as a predisposing condition. Aim: To collect recent global data on the relationship between MASLD and hepatic cancer. Methods: A systematic review was conducted, which included an analysis of studies on the relationship between MASLD and the incidence of hepatic cancers, focusing on the role of fibrosis and MASLD severity as predictors of cancer risk. Following standard methodological frameworks for the assessment of longitudinal studies, the review gathered information on fibrosis scores, hepatocellular carcinoma (HCC) incidence, and other types of hepatic neoplasms. Results: A total of 522 studies were initially identified, of which 6 studies were appropriate for the review. They collectively revealed that the stage of fibrosis in MASLD is a significant independent predictor of mortality and liver-related events, with higher fibrosis stages correlating with greater risk. Longitudinal data showed that increases in FIB-4 scores were linked to a higher risk of developing HCC and cirrhosis. MASLD was also associated with an increased risk of non-hepatic cancers such as colorectal cancer in males and breast cancer in females. The severity of MASLD was found to be a modifiable risk factor for biliary tract cancer (BTC), with the risk further amplified by diabetes. Moreover, lifestyle factors and comorbidities, such as smoking and diabetes, were identified as modifiers of cancer risk in MASLD patients. Conclusions: The systematic review identified the association between MASLD and an elevated risk of hepatic cancer, establishing a clear link between the severity of liver fibrosis and the incidence of HCC and other hepatic neoplasms. This supports the need for screening for hepatic cancer in patients with MASLD, particularly in the presence of advanced fibrosis or other risk-modifying factors.
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  • 文章类型: Case Reports
    糖原贮积病1A(GSD1A),也被称为VonGierke病,是一种影响肝脏糖原代谢的罕见常染色体隐性遗传疾病。它最常见于婴儿期,伴有低血糖和未能茁壮成长,但是据报道,直到成年后才被诊断出来。一名20多岁的女性患有糖尿病,表现出右上腹疼痛,被发现患有几例出血性肝腺瘤。该患者自9个月大的胰腺切除术以来,由于持续的低血糖发作和可疑的胰岛素瘤,患有胰岛素依赖型糖尿病。住院期间,肝腺瘤被栓塞,但显著的乳酸性酸中毒和低血糖仍在继续。进一步的检查发现了慢性乳酸水平,在几次住院期间,大于5mmol/L肝组织细胞学检查排除了肝细胞癌,患者已出院,并建议进行基因检测的随访,证实了GSD1A的诊断。
    Glycogen storage disease type 1A (GSD1A), also known as Von Gierke\'s disease, is a rare autosomal recessive disorder affecting glycogen metabolism in the liver. It most commonly presents in infancy with hypoglycaemia and failure to thrive, but cases have been reported as undiagnosed until adulthood. A woman in her early 20s with diabetes mellitus presented with right upper quadrant pain and was found to have several haemorrhagic hepatic adenomas. This patient had insulin-dependent diabetes since a pancreatectomy at age 9 months due to continued episodes of hypoglycaemia and suspected insulinoma. During the hospital stay, the hepatic adenomas were embolised, but significant lactic acidosis and hypoglycaemia continued. Further workup revealed a chronic lactic acid level, during several hospital stays, of above 5 mmol/L. After cytology of hepatic tissue ruled out hepatocellular carcinoma, the patient was discharged and recommended to follow-up for genetic testing, which confirmed the diagnosis of GSD1A.
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  • 文章类型: Journal Article
    背景:慢性炎症已被证明可促进癌症进展。酒渣鼻确实是一种长期的炎症性皮肤病,据报道与几种恶性肿瘤的风险增加有关。但是缺乏因果关系的证据。
    目的:为了系统地估计酒渣鼻与几种癌症之间的因果关系,包括皮肤恶性黑色素瘤(CMM),皮肤鳞状细胞癌(cSCC),基底细胞癌(BCC),光化性角化病(AK),甲状腺癌,乳腺癌,胶质瘤和肝癌,以及探索潜在的潜在发病机制。
    方法:我们进行了一项双向双样本孟德尔随机化研究,以探讨酒渣鼻与几种癌症之间的潜在因果关系。使用与酒渣鼻和癌症相关的全基因组显著单核苷酸多态性建立仪器变量。因果关系的评估是通过多种方法进行的,并通过敏感性分析评估结果的稳健性。
    结果:没有明显的迹象表明酒渣鼻对CMM的因果关系(pivw=0.71),cSCC(枢轴=0.45),BCC(枢轴=0.90),AK(pivw=0.73),甲状腺癌(pivw=0.59),胶质瘤(枢轴=0.15),和肝癌(pivw=0.07),但是酒渣鼻的遗传风险与人类表皮生长因子受体(HER)阴性乳腺癌的易感性增加有关(优势比[OR],1.10;95%置信区间[CI],1.02-1.18;枢轴=0.01)。TANK(TRAF家族成员相关的核因子κB(NFKB)激活剂)被鉴定为两种酒渣鼻的共同保护基因(OR,0.90;95%CI,0.82-0.99;pivw=0.048)和HER阴性乳腺恶性肿瘤(OR,0.86;95%CI,0.75-0.98;枢轴=0.032),主要富含NF-κB信号转导的负调节,可能有助于酒渣鼻与乳腺癌这种亚型之间的遗传联系。
    结论:我们的研究结果为酒渣鼻和HER阴性的乳腺恶性肿瘤风险之间的因果关系提供了暗示性证据。
    BACKGROUND: Chronic inflammation has been shown to promote cancer progression. Rosacea is indeed a long-term inflammatory skin condition and had been reported to link with increased risk for several types of malignancies, but evidence for causality is lacking.
    OBJECTIVE: To systematically estimate the causal relationship between rosacea and several types of cancer, including cutaneous malignant melanoma (CMM), cutaneous squamous cell carcinoma (cSCC), basal cell carcinoma (BCC), actinic keratosis (AK), thyroid cancer, breast cancer, glioma and hepatic cancer, as well as explore the potential underlying pathogenesis.
    METHODS: We conducted a bidirectional two-sample Mendelian randomization study to probe the potential causal relationships between rosacea and several types of cancer. Instrumental variables were established using genome-wide significant single nucleotide polymorphisms associated with rosacea and cancers. The assessment of causality was carried out through multiple methods, and the robustness of the results was evaluated via sensitivity analyses.
    RESULTS: There was no significant indication of causal effects of rosacea on CMM (pivw = 0.71), cSCC (pivw = 0.45), BCC (pivw = 0.90), AK (pivw = 0.73), thyroid cancer (pivw = 0.59), glioma (pivw = 0.15), and hepatic cancer (pivw = 0.07), but the genetic risk of rosacea was associated with an increased susceptibility to human epidermal growth factor receptor (HER)-negative malignant neoplasm of breast (odds ratio [OR], 1.10; 95% confidence interval [CI], 1.02-1.18; pivw = 0.01). TANK (TRAF family member associated nuclear factor kappa B (NFKB) activator) was identified as a common protective gene for both rosacea (OR, 0.90; 95% CI, 0.82-0.99; pivw = 0.048) and HER-negative malignant neoplasm of the breast (OR, 0.86; 95% CI, 0.75-0.98; pivw = 0.032), which was primarily enriched in the negative regulation of NF-κB signal transduction and may contribute to the genetic links between rosacea and this subtype of breast cancer.
    CONCLUSIONS: Our findings provide suggestive evidence for causal links between rosacea and HER-negative malignant neoplasm of the breast risk.
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