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Neoadjuvant therapies in resectable hepatocellular carcinoma: Exploring strategies to improve prognosis. 可切除肝细胞癌的新辅助疗法:探索改善预后的策略。
IF 5.5 4区 生物学 Q1 BIOLOGY Pub Date : 2024-03-19 Epub Date: 2024-02-20 DOI: 10.5582/bst.2023.01436
Ya-Nan Ma, Xuemei Jiang, Peipei Song, Wei Tang

Hepatocellular carcinoma (HCC), a challenging malignancy, often necessitates surgical intervention, notably liver resection. However, the high recurrence rate, reaching 70% within 5 years post-resection, significantly impacts patient outcomes. Neoadjuvant therapies aim to preoperatively address this challenge, reducing lesion size, improving surgical resection rates, deactivating potential micro-metastases, and ultimately lowering postoperative recurrence rates. This review concentrates on advances in research on and clinical use of neoadjuvant therapies for HCC, with particular attention to the use of immune checkpoint inhibitors (ICIs) targeting programmed cell death-1 (PD-1), programmed cell death ligand-1 (PD-L1), and cytotoxic T-lymphocyte-associated protein-4 (CTLA-4). Ongoing clinical studies exploring immunotherapy combined with a tyrosine kinase inhibitor (TKI), interventional therapy, radiotherapy, and other modalities offer promising insights into overcoming resistance to monotherapies. In summary, neoadjuvant therapies hold significant promise in terms of improving the prognosis for patients with HCC and enhancing long-term survival, particularly through innovative combination strategies.

肝细胞癌(HCC)是一种具有挑战性的恶性肿瘤,通常需要进行外科干预,特别是肝切除术。然而,切除术后5年内的复发率高达70%,严重影响了患者的预后。新辅助疗法旨在术前应对这一挑战,缩小病灶大小,提高手术切除率,抑制潜在的微转移,最终降低术后复发率。这篇综述集中介绍了HCC新辅助疗法的研究进展和临床应用,尤其关注针对程序性细胞死亡-1(PD-1)、程序性细胞死亡配体-1(PD-L1)和细胞毒性T淋巴细胞相关蛋白-4(CTLA-4)的免疫检查点抑制剂(ICIs)的应用。正在进行的临床研究探索了免疫疗法与酪氨酸激酶抑制剂(TKI)、介入疗法、放疗和其他方式的结合,为克服单一疗法的耐药性提供了有希望的见解。总之,新辅助疗法在改善 HCC 患者预后和提高长期生存率方面大有可为,尤其是通过创新的联合疗法。
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引用次数: 0
Automated machine learning-based model for the prediction of pedicle screw loosening after degenerative lumbar fusion surgery. 基于机器学习的椎弓根螺钉松动自动预测模型,用于预测退行性腰椎融合手术后的椎弓根螺钉松动。
IF 5.5 4区 生物学 Q1 BIOLOGY Pub Date : 2024-03-19 Epub Date: 2024-02-27 DOI: 10.5582/bst.2023.01327
Feng Jiang, Xinxin Li, Lei Liu, Zhiyang Xie, Xiaotao Wu, Yuntao Wang

The adequacy of screw anchorage is a critical factor in achieving successful spinal fusion. This study aimed to use machine learning algorithms to identify critical variables and predict pedicle screw loosening after degenerative lumbar fusion surgery. A total of 552 patients who underwent primary transpedicular lumbar fixation for lumbar degenerative disease were included. The LASSO method identified key features associated with pedicle screw loosening. Patient clinical characteristics, intraoperative variables, and radiographic parameters were collected and used to construct eight machine learning models, including a training set (80% of participants) and a test set (20% of participants). The XGBoost model exhibited the best performance, with an AUC of 0.884 (95% CI: 0.825-0.944) in the test set, along with the lowest Brier score. Ten crucial variables, including age, disease diagnosis: degenerative scoliosis, number of fused levels, fixation to S1, HU value, preoperative PT, preoperative PI-LL, postoperative LL, postoperative PT, and postoperative PI-LL were selected. In the prospective cohort, the XGBoost model demonstrated substantial performance with an accuracy of 83.32%. This study identified crucial variables associated with pedicle screw loosening after degenerative lumbar fusion surgery and successfully developed a machine learning model to predict pedicle screw loosening. The findings of this study may provide valuable information for clinical decision-making.

螺钉固定是否充分是脊柱融合术能否成功的关键因素。本研究旨在利用机器学习算法识别关键变量,预测退行性腰椎融合手术后椎弓根螺钉松动的情况。研究共纳入了552名因腰椎退行性疾病接受原发性经椎管腰椎固定术的患者。LASSO方法确定了与椎弓根螺钉松动相关的主要特征。收集的患者临床特征、术中变量和放射学参数被用于构建八个机器学习模型,包括一个训练集(80%的参与者)和一个测试集(20%的参与者)。XGBoost 模型表现最佳,测试集的 AUC 为 0.884(95% CI:0.825-0.944),Brier 评分最低。研究人员选择了十个关键变量,包括年龄、疾病诊断:退行性脊柱侧凸、融合水平数、S1固定、HU值、术前PT、术前PI-LL、术后LL、术后PT和术后PI-LL。在前瞻性队列中,XGBoost 模型的准确率高达 83.32%,表现出了卓越的性能。本研究确定了退行性腰椎融合手术后与椎弓根螺钉松动相关的关键变量,并成功开发了一个机器学习模型来预测椎弓根螺钉松动。该研究结果可为临床决策提供有价值的信息。
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引用次数: 0
Diabetes mellitus, glycemic traits, SGLT2 inhibition, and risk of pulmonary arterial hypertension: A Mendelian randomization study. 糖尿病、血糖特征、SGLT2 抑制与肺动脉高压风险:孟德尔随机研究
IF 5.5 4区 生物学 Q1 BIOLOGY Pub Date : 2024-03-19 Epub Date: 2024-02-08 DOI: 10.5582/bst.2024.01006
Jiang-Shan Tan, Yanmin Yang, Jingyang Wang, Yimeng Wang, Tingting Lv, Yuyuan Shu, Wei Xu, Lingtao Chong

This study aimed to investigate the causal role of diabetes mellitus (DM), glycemic traits, and sodium-glucose cotransporter 2 (SGLT2) inhibition in pulmonary arterial hypertension (PAH). Utilizing a two-sample two-step Mendelian randomization (MR) approach, we determined the causal influence of DM and glycemic traits (including insulin resistance, glycated hemoglobin, and fasting insulin and glucose) on the risk of PAH. Moreover, we examined the causal effects of SGLT2 inhibition on the risk of PAH. Genetic proxies for SGLT2 inhibition were identified as variants in the SLC5A2 gene that were associated with both levels of gene expression and hemoglobin A1c. Results showed that genetically inferred DM demonstrated a causal correlation with an increased risk of PAH, exhibiting an odds ratio (OR) of 1.432, with a 95% confidence interval (CI) of 1.040-1.973, and a p-value of 0.028. The multivariate MR analysis revealed comparable outcomes after potential confounders (OR = 1.469, 95%CI = 1.021-2.115, p = 0.038). Moreover, genetically predicted SGLT2 inhibition was causally linked to a reduced risk of PAH (OR = 1.681*10-7, 95%CI = 7.059*10-12-0.004, p = 0.002). Therefore, our study identified the suggestively causal effect of DM on the risk of PAH, and SGLT2 inhibition may be a potential therapeutic target in patients with PAH.

本研究旨在探讨糖尿病(DM)、血糖特征和钠-葡萄糖共转运体2(SGLT2)抑制在肺动脉高压(PAH)中的因果作用。我们采用双样本两步孟德尔随机化(MR)方法,确定了糖尿病和血糖特征(包括胰岛素抵抗、糖化血红蛋白、空腹胰岛素和葡萄糖)对 PAH 风险的因果影响。此外,我们还研究了 SGLT2 抑制对 PAH 风险的因果影响。SGLT2 抑制的遗传替代物被确定为 SLC5A2 基因中与基因表达水平和血红蛋白 A1c 相关的变异。结果显示,遗传学推断的 DM 与 PAH 风险增加有因果关系,其几率比 (OR) 为 1.432,95% 置信区间 (CI) 为 1.040-1.973,P 值为 0.028。多变量 MR 分析显示,扣除潜在的混杂因素后,结果相当(OR = 1.469,95%CI = 1.021-2.115,p = 0.038)。此外,基因预测的 SGLT2 抑制与 PAH 风险的降低存在因果关系(OR = 1.681*10-7,95%CI = 7.059*10-12-0.004,p = 0.002)。因此,我们的研究确定了 DM 对 PAH 风险的提示性因果效应,SGLT2 抑制可能是 PAH 患者的潜在治疗靶点。
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引用次数: 0
Socioeconomic disparities in education placement for children of primary school age with autism spectrum disorder in China. 中国小学学龄自闭症谱系障碍儿童教育安置的社会经济差异。
IF 5.5 4区 生物学 Q1 BIOLOGY Pub Date : 2024-03-19 Epub Date: 2024-02-08 DOI: 10.5582/bst.2023.01319
Yanan Zhao, Rong Zhang, Xiaoying Zheng

Relatively little is known about education placements for children with autism spectrum disorder (ASD) in China. While disparities in ASD diagnoses and services for the population broadly are often documented, the presence and determinants of differences in the educational placement of ASD children are less studied and understood. By identifying who is likely to be in segregated settings, we can discern how to best support them and facilitate a possible transition to a less restrictive setting. This study describes four placements (regular schools, special schools, institutions, homes) and their influencing factors retrospectively in a large sample (n = 2,190) of Chinese primary school-aged children (6-12 years old). We divided ASD into severe and mild to moderate categories for analysis. Children with ASD were more likely to study in a regular school (48.60%), while 13.88% were in a special school. Children with severe ASD were placed in less regular settings than children with mild to moderate ASD. However, families with higher socioeconomic status (SES) were more likely to place their children in regular schools than lower SES families if their children experienced mild to moderate symptoms. Children with severe ASD were more likely to be placed in expensive institutions for families with higher SES than those with lower SES. SES disparities in educational placement existed and had two manifestations. It is important to characterize educational placements of students with ASD to determine the extent to which they are placed in general education settings, which are often the preferred placement.

人们对中国自闭症谱系障碍(ASD)儿童的教育安置情况知之甚少。虽然自闭症诊断和服务方面的差异经常被记录在案,但对自闭症儿童教育安置差异的存在和决定因素的研究和了解却较少。通过识别哪些儿童有可能被安置在隔离环境中,我们就可以知道如何为他们提供最好的支持,并帮助他们过渡到限制性较小的环境。本研究回顾性地描述了中国小学学龄儿童(6-12 岁)的四种安置环境(普通学校、特殊学校、福利院、家庭)及其影响因素。我们将自闭症分为严重和轻中度两类进行分析。患有 ASD 的儿童更有可能在普通学校学习(48.60%),而 13.88% 的儿童在特殊学校学习。与轻度至中度自闭症儿童相比,重度自闭症儿童被安置在较不正规的环境中。然而,与社会经济地位较低的家庭相比,社会经济地位较高的家庭更有可能将有轻度至中度症状的孩子安置在普通学校。与社会经济地位较低的家庭相比,社会经济地位较高的家庭更有可能将重度自闭症患儿安置在昂贵的机构中。教育安置方面的社会经济地位差异存在,并有两种表现形式。对患有 ASD 的学生的教育安置情况进行分析,以确定他们在多大程度上被安置在普通教育环境中,这一点非常重要,因为普通教育环境通常是首选的安置场所。
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引用次数: 0
Comparison of diagnosis-related groups (DRG)-based hospital payment system design and implementation strategies in different countries: The case of ischemic stroke. 比较不同国家基于诊断相关分组(DRG)的医院支付系统设计和实施策略:以缺血性中风为例。
IF 5.5 4区 生物学 Q1 BIOLOGY Pub Date : 2024-03-19 Epub Date: 2024-02-24 DOI: 10.5582/bst.2023.01027
Yuan Liu, Gang Wang, Tian-Ge Qin, Susumu Kobayashi, Takashi Karako, Peipei Song

Diagnosis-related groups (DRG) based hospital payment systems are gradually becoming the main mechanism for reimbursement of acute inpatient care. We reviewed the existing literature to ascertain the global use of DRG-based hospital payment systems, compared the similarities and differences of original DRG versions in ten countries, and used ischemic stroke as an example to ascertain the design and implementation strategies for various DRG systems. The current challenges with and direction for the development of DRG-based hospital payment systems are also analyzed. We found that the DRG systems vary greatly in countries in terms of their purpose, grouping, coding, and payment mechanisms although based on the same classification concept and that they have tended to develop differently in countries with different income classifications. In high-income countries, DRG-based hospital payment systems have gradually begun to weaken as a mainstream payment method, while in middle-income countries DRG-based hospital payment systems have attracted increasing attention and increased use. The example of ischemic stroke provides suggestions for mutual promotion of DRG-based hospital payment systems and disease management. How to determine the level of DRG payment incentives and improve system flexibility, balance payment goals and disease management goals, and integrate development with other payment methods are areas for future research on DRG-based hospital payment systems.

以疾病诊断相关分组(DRG)为基础的医院支付系统正逐渐成为急性病住院治疗的主 要报销机制。我们回顾了现有文献以了解基于 DRGs 的医院支付系统在全球的使用情况,比较了十个国家原有 DRGs 版本的异同,并以缺血性脑卒中为例了解了各种 DRGs 系统的设计和实施策略。此外,还分析了目前以 DRG 为基础的医院支付系统所面临的挑战和发展方向。我们发现,虽然基于相同的分类概念,但各国的 DRG 系统在目的、分组、编码和支付机制等方面存在很大差异,而且在收入分类不同的国家,DRG 系统的发展也不尽相同。在高收入国家,以 DRG 为基础的医院支付系统作为主流支付方式的地位已开始逐渐削弱,而在中等收入国家,以 DRG 为基础的医院支付系统已引起越来越多的关注和使用。缺血性脑卒中的例子为基于 DRG 的医院支付系统与疾病管理的相互促进提供了建议。如何确定 DRG 支付激励水平并提高系统灵活性,平衡支付目标和疾病管理目标,以及与其他支付方式的融合发展,是基于 DRG 的医院支付系统未来研究的方向。
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引用次数: 0
Development of a novel cholesterol tag-based system for trans-membrane transport of protein drugs. 开发基于胆固醇标签的新型蛋白质药物跨膜转运系统。
IF 5.5 4区 生物学 Q1 BIOLOGY Pub Date : 2024-01-30 Epub Date: 2023-12-08 DOI: 10.5582/bst.2023.01285
Pengfei Zhao, Shuo Song, Zhuojun He, Guiqin Dai, Deliang Liu, Jiayin Shen, Tetsuya Asakawa, Mingbin Zheng, Hongzhou Lu

The main technological difficulties of developing an intracellular (transmembrane) transport system for protein drugs lie in two points: i) overcoming the barriers in the cellular membrane, and ii) loading enough protein drugs, and particularly high-dose proteins, into particles. To address these two technological problems, we recently developed a novel cholesterol tag (C-Tag)-based transmembrane transport system. This pilot study found that the C-Tag dramatically improved the cellular uptake of Fab (902-fold, vs. Fab alone) into living cells, indicating that it successfully achieved transmembrane transport. Moreover, C-Tag-mediated membrane transport was verified using micron-scale large unilamellar vesicles (LUVs, approximately 1.5 μm)-based particles. The C-Tagged Fab was able to permeate the liposomal bilayer and it greatly enhanced (a 10.1-fold increase vs. Fab alone) internalization of proteins into the LUV-based particles, indicating that the C-Tag loaded enough proteins into particles for use of high-dose proteins. Accordingly, we established a novel C-Tag-based transport system that has overcome the known technological difficulties of protein transmembrane delivery, and this might be a useful technology for drug development in the future.

开发蛋白质药物细胞内(跨膜)转运系统的主要技术难点在于两点:一是克服细胞膜的障碍,二是将足够的蛋白质药物,尤其是高剂量蛋白质装入颗粒中。为了解决这两个技术难题,我们最近开发了一种基于胆固醇标签(C-Tag)的新型跨膜转运系统。这项试验性研究发现,C-Tag 显著提高了活细胞对 Fab 的吸收率(与单独的 Fab 相比提高了 902 倍),表明它成功实现了跨膜转运。此外,C-Tag 介导的膜转运还通过使用微米级的大型单胺囊泡(LUVs,约 1.5 μm)颗粒得到了验证。C-Tagged Fab 能够渗透脂质体双分子层,并大大增强了蛋白质在基于 LUV 的颗粒中的内化(与单独使用 Fab 相比增加了 10.1 倍),这表明 C-Tag 能够将足够的蛋白质装入颗粒中,以用于高剂量蛋白质。因此,我们建立了一种新型的基于 C-Tag 的转运系统,克服了已知的蛋白质跨膜转运的技术难题,这可能是未来药物开发的一项有用技术。
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引用次数: 0
Risk factors for postoperative recurrence of pT2-3N0M0 esophageal squamous cell carcinoma and patterns of its recurrence. pT2-3N0M0 食管鳞癌术后复发的风险因素及其复发模式。
IF 5.5 4区 生物学 Q1 BIOLOGY Pub Date : 2024-01-30 Epub Date: 2023-12-20 DOI: 10.5582/bst.2023.01294
Li Niu, Bo Hu, Li Zhang, Mei Kang

This study aimed to explore the patterns of postoperative recurrence in patients with pT2-3N0M0 esophageal squamous cell carcinoma (ESCC) and to identify the risk factors for the recurrence. Patients with pT2-3N0M0 ESCC who were treated at our hospital from January 2010 to August 2019 were divided into three categories: those with anastomotic recurrence, those with lymph node recurrence, and those with hematogenous metastasis. The sites of initial recurrence and metastasis were counted and potential risk factors were analyzed using univariate and multivariate Cox proportional hazard regression. Four hundred and eighty-five patients with pT2-3N0M0 ESCC were ultimately included, 176 (36.29%) of whom experienced tumor recurrence or metastasis. Cox multivariate analysis revealed that the postoperative T-stage, procedure, tumor location, and degree of differentiation were independent risk factors for postoperative recurrence (P < 0.05). The median time of recurrence was 38 months, and the most common site of recurrence was the lymph nodes in 126 patients (71.59%), followed by hematogenous metastasis in 73 patients (41.47%), and anastomotic recurrence in 21 patients (11.93%). 119 patients (67.61%) experienced recurrence within 36 months, with a probability of recurrence of 84.09% within 5 years, and recurrence remained relatively unchanged after 5 years. The proportion of postoperative lymph node recurrence and hematogenous metastasis in patients with pT3N0M0 ESCC was significantly higher than that in patients with pT2N0M0 ESCC (P < 0.05). At higher tumor locations in the body, the proportion of lymph node recurrence increased (P < 0.05). In conclusion, postoperative T-stage, procedure, tumor location, and degree of differentiation were independent risk factors for postoperative recurrence in pT2-3N0M0 ESCC, with regional lymph node recurrence being the most common pattern, emphasizing the importance of regional lymph nodes in this context.

本研究旨在探讨pT2-3N0M0食管鳞状细胞癌(ESCC)患者术后复发的模式,并确定复发的风险因素。将2010年1月至2019年8月在我院接受治疗的pT2-3N0M0 ESCC患者分为三类:吻合口复发者、淋巴结复发者和血行转移者。统计了初次复发和转移的部位,并采用单变量和多变量考克斯比例危险回归分析了潜在的风险因素。最终纳入了485名pT2-3N0M0 ESCC患者,其中176人(36.29%)出现肿瘤复发或转移。Cox多变量分析显示,术后T分期、手术方式、肿瘤位置和分化程度是术后复发的独立危险因素(P<0.05)。中位复发时间为 38 个月,126 例患者(71.59%)最常见的复发部位是淋巴结,其次是 73 例患者(41.47%)的血行转移和 21 例患者(11.93%)的吻合口复发。119 名患者(67.61%)在 36 个月内复发,5 年内复发的概率为 84.09%,5 年后复发率相对不变。pT3N0M0 ESCC患者术后淋巴结复发和血行转移的比例明显高于pT2N0M0 ESCC患者(P<0.05)。体内肿瘤位置越高,淋巴结复发的比例越高(P < 0.05)。总之,术后T分期、手术方式、肿瘤位置和分化程度是pT2-3N0M0 ESCC术后复发的独立危险因素,其中区域淋巴结复发是最常见的模式,强调了区域淋巴结在这方面的重要性。
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引用次数: 0
Immunity debt: Hospitals need to be prepared in advance for multiple respiratory diseases that tend to co-occur. 免疫债务:医院需要提前做好应对多种呼吸道疾病并发的准备。
IF 5.5 4区 生物学 Q1 BIOLOGY Pub Date : 2024-01-30 Epub Date: 2023-12-08 DOI: 10.5582/bst.2023.01303
Ting Li, Cordia Chu, Biying Wei, Hongzhou Lu

As SARS-CoV-2 transitions from a pandemic to an endemic presence, a significant rise in respiratory diseases such as influenza and Mycoplasma pneumonia is challenging healthcare systems weakened by the impact of COVID-19. This commentary examines the global resurgence of respiratory pathogens, heightened by the post-pandemic "immunity debt", through an analysis of WHO surveillance data and national health reports. Findings reveal a substantial increase in respiratory illnesses, notably among children, compounded by a shortage of pediatricians and growing antimicrobial resistance. This underscores the need to improve hospital preparedness, optimize clinical responses, and enhance public health strategies to effectively navigate the impending peak of concurrent respiratory infections.

随着 SARS-CoV-2 从大流行转变为地方性流行,流感和支原体肺炎等呼吸道疾病的显著增加正在挑战因 COVID-19 的影响而变得脆弱的医疗保健系统。这篇评论通过分析世界卫生组织的监测数据和各国的卫生报告,探讨了大流行后 "免疫债务 "加剧的全球呼吸道病原体重新抬头的问题。研究结果表明,呼吸道疾病大幅增加,尤其是儿童呼吸道疾病,而儿科医生短缺和抗菌药耐药性不断增加又加剧了这一问题。这突出表明,有必要改进医院的准备工作,优化临床应对措施,并加强公共卫生战略,以有效地应对即将到来的并发呼吸道感染高峰期。
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引用次数: 0
Feasibility of novel intraoperative navigation for anatomical liver resection using real-time virtual sonography combined with indocyanine green fluorescent imaging technology. 利用实时虚拟声像图结合吲哚青绿荧光成像技术,为解剖性肝脏切除术提供新型术中导航的可行性。
IF 5.5 4区 生物学 Q1 BIOLOGY Pub Date : 2024-01-30 Epub Date: 2023-12-13 DOI: 10.5582/bst.2023.01265
Changsheng Pu, Tiantian Wu, Qiang Wang, Yinmo Yang, Keming Zhang

To analyze the feasibility and clinical effect of novel intraoperative navigation of real-time virtual sonography (RVS) combined with indocyanine green (ICG) fluorescent imaging technology in anatomical liver resection (ALR) for hepatocellular carcinoma. The clinical data of 41 patients who underwent ALR using RVS intraoperative navigation combined with ICG fluorescent imaging technology in the Department of Hepatobiliary Surgery of Peking University International Hospital from January 2020 to May 2022 were retrospectively analyzed. RVS was applied to guide the surgical plane through fusing real-time intraoperative ultrasound images with corresponding preoperative CT or MRI images. Operation methods, operation time, intraoperative blood loss, operative margin, hospital stay and postoperative complications were analyzed. The 1-year overall survival rate and tumor-free survival rate of patients were followed up by outpatient review or telephone calls. ALR surgery was performed on each of 41 patients. There were no deaths during perioperative period and postoperative complications occurred in 7 cases (17.1%). The postoperative pathological examinations demonstrated all cases of hepatocellular carcinoma and negative operative margins. The 41 patients were followed up for 12 to 20 months, with a median follow-up time of 14 months. The overall survival rate 1 year after surgery was 100.0% (41/41), 3 patients (7.3%) experienced tumor recurrence, and the tumor-free survival rate of 1 year after surgery was 92.7% (38/41). In conclusion, novel intraoperative navigation of RVS combined with ICG fluorescent imaging technology is safe and feasible in anatomical segmental hepatectomy of hepatocellular carcinoma.

目的 分析实时虚拟声像图(RVS)结合吲哚青绿(ICG)荧光成像技术的新型术中导航在肝细胞癌解剖性肝脏切除术(ALR)中的可行性和临床效果。回顾性分析了2020年1月至2022年5月在北京大学国际医院肝胆外科使用RVS术中导航结合ICG荧光成像技术进行ALR的41例患者的临床数据。通过融合术中实时超声图像和相应的术前 CT 或 MRI 图像,应用 RVS 引导手术平面。分析了手术方法、手术时间、术中失血量、手术切缘、住院时间和术后并发症。通过门诊复查或电话随访患者的 1 年总生存率和无瘤生存率。41名患者均接受了ALR手术。围手术期无死亡病例,术后并发症有7例(17.1%)。术后病理检查显示所有病例均为肝细胞癌,手术切缘阴性。41 名患者接受了 12 至 20 个月的随访,中位随访时间为 14 个月。术后 1 年的总生存率为 100.0%(41/41),3 名患者(7.3%)出现肿瘤复发,术后 1 年的无瘤生存率为 92.7%(38/41)。总之,结合ICG荧光成像技术的新型RVS术中导航在肝细胞癌的解剖分段肝切除术中是安全可行的。
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引用次数: 0
The immune response of hepatocellular carcinoma after locoregional and systemic therapies: The available combination option for immunotherapy. 肝细胞癌局部和全身治疗后的免疫反应:免疫治疗的可用组合选择。
IF 5.5 4区 生物学 Q1 BIOLOGY Pub Date : 2024-01-30 Epub Date: 2023-11-19 DOI: 10.5582/bst.2023.01275
Yuxin Duan, Hua Zhang, Tao Tan, Wentao Ye, Kunli Yin, Yanxi Yu, Meiqing Kang, Jian Yang, Rui Liao

Hepatocellular carcinoma (HCC) is associated with a highly heterogeneous immune environment that produces an immune response to various locoregional treatments (LRTs), which in turn affects the effectiveness of immunotherapy. Although LRTs still dominate HCC therapies, 50-60% of patients will ultimately be treated with systemic therapies and might receive those treatments for the rest of their life. TACE, SIRT, and thermal ablation can dramatically increase the immunosuppressive state of HCC, a condition that can be addressed by combination with immunotherapy to restore the activity of lymphocytes and the secretion of cellular immune factors. Immune treatment with locoregional and systemic treatments has dramatically changed the management of HCC. In this review, we examine the research on the changes in the immune microenvironment after locoregional or systemic treatment. We also summarize the regulation of various immune cells and immune factors in the tumor microenvironment and discuss the different infiltration degrees of immune cells and factors on the prognosis of HCC to better compare the efficacy between different treatment methods from the perspective of the tumor microenvironment. This information can be used to help develop treatment options for the upcoming new era of HCC treatment in the future.

肝细胞癌(HCC)与高度异质的免疫环境有关,该免疫环境对各种局部治疗(LRTs)产生免疫反应,进而影响免疫治疗的有效性。尽管lrt仍是HCC治疗的主流,但50-60%的患者最终将接受全身治疗,并可能终生接受这些治疗。TACE、SIRT和热消融可显著增加HCC的免疫抑制状态,这种情况可以通过联合免疫治疗来恢复淋巴细胞的活性和细胞免疫因子的分泌。局部和全身的免疫治疗极大地改变了肝癌的治疗。本文综述了局部或全身治疗后免疫微环境变化的研究进展。我们还总结了各种免疫细胞和免疫因子在肿瘤微环境中的调节作用,探讨了免疫细胞和免疫因子浸润程度的不同对HCC预后的影响,以便从肿瘤微环境的角度更好地比较不同治疗方法的疗效。这些信息可用于帮助制定未来HCC治疗新时代的治疗方案。
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