Hepatocarcinoma and postoperative diagnosis _'s symptom that recurs

Hepatocarcinoma and postoperative diagnosis _'s symptom that recurs
It influences one of patient's curative effect of hepatocarcinoma and key obtained, survived for a long time that the recurring of hepatocarcinoma is shifted, already become at present, also the focus that hepatocarcinoma at present studies. How to predict the emergence of the metastasis of cancer of liver before shifting in tumour and when the clinical little transformation cooking stove just sprouted, can make early diagnosis. In recent years, domestic and foreign to act as, study more, sketch it as follows to this.
First, rate and influence factor of recuring
There are materials that indicate, the recuring rate is 61.5% in 5 after hepatocarcinoma is excised, small hepatocarcinoma is 43.5%. Have expert analysis AFP positive in front of the 308 skill, hepatocarcinoma excise postoperative AFP drop normal case (belong to comparatively reliable excision of effecting a radical cure etc. to, the recuring rate is 9.2% - 85.0% respectively in 10. It shows to compare and recur and recur a group of materials: General survey is found, - valley ammonia acyl is transferred to peptide enzyme ( - GPT) Value less than or equal to 5 cm, portal vein, have the intersection of cancer and bolt, complement until immunization therapy 6 index low main factor of recuring etc. while being postoperative than low, the intersection of TNM and by stages early, the intersection of tumour and body.
The second, inferior and clinical one that recur and shift makes a diagnosis and gives treatment
It is basically similar that hepatocarcinoma excises the postoperative inferior clinical discovery route that recurs to shift and treats principle and inferior clinical hepatocarcinoma. It is extremely important to follow up a case by regular visits to postoperative fixedly and for a long time. Usually reexamine once every 2- 3 months in 2 years after the operation, reexamine once every 3- 6 months later, reexamine, include AFP mainly, Ultrasonography B, the intersection of X-ray and the intersection of chest and slice, make CT if necessary, MRI,etc.. It is the main therapeutic method to and then perform the operation. Study hepatocarcinoma and recur and excise again (202) The survival rate of the next 5 years is 35.4%, survival rate is 56.0% in 5 such as calculating from postoperative the first time. The isolatism lung shifts the cancer operation to excise (8) And then survive for 5 months of 10 (from 8 months to 6 months of 19) on average ,If survived for 2 months of 13 (one year and 4 months until 9 months of 23) on average from the moment that the first hepatocarcinoma is calculated after excising . In that it is 23 years and 9 months, 23 years that 3 example persons who shifts lung still survive respectively so far. So, recur and shift cancer and excise and play an important role in further improving the curative effect of hepatocarcinoma again.
Third, shift animal's model and cell one
Study hepatocarcinoma and recur and shift, there should be model and cell one of animal's metastasis of cancer of people's liver at first. The efforts for many years that I have passed, have set up the model of naked mouse's metastasis of cancer of people's liver at first at home and abroad and already spread more than 70 generations, still keep shifting the characteristic. Set up the high transformation latent energy cell one of people's hepatocarcinoma at first at the same time, has already spread more than 70 generations, have offered the valuable model for studying the metastasis of cancer of liver.
Fourth, predict the index
If can find a more sensitive mark, can predict before recuring and shifting in tumour that shift the emergence recuring, have great significance in the clinical practice. In recent years, there are experts from pathologic level, cell level and molecule level, study, look for marks in and excises the sample in serumming. Find tentatively, some cancer genes, growth factor, other factors and hepatocarcinoma are the positive correlation: p16(CDKN2) Sudden change, p53, p21, H-ras, c-erbB-2, mdm2, transform growth factor (TGF) Growth factor of ,'s epidermis (EGF) Skin growth factor (VEGF) in receptor, blood vessel And the receptor (KDR) MRNA, fine to dissolve zymogen activator inhibitor (PAI-1) , the thrombus regulates albumens(thrombomodulin) When; Some are presented and shouldered relevantly: Nm23-HI gene, Kai-1 gene, TIMP-2,etc.. Ground substance and hepatocarcinoma are the positive correlation outside some cells: Ground substance metal protease (MMP-2) , cells adhere to molecule - a (ICAM-1) ; But some are presented and shouldered relevantly: Calcium mucoprotein of cover (E-cadherin) as above , combine plain 5 (integrin 5) . The expert uses model of naked mouse's metastasis of cancer of people's liver as the material for the first time in the world, observe and adhere to molecule - 1 and growth of the hepatocarcinoma, transfer to later period, develop the dynamic change of process entirely among serum cells, find that adheres to molecule - 1 to maintain at lower level all the time before the metastasis of cancer of liver took place among cells, entered more than two times high suddenly after shifting and happening, and would maintain at higher level afterwards, thus can reflect more sensitively hepatocarcinoma shifts the mark thing that happens in early days to adhere to molecule - 1 to brief on cells. The above-mentioned result has offered the experiment basis for the fact that hepatocarcinoma of clinical research attacked the prediction index shifted.
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