The effect of transcatheter arterial chemoembolization on CYP1A2 activity in patients with hepatocellular carcinoma
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Aim: CYP1A2, a constitutive enzyme expressed in the liver, is among the phase I enzymes responsible for polycyclic aromatic hydrocarbons metabolism. Phenacetin O-de-ethylation is a marker for CYP1A2 activity. This study investiagtes the metabolism of phenacetin in patients with hepatocellular carcinoma (HCC). Methods: The phenacetin test was performed in 56 normal subjects and 92 HCC patients. The test was repeated in HCC patients after treatment with transcatheter arterial chemoembolization (TACE). The recovery of phenacetin's urinary metabolites was studies in 12 normal subjects and 14 patients with HCC. Results: Compared with normal controls, the recovery of phenacetin O-de-ethylated metabolites decreased by 42·5% (P < 0·01) in patients with HCC and diminished further after TACE (P < 0·05). The ratio of plasma total paracetamol to phenacetin was much lower than in normal controls (P < 0·01) and was reduced by 40·7% more after TACE (P < 0·05). Conclusions: The metabolism of phenacetin is impaired in patient with HCC. TACE damages the activity of CYP1A2. The phenacetin test can be used to predict effect of TACE on liver function in HCC patients.Keywords:
Transcatheter arterial chemoembolization
To compare the efficacy and safety of transcatheter arterial chemoembolization (TACE) combined with sorafenib and camrelizumab or with sorafenib alone in patients with intermediate or advanced hepatocellular carcinoma (HCC).
Transcatheter arterial chemoembolization
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Introduction: Early detection and diagnosis of hepatocellular carcinoma is important because number, size and type of malignant lesions strongly influence patients' management. Aim of our study was to evaluate the sono-hepatic-arteriography (Sono-HA) in the detection of focal liver lesions in patients with hepatocellular carcinoma undergoing TACE and to assess the embolization result.
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Foreword. Preface. 1. The background to hepatocellular carcinoma and the liver. 2. Premalignant lesions of hepatocellular carcinoma. 3. Pathomorphologic characteristics of early-stage small hepatocellular carcinoma. 4. Morphologic evolution of hepatocellular carcinoma: from early to advanced. 5. Angioarchitecture of hepatocellular carcinoma. 6. Advanced hepatocellular carcinoma. 7. Multicentric occurrence of hepatocellular carcinoma. 8. Combined hepatocellular carcinoma and cholangiocarcinoma. 9. Nodular lesions mimicking hepatocellular carcinoma. 10. Biopsy diagnosis of tumorous lesions of the liver. 11. Chemoprevention of hepatocellular carcinoma. Index
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Hepatocellular carcinoma is the most common malignancy among males and the 7th among female patients in the Kingdom of Saudi Arabia. This is due to the endemicity of hepatitis B and hepatitis C. Spontaneous rupture of hepatocellular carcinoma is rare. We report 4 cases of spontaneous rupture of hepatocellular carcinoma. Initial control of bleeding was achieved surgically in 3 patients and by embolization in the 4th patient. All patients had very good hepatic reserve as reflected by Child-Pugh scoring (A & B). We found that the incidence of ruptured hepatocellular carcinoma among 85 patients was 4.7%. The prognosis of this subgroup of patients is poor as reflected by the low median survival ranging from 6-16 weeks.
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Hepatitis B
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The problem and approaches to the treatment of hepatocellular carcinoma as seen in Japan are reported. Current Japanese methods for the detection of hepatocellular carcinoma and the methods used to treat hepatocellular carcinoma are described. Included in the latter discussion is a description of the untoward effects of each treatment. Finally an alogorithm for the treatment of hepatocellular carcinoma is presented based upon the Japanese experience.
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AIM To investigate the mechanism involved in the induction effort of diphenytriazol on rat hepatic cytochrome P-450 CYP1A1/2 enzymes. METHODS Sprague-Dawley rats were pretreated intraperitoneally with the same daily dose of diphenytriazol for different days. The mRNA level of cytochrome P-450 CYP1A1/CYP1A2 in diphenytriazol pretreated rats liver was evaluated by RT-PCR. RESULTS Both of the expression levels of cytochrome P-450 CYP1A1 and CYP1A2 mRNA were significantly improved. For cytochrome P-450 CYP1A1 mRNA, the control group was 0.270±0.040, and diphenytriazol treated for 1, 2 and 4 d groups were 0.343±0.055, 0.417±0.045 and 0.603±0.083, respectively; for CYP1A2 mRNA, the control group was 0.613±0.189, and diphenytriazol treated for 1, 2 and 4 d groups were 1.510±0.226, 3.057±0.518 and 4.120±0.458, respectively. The correlation coefficient between the expression level of target mRNA and the treatment time were 0.9984 and 0.9563, respectively. CONCLUSION Diphenytriazol has inductive effect on expressions of rat hepatic cytochrome P-450 CYP1A1/2.
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The aim of this study was to determine the characteristics of hepatocellular carcinoma at a major health center in southern Turkey. Computed tomography was compared to the combination of ultrasonography and serum alpha-fetoprotein determination in the diagnosis of hepatocellular carcinoma.Of 226 patients with liver cirrhosis, 35 were diagnosed with hepatocellular carcinoma on first admission or during follow-up in the period between 1999 and 2002. The features investigated were, age at time of hepatocellular carcinoma diagnosis, etiology of cirrhosis, severity of cirrhosis at presentation, tumor pattern, stage of hepatocellular carcinoma, serum alpha-fetoprotein level, and dynamic computed tomography findings. Results were compared to previous findings in Turkey and elsewhere.In the hepatocellular carcinoma patients, the male:female ratio was 4:1 and the mean age at presentation was 61 years. Chronic hepatitis B virus infection (65.7%) and chronic hepatitis C virus infection (28.6%) were the most frequently identified risk factors for hepatocellular carcinoma. Forty percent of the patients had Child-Pugh A cirrhosis when they were diagnosed with hepatocellular carcinoma. Sixty-seven percent of patients had fewer than three hepatocellular carcinoma nodules in the liver at the time of diagnosis. Only three of the hepatocellular carcinoma cases were Okuda stage I. The combination of ultrasonography and serum alpha-fetoprotein >20 ng/ml identified hepatocellular carcinoma in 32 of the 35 total cases.The results indicate that hepatitis B virus infection in patients with cirrhosis is still the leading risk factor for the development of hepatocellular carcinoma. Also, early-stage hepatocellular carcinoma is rarely diagnosed in cirrhosis patients from this region of Turkey. Surveillance with computed tomography for early diagnosis of hepatocellular carcinoma seems not to be mandatory.
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Hepatitis C
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Background: Serum level of insulin-like growth factor-Ⅱ (IGF-Ⅱ) is associated with the prognosis of primary hepatocellular carcinoma. Thus, serum IGF-Ⅱ measurement is helpful for the evaluation of therapeutic efficacy in primary hepatocellular carcinoma. Aims: To investigate the effect of transcatheter arterial chemoembolization (TACE) on serum IGF-Ⅱ level in patients with primary hepatocellular carcinoma, and the clinical significance of serum IGF-Ⅱ measurement. Methods: 33 patients with primary hepatocellular carcinoma received TACE therapy and 48 healthy subjects served as controls in this study. The serum levels of IGF-Ⅱ were measured by radioimmunoassay in all patients and controls. Results: The serum level of IGF-Ⅱ in patients with primary hepatocellular carcinoma before and after TACE treatment were all significantly higher than that in normal controls (P0.001). After three times TACE treatment, the serum IGF-Ⅱ level decreased markedly than that before treatment (P0.05). During the treatment period, the serum IGF-Ⅱ level decreased gradually in patients who survived and increased in those who died. Conclusions: Serum level of IGF-Ⅱ that may reduce after TACE therapy in patients with primary hepatocellular carcinoma, is a marker for the prognosis and therapeutic efficacy evaluation of TACE in patients with primary hepatocellular carcinoma.
Transcatheter arterial chemoembolization
Clinical Significance
Therapeutic effect
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Objective To evaluate serum AFP levels and their influence factors in patients with hepatocellular carcinoma.Methods From January 1995 to December 1999,140 patients were subjected to hepatectomy in our hospital,AFP levels of the patients were evaluated.The data of the patients were analyzed by nonconditional logistic regression with SPSS10.0.Results The positive rate of AFP was 62.9% in patients with hepatocellular carcinoma.The positive rate of AFP of small hepatocellular carcinoma(52.0%) was significantly higher than that of large hepatocellular carcinoma (73.9%) ( P 0.05).It was showed that the AFP levels were related to tumor size and cirrhosis through logistic regression( P 0.05).Conclusion Sensitivity of AFP in hepatocellular carcinoma diagnosis,especially in small hepatocellular cancer was lower.It was notably increased when combined with other diagnostic methods.
Alpha-fetoprotein
Liver Cancer
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