Abstract:Primary hepatic carcinoma refers mainly to hepatocellular carcinoma and intrahepatic cholangiocarcinoma which always lacks standardized diagnostic criteria and system. “Guidelines for the diagnosis of primary hepatocellular carcinoma (2015)” gives the pathologists and clinicians guiding suggestions and advice for the pathologic diagnosis of hepatocellular carcinoma from the respects of gross specimen examination, evaluation of chronic liver disease, small hepatocellular carcinoma, satellite nodules as well as immunohistochemistry which are of deep clinical concern.

Abstract:热销融作为肿瘤的治疗方法之一已经广泛应用于肝癌等领域。然而国内外对于其在甲状腺结节的临床应用中仍然有很大的分歧。韩国放射协会和意大利专家分别在2012年和2015年发表了甲状腺结节的热消融治疗共识。而目前国内甲状腺的热消融处于起步阶段，发展极为迅猛，但在繁荣的背后乱象丛生，缺乏严格的指证把握。为严格规范热销融技术在甲状腺肿瘤中的应用，浙江省抗癌协会甲状腺肿瘤专业委员会多次组织相关专业的专家进行研讨，几经易稿，初步达成共识，制定了“甲状腺良性结节，微小癌及颈部转移性淋巴结热销融治疗浙江省专家共识（2015版）”。再次强调本共识的目的是严格规范，加强管理。请全国专家给予指导及宝贵的意见。

Abstract:Intrahepatic cholangiocarcinoma (ICC) is the second most common primary liver cancer. Resection remains the only hope of cure in patients with ICC. Lymph node metastasis is an important prognostic risk factor for patients with ICC. The role of routine lymphadenectomy during hepatic resection for ICC still represents an issue of debate. This article discusses the controversies about lymphadenectomy for ICC.

Abstract:Objective: To investigate the guiding significance of the criteria of TNM classification (6th edition) developed by American Joint Committee on Cancer (AJCC) in estimating prognosis of primary liver cancer (PLC). Methods: A total of 2 456 PLC patients undergoing liver resection recorded in the seer database between 2004 and 2010 were included in this study. Of the patients, 2 270 cases (92.4%) had hepatocellular carcinoma (HCC), 145 cases (5.9%) had intrahepatic cholangiocarcinoma (ICC), and 41 cases (1.7%) had combined HCC and ICC (cHCC-ICC). The overall survivals (OS) of the patients with different types of PLC were analyzed and compared, and the relations of TNM classification with the prognosis of the patients were also analyzed. Results: The 1-, 3-, and 5-year OS was 83.0%, 58.1% and 46.6% in HCC patients, 80.0%, 45.5% and 26.2% in ICC patients and 63.4%, 29.3% and 29.3% in cHCC-ICC patients respectively, and the OS in the former was significantly better than those in the latter two groups (P=0.049, 0.004), but showed no statistical difference between the latter two groups (P>0.05). For HCC or ICC, the OS in patients with TNM stage I was significantly better than those in patients with other TNM stages (all P<0.05), but no statistical difference was noted among patients in different stage III stratifications (IIIA, IIIB, IIIC) (both P>0.05); for cHCC-CC patients, the OS had no statistical difference among patients of all TNM stages (P>0.05). The presence of lymph node metastasis (N1) in PLC was rare (3.9%), and OS showed no statistical difference among HCC, ICC and cHCC-CC patients with N0 disease (P>0.05). Conclusion: There are some limitations in TNM staging system for estimation of prognosis of PLC, so some new pathological indicators should be incorporated into the system so as to satisfy clinical needs.

Abstract:Objective: To compare the clinical efficacy of anterior approach and conventional approach in right hemihepatectomy for hepatocellular carcinoma. Methods: Literature on studies comparing anterior approach and conventional approach for right hemihepatectomy in treatment of hepatocellular carcinoma was obtained through computerized and manual searches. The quality of the included studies was assessed, according to the Cochrane guidelines, and after data extraction, the Meta-analysis was performed by RevMan 5.3 software. Results: Nine studies were finally included, involving 1 344 patients, of whom 619 cases received anterior approach operation and 725 cases underwent conventional approach operation. The results of Meta-analysis showed that patients undergoing anterior approach operation were superior to those undergoing conventional approach operation in 1, 3-year overall survival (OR=1.85, 95% CI=1.25–2.71, P=0.002; OR=3.11, 95% CI=2.16–4.46, P<0.00001) and disease free survival (OR=2.27, 95% CI=1.60–3.22, P<0.00001; OR=3.13, 95% CI=2.11–4.64, P<0.00001) as well as perioperative mortality (OR=0.33, 95% CI=0.15–0.70, P=0.004); there was no statistical difference in operative time, intraoperative blood loss, incidence of postoperative complications and length of hospital stay between patients undergoing anterior approach operation and conventional approach operation (all P>0.05). Conclusion: Anterior approach right hemihepatectomy is safe and better in meeting the tumor-free principle than conventional approach, and it can also improve the overall survival rate, disease-free survival rate and reduce perioperative mortality.

Abstract:Objective: To investigate the feasibility and safety of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in treatment of massive hepatocellular carcinoma with cirrhosis. Methods: The clinical data of two patients with massive right lobe primary hepatocellular carcinoma and concomitant cirrhosis undergoing ALPPS in Affiliated Zhongda Hospital of Southeast University in August 2014 and January 2015 respectively were retrospectively analyzed. The treatment efficacy was assessed by using perioperative variables and follow-up data. Results: Both patients underwent first-stage surgical procedures of right portal vein ligation and in situ partitioning of the liver parenchyma. The remnant liver volume was rapidly increased in both of them after the first-stage operation, which in case 1 increased to 704.8 mL (accounted for 60.3% of the standard liver volume) at postoperative day (POD) 6, and in case 2 increased to 771.3 mL (accounted for 63.6% of the standard liver volume) at POD 11. Both patients then underwent second-stage extended right hemihepatectomy. The operative time for the first-stage procedure was 240 min and 210 min respectively, with intraoperative blood loss of 600 mL in each case; the operative time for the second-stage procedures was 300 min and 325 min, with intraoperative blood losses of 1 000 mL and 800 mL, respectively. No perioperative death or serious postoperative complications occurred in either patient, and both patients were alive and no new intra- or extra-hepatic recurrence was observed in either of them during 6-month follow-up period. Conclusion: ALPPS is safe and feasible for massive liver cancer with cirrhosis.

Abstract:Objective: To investigate the causal factors and clinical features of biloma in hepatocellular carcinoma (HCC) patients following interventional procedures. Methods: The clinical data of 500 HCC patients undergoing transcatheter arterial chemoembolisation (TACE) from January 2013 to January 2015 were reviewed. The risk factors for occurrence of postoperative biloma and its clinical features were analyzed. Results: Biloma occurred in 45 (9.0%) of the 500 patients after operation. Results of statistical analysis identified that presence of bile duct dilatation, history of liver resection before TACE, non-superselective intubation and use of polyvinyl alcohol (PVA) particles were risk factors for biloma (all P<0.05). Of the 45 patients with biloma, 10 cases had clinical symptoms that mainly included jaundice and fever, the average diameter of the biloma was significantly larger than that in asymptomatic patients (8.12 mm vs. 21.84 mm, P<0.05), and the biloma was reduced in 8 cases and disappeared in 2 after aspiration drainage; 35 asymptomatic patients received regular review with imaging examinations. Conclusion: For HCC patients with risk factors, preoperative assessment and preventive measures should be taken. Aspiration drainage should be performed in symptomatic biloma patients, and regular review and imaging examinations should be conducted in asymptomatic biloma patients, so as to give timely aspiration drainage for those with enlargement of biloma, which also can offer favorable results.

Abstract:Objective: To investigate the relationship between the distance of lesions of liver cancer from the liver capsule or subsegmental portal vein branches and intraoperative pain during CT-guided microwave ablation (MWA) under local anesthesia. Methods: Seventy-eight patients with liver cancer undergoing MWA treatment following successful hepatic arterial chemoembolization were selected. According to the primary location of the lesions, they were divided into proximal group (distance between lesions and the liver capsule or subsegmental portal vein branches less than or equal to 5 cm, 32 cases and 37 lesions), and distal group (distance between lesions and the liver capsule or subsegmental portal vein branches more than 5 cm, 46 cases and 54 lesions). The differences of treatment efficacy, degree of intra-procedural pain and other variables between the two groups were compared. Results: The difference in complete tumor ablation rate between proximal group and distal group had no statistical significance (75.86% vs. 81.48%, P>0.05). The AFP levels in both groups were significantly reduced compared with preoperative values (both P<0.05), but no significant inter-group difference was noted (P>0.05). Stratified comparison according to tumor size (≤2 cm and >2 cm) showed that there was no significant difference in VAS score, maximum tolerable dose, and ablation time between the two groups (all P>0.05), but the intraoperative VAS score, relative VAS value and dose of pethidine requirement in proximal group were significantly higher than those in distal group (all P<0.05); the intraoperative VAS score, ablation time and dose of pethidine requirement of patients with tumor size >2 cm in either proximal group or distal group were significantly higher than those of patients with tumor size ≤2 cm (all P<0.05). Conclusion: Pain perception is increased during MWA treatment in liver cancer patients with distance between lesion and the liver capsule or subsegmental portal vein branches ≤5 cm and is especially more obvious in those with tumor diameter larger than 2 cm.

Abstract:Objective: To analyze the features of intratumoral microvessels (MV) in hepatocellular carcinoma with hemorrhagic/necrotic phenotype (HN-HCC). Methods: A total of 104 specimens of HCC were collected, which included 72 cases of HN-HCC and 32 cases of non-HN-HCC (NHN-HCC). Each HCC specimen was divided into 3 regions designated as the central region of the tumor, intermediate region between the core and margin of the tumor and marginal region of the tumor. The differences in morphological profiles of the intratumoral MV and mRNA expressions of angiogenesis-associated genes that included the BTB/POZ domain-containing protein 7 (BTBD7), hypoxia-inducible factor 1α (HIF-1α) and angiopoietin 2 (Ang-2) between the parallel regions of the two types of HCC were compared. Results: The patterns of the intratumoral MV were classified as vessels that encapsulated tumor clusters (VETC), capillary vessels (CV) and combined VETC and CV (VETC+CV). Comparison between the parallel regions of the two types of HCC showed that in each parallel region of HN-HCC compared with NHN-HCC, the VETC positive rate was increased (65% vs. 29%, 76% vs. 9%, 70% vs.16%), while the CV positive rate was decreased (23% vs. 55%, 3% vs. 72%, 11% vs. 59%) and all differences had statistical significance (all P<0.05), but the VETC+CV positive rate had no difference (all P>0.05); the mRNA expressions of BTBD7, HIF-1α, and Ang-2 were all significantly up-regulated (all P<0.05). Conclusion: There is disorder of intratumoral MV architecture with aberrant expressions of angiogenesis-associated genes in HN-HCC, which may induce local hypoxia and ischemia as well as tumor invasion and metastasis.

Abstract:Objective: To investigate the microRNA-616(miR-616) expression in hepatocellular carcinoma (HCC) and its clinical significance. Methods: The miR-616 expressions in specimens of HCC and adjacent non-tumorous tissue from 80 HCC patients, as well as in normal hepatic cells and different HCC cell lines were determined by real-time PCR. The relations of miR-616 expression with pathologic factors and prognosis of HCC patients were analyzed and the changes in invasion and metastatic abilities in HCC cells after miR-616 overexpression or inhibition were observed. Results: The miR-616 expression in HCC tissue was significantly elevated compared with adjacent non-tumorous liver tissue, and further, in recurrent cases was significantly higher than that in non-recurrent cases and in cases with metastasis was significantly higher than that in cases without metastasis(all P<0.05). The miR-616 expressions were significantly increased in all HCC cell lines compared with normal hepatic cells, which in highly invasive HCC cells were significantly higher than those in lowly invasive HCC cells (all P<0.05). The miR-616 expression was significantly associated with the presence or absence of portal vein tumor thrombus, Edmondson-Steiner grade and TNM stage of HCC patients (all P<0.05), and both overall survival and disease-free survival in HCC patients with high miR-616 expression were significantly lower than those in patients with low miR-616 expression(both P<0.05). The invasive and metastatic abilities in HCC cells were significantly increased after miR-616 overexpression and were significantly reduced after miR-616 inhibition (all P<0.05). Conclusion: MiR-616 expression is increased in HCC, and the high miR-616 expression level is closely associated with poor prognosis.

Abstract:Objective: To investigate the association of Tspan8 expression with metastatic potential and prognosis in hepatocellular carcinoma (HCC). Methods: The mRNA and protein expressions in different HCC cell lines and surgical specimens of 80 HCC patients were determined by qRT-PCR and Western blot analysis, and Tspan8 expressions in tissue samples from another 352 HCC patients were detected by tissue microarray. The relations of Tspan8 expression with clinicopathologic factors as well as recurrence and prognosis in HCC patients were analyzed. Results: Both mRNA and protein expressions of Tspan8 were significantly higher in HCC cell lines with high metastatic potential (MHCC97-H, MHCC97-L) than those in HCC cell lines with low metastatic potential (PLC/PRF/5, SMMC7721, HepG2), significantly higher in HCC tissue than those in tumor-adjacent tissue or normal liver tissue, and significantly higher in HCC tissue from patients with intrahepatic metastases or vascular invasion than those in HCC tissue from patients without intrahepatic metastases and vascular invasion (all P<0.05). High Tspan8 expression was independent risk factor for postoperative recurrence (HR=1.64, 95% CI=1.21–2.23, P=0.002) and survival (HR=1.66, 95% CI=1.23–2.25, P=0.001), and in patients with high Tspan8 expression compared with those with low Tspan8 expression, the postoperative 5-year overall survival was signi?cantly decreased and time to tumor recurrence was significantly shortened (both P<0.05). Conclusion: Tspan8 can promote HCC metastasis and invasion, and patients with high Tspan8 may face a poor prognosis.

Abstract:Objective: To investigate the expression of carbohydrate response element binding protein (ChREBP) and its biological actions in hepatocellular carcinoma (HCC). Methods: The mRNA and protein expressions of ChREBP in 73 specimens of HCC along with its adjacent tissue, as well as different HCC cell lines and normal hepatic cell line were determined by q-PCR, immunohistochemical staining and Western blot analysis, respectively. The changes in cell cycle, apoptosis and proliferation in HCC cells were observed after the siRNA interference of ChREBP2 expression. Results: Both mRNA and protein expressions of ChREBP were significantly increased in HCC tissue compared with tumor-adjacent tissue, and significantly increased in all studied HCC cell lines compared with normal hepatic cell line (all P<0.05). After interference of ChREBP2 expression, HCC cells presented significant G1/S phase arrest and inhibition of proliferation (both P<0.05), but apoptosis showed no significant change (P>0.05). Conclusion: ChREBP expression is elevated in HCC, which may probably promote proliferation of HCC cells through cell cycle regulation, and thereby plays an important role in the progression of HCC.

Abstract:Objective: To investigate the relationship between inactivation of cancer suppressor gene and liver cancer stem cells (LCSC) in hepatocellular carcinoma (HCC) and the clinical significance. Methods: The protein expressions of cancer suppressor gene Merlin and LCSC surface marker in 116 specimens of HCC tissue were determined by immunohistochemical staining, and then the relations of their expressions with clinicopathologic factors and prognosis of HCC patients were analyzed. Results: According to the cut-off values of Merlin and Nanog expression levels calculated by X-tile software, in the 116 HCC patients, 92 cases (79.3%) had low Merlin expression and 24 cases (20.7%) had high Merlin expression; 36 cases (31.0%) had high Nanog expression and 80 cases (69.0%) had low Nanog expression. Univariate analysis showed that HCC tissues with poor differentiation, satellite lesions, venous invasion or hemorrhagic necrosis had low Merlin but high Nanog expression (all P<0.05). Multivariate analysis showed that low Merlin expression and high Nanog expression were independent predictors for postoperative survival and recurrence (both P<0.05). After the patients were divided into low risk group (high Merlin and low Nanog expression), medial risk group (high Merlin and high Nanog expression or low Merlin and low Nanog expression) and high risk group (low Merlin and high Nanog expression), the analysis demonstrated that both overall survival rate (low risk group>medial risk group>high risk group) and recurrence rate (low risk group

Abstract:Objective: To investigate the expression of cell division cycle 6 (CDC6) in hepatocellular carcinoma (HCC) and its clinical significance. Methods: The mRNA and protein expressions of CDC6 in 85 surgical specimens of HCC tissue and matched adjacent tissue were determined by qRT-PCR, Western blot analysis and immunohistochemical staining, respectively. The relations of CDC6 expression with clinicopathologic characteristics and prognosis of HCC patients were analyzed. Results: Both mRNA and protein expression levels of CDC6 were increased in HCC tissue compared with adjacent tissue, and quantitative analysis of qRT-PCR results showed that the difference had statistical significance (P<0.05). The CDC6 expression was significantly related to tumor size, clinical stage, degree of differentiation and satellite lesions (all P<0.05). Both tumor-free survival rate and overall survival rate in patients with high CDC6 expression were significantly lower than those in patients with low CDC6 expression (both P<0.05), and both univariate and multivariate analyses showed that CDC6 was an independently risk factor for tumor-free survival rate (HR=1.089, 95% CI=0.986–1.186, P=0.033) and overall survival rate (HR=2.441, 95% CI=1.128–3.652, P=0.012) in HCC patients. Conclusion: CDC6 is highly expressed in HCC tissue, and is closely related to malignant clinicopathologic features and poor prognosis. CDC6 may contribute to the occurrence and development of HCC, and may be used as an index for estimating tumor recurrence and outcomes.

Abstract:Objective: To investigate the expression and clinical value of neurotrophin receptor-interacting melanoma antigen-encoding protein (NRAGE) in small hepatocellular carcinoma (HCC) and its clinical significance. Methods: The NRAGE expressions in 160 specimens of small HCC tissue with paired adjacent non-tumorous tissue were determined by immunohistochemical staining. The relations of NRAGE expression with clinicopathological features and prognosis of small HCC patients were analyzed. Results: The positive expression rate of NRAGE in small HCC tissue was significantly higher than that in adjacent tissues (63.13% vs. 14.38%, P<0.05). NRAGE expression was significantly related to age, preoperative AFP level, complete capsule and recurrence (all P<0.05). Univariate prognostic analysis showed that microvascular invasion, AFP level, childhood lesions, complete capsule, recurrence, serosal invasion, Barcelona stage, degree of differentiation and NRAGE expression were factors affecting the prognosis of small HCC patients (all P<0.05), and multivariate prognostic analysis showed that NRAGE expression together with microvascular invasion, preoperative AFP level, recurrence, and Barcelona stage were independent risk factors for prognosis of small HCC patients (all P<0.05). In addition, the 5-year survival rate of patients with high NRAGE expression was significantly lower than those with low NRAGE expression (35.63% vs. 54.23%, P<0.05). Conclusion: NRAGE expression is up-regulated in small HCC tissue, and patients with high NRAGE expression may have an unfavorable prognosis.

Abstract:Objective: To study the influence of splenectomy on development of hepatic fibrosis through observation of the changes in mRNA expressions of TGF-β1 and α-SMA in liver tissue after splenectomy performed at different time periods in rats with hepatic fibrosis. Methods: Fifty male SD rats were randomly allocated into normal control group, liver fibrosis model group (model group) and liver fibrosis model with splenectomy group (splenectomy group). The liver fibrosis model was induced by intraperitoneal injection of 40% CCl4, and rats in splenectomy group underwent splenectomy at early stage (2 weeks), mid stage (4 weeks) and late stage (6 weeks) after model induction in batches, respectively. All rats were sacrificed at 8 weeks after model induction, the pathological changes in the liver tissues were evaluated by HE staining, and the mRNA expression levels of TGF-β1 and α-SMA in the liver tissues were determined by qRT-PCR method. Results: The structure of hepatic lobules was intact in normal control group, while in model group, it was destroyed with fibrous tissue hyperplasia and pseudo-lobule formation; pathological changes of hepatic fibrosis of different degrees were found in all splenectomy groups, which presented with increasing severity with the lag of time of splenectomy, but all were milder than that in model group. The results of qRT-PCR showed that compared with normal control group, the mRNA expression levels of both TGF-β1 and α-SMA in all other groups were significantly increased (all P<0.05), and the increasing degrees in both factors were presented as follows: model group > late-stage splenectomy group > mid-stage splenectomy group > early-stage splenectomy group (all P<0.05). Conclusion: Splenectomy can reduce the expression levels of TGF-β1 and α-SMA in liver tissue, which suggests that the spleen may be involved in the occurrence and developent of liver fibrosis.

Abstract:Objective: To compare the effects of internal and external biliary drainage on liver function and regeneration after hepatectomy in rats with biliary tract obstruction. Methods: SD rats were randomly divided into internal drainage group (ID group), external drainage group (ED group) and control group. Rats in both ID and ED group underwent common bile duct (CBD) ligation, and those in control group underwent sham operation. Rats in each group underwent partial (70%) hepatectomy at 72 h after CBD ligation, and those in ID and ED group had simultaneous internal and external biliary drainage, respectively. The serum samples and remnant liver tissue of the rats were harvested on day 0, 1, 2, 3 and 7 after liver resection, and the liver function parameters, and the number of mitotic cells and expression of proliferating cell nuclear antigen (PCNA) in liver tissues were determined, and the ratio of the remnant liver weight to body weight of the rats on day 7 after liver resection was also calculated. Results: Compared with control group, the serum levels of total bilirubin (TIBL) and aspartate aminotransferase (AST) were significantly increased, but albumin (ALB) level was significantly decreased in both ID and ED group at each time point after liver resection (all P<0.05), while the comparison between ID and ED group, with exception of the TIBL level which showed no significant change (all P>0.05), the other two parameters were better in ID group than those in ED group (all P<0.05). Compared with control group, at most of the time periods, the number of mitotic cells in liver tissues of both ID and ED group were significantly decreased (all P<0.05), which in ID group was higher than that in ED group and was significantly different on day 2 and 3 after liver resection (both P<0.05). Both the speed and amplitude of elevation of the increase of PCNA expression level in control group were greater than those in either ID or ED group (all P<0.05), but increase of amplitude and speed of decline of PCNA expression were greater in ID group than those in ED group (all P<0.05). The ratio of the remnant liver weight to body weight at day 7 after liver resection in either ID or ED group was reduced compared with control group (both P<0.05), but it was greater in ID group than that in ED group (P<0.05). Conclusion: After partial hepatectomy in rats with biliary tract obstruction, internal biliary drainage can improve post-hepatectomy liver function and promote regeneration of the residual liver.

Abstract:Objective: To systematically evaluate the risk factors for lymphatic metastasis of thyroid microcarcinoma (TMC), and provide a basis for its treatment and assessment of metastatic risk. Methods: Studies published from January 2005 to July 2015 in domestic and international journals concerning the risk factors for lymphatic metastasis of TMC were collected by searching relevant databases, and then Meta-analysis was performed. Results: A total of 12 studies were included, involving 3 355 patients, of whom 1 292 cases (38.51%) had lymphatic metastasis. Results of Meta-analysis showed that young age (OR=1.46, 95% CI=1.20?1.78), male sex (OR=2.26, 95% CI=1.65?3.09), tumor size larger than 0.5 cm (OR=0.46, 95% CI=0.36?0.59), multiple primary lesions (OR=0.52, 95% CI=0.42?0.65), and presence of extracapsular invasion (OR=3.22, 95% CI=2.04?5.08) were risk factors for lymphatic metastasis of TMC (all P<0.05). Conclusion: TMC patients with age <45 years, male gender, tumor diameter ≥0.5 cm, multiple primary lesions, or presence of extracapsular invasion, should be vigilant of lymphatic metastasis.

Abstract:Objective: To investigate the clinicopathologic characteristics of thyroid carcinoma (TC) with concomitant lymphocytic thyroiditis (LT). Methods: The clinical data of 87 patients with TC alone (TC group) and 129 patients with TC and concomitant LT (TC plus LC group) were retrospectively analyzed, and the latter included 40 cases had concomitant Hashimoto's thyroiditis (HT), 81 cases had concomitant chronic lymphocytic thyroiditis (CLT) and 8 cases had concomitant HT and CLT. Results: All patients received surgical treatment that included unilateral thyroid lobectomy, and sub-total or total thyroidectomy with lymph node dissection of different scopes according to the disease conditions of the patients. In patients with TC and concomitant LT, only one case (0.8%) was medullary thyroid carcinoma (MTC), and all the remaining cases were papillary thyroid carcinoma (PTC). In TC plus LC group compared with TC group, the proportions of female gender, microcarcinoma, unilateral lobe involvement and negative cervical lymph node were significantly increased, while the maximum diameter of tumor was significantly decreased (all P<0.05). Among patients in TC plus LC group, there was no significant difference in any studied clinicopathologic variables between cases with concomitant HT and concomitant CLT (all P>0.05). Conclusion: TC that coexists with LT is dominated by PTC, and the majority of cases are female gender. LT may possibly inhibit metastasis of TC within the gland and to the lymph nodes, and the clinicopathologic features are similar between TC combined with CLT and TC combined with HT.

Abstract:Objective: To investigate the predictive factors for incidental thyroid carcinoma through its ultrasonic and pathological features. Methods: The clinicopathologic data of 541 patients with thyroid cancer treated in the First Affiliated Hospital of Harbin Medical University between January 2014 and October 2014 were retrospectively analyzed. Of the patients, 108 cases were incidental thyroid carcinoma (observational group), and 421 cases were non- incidental thyroid carcinoma (control group). Differences in clinicopathologic features between the two groups of patients were compared. Results: There was significant difference between the two groups in the proportions of age, number of lesions, pathological classification, structure of lesions, whether or not combined with benign thyroid disease, presence or absence of calcification, color of lesion, aspect ratio of nodules, elasticity score, boundary conditions, echo intensity, whether or not lymph node dissection of the central compartment was performed (all P<0.05). Logistic regression analysis revealed that follicular carcinoma, absence of calcification, aspect ratio less than 1, clear boundaries, non-hypoecho, elasticity score less than 3 and the ratio between the diameter of tumor and tumor-bearing nodule less than 30% were predictive factors for incidental thyroid carcinoma (all P<0.05). Conclusion: Follicular carcinoma, absence of calcification, length to width ratio less than 1, clear boundaries, non-hypoecho, elasticity score less than 3 and the ratio between the diameter of tumor and tumor-bearing nodule less than 30% are predictive factors for incidental thyroid carcinoma.

Abstract:Liver resection is an important treatment modality for liver diseases. However, the postoperative complications adversely affect the outcome of treatment. Systemic inflammatory response after liver resection is a crucial factor for causing postoperative complications. Inhibiting the inflammatory reaction can effectively reduce the incidence of postoperative complications, which has an important clinical significance in postoperative recovery of patients. In recent years, precise hepatectomy technique has received increasing attention in terms of relieving postoperative inflammation. Here the authors, based on the relevant literature review, summarize the alleviating effect of precise hepatectomy on postoperative inflammation.

Abstract:The long non-coding RNAs (lncRNAs) are defined as RNA molecules with a length of 200-100 000 nucleotides that lack protein-coding capacity. Growing evidence indicates that lncRNAs are closely associated with the pathogenesis and progression of hepatocellular carcinoma (HCC) as well as the outcomes of patients, through their participation in regulation of gene expression at transcriptional, post-transcriptional and epigenetic level, and thereby influence the processes of proliferation, apoptosis, angiogenesis, invasion, and metastasis of tumor cells. Some lncRNAs that are aberrantly expressed in HCC may potentially be used for diagnostic or prognostic markers of HCC. In this paper, the authors address the recent research progress of lncRNA in HCC.

Abstract:目的：探讨甲胎蛋白（AFP）、高尔基体糖蛋白73（GP73）、超氧化物歧化酶（SOD）联合检测对原发性肝癌的诊断价值。 方法：选取收治的原发性肝癌和肝硬化患者各100例（分别为肝癌组和肝硬化组），抽取患者静脉血，采用电化学发光法检测AFP、酶联免疫吸附法检测GP73、黄嘌呤氧化酶法检测SOD，并与100例同期健康体检者（对照组）进行对照，绘制受试者工作特征曲线（ROC），观察AFP、GP73及SOD联合检测对原发性肝癌的诊断价值。 结果：肝癌组血清AFP、GP73显著高于肝硬化组和对照组（P<0.05），SOD水平明显低于肝硬化组和对照组（P<0.05）。AFP、GP73及SOD单纯检测在原发性肝癌患者诊断中最佳节点分别为150.29 μg/L、214.78 μg/L和55.61 IU/mL，联合检测AUC高达0.902，明显高于单纯检测AFP、GP73及SOD的0.726、 0.813及0.791。 结论：AFP、GP73及SOD联合检测用于原发性肝癌的诊断，可显著提高检出率。

Abstract:目的：探讨肝细胞癌切除术后复发患者采用射频消融术（RFA）治疗的临床效果。 方法：选取2008—2012年收治的97例肝细胞癌切除术后复发患者作为观察对象，其中再次治疗采用射频消融术者58例（射频组）、选择采用无水酒精注射治疗者39例（无水酒精组），比较两组肿瘤复发治疗效果。 结果：病灶≤3 cm和>3 cm者，射频组的治疗次数均低于无水酒精组,差异有统计学意义（P<0.05）；病灶≤3 cm者，射频组灭活率为90.24%，无水酒精组为80.00%，组间比较无统计学差异（P>0.05）； 病灶>3 cm者，射频组病灶灭活率明显高于无水酒精组（82.61% vs. 50.00%，P<0.05）。 射频组并发症率低于无水酒精组但无统计学差异（31.03% vs. 41.03%, P>0.05）；射频组末次治疗后的1、2、 3年存活率分别为84.48%、62.07%、43.01%均明显高于无水酒精组的64.10%、42.03%、20.51%，差异均有统计学意义（P<005）；射频组总生存中位时间明显长于无水酒精组（18个月 vs.13个月，Log-rank χ2=5.566，P=0.018）。 结论：肝细胞癌切除术后复发采用射频消融术治疗临床疗效良好。

Abstract:目的：探讨快速康复在腹腔镜肝切除围手术期中应用的安全性及优越性。 方法：选取行腹腔镜肝部分切除术48例，观察组（26例）采取快速康复治疗方案，对照组（22例）采用传统治疗方案。对两组患者手术情况及术后指标进行对比分析。 结果：观察组术中出血量、术后排气排便时间、住院时间、体力康复评分明显优于对照组，且并发症发生率更低（均P<0.05）。 结论：快速康复在肝脏部分切除手术中具有良好的应用效果，能改善患者心理及生理功能，降低并发症发生率。

Abstract:目的：探讨腹腔镜辅助下胃十二指肠溃疡急性穿孔修补术及术后疗效及安全性。 方法：回顾性分析手术治疗的胃十二指肠溃疡急性穿孔58例患者的临床资料，根据患者手术方法不同分为腹腔镜组（32例）和开腹组（26例），腹腔镜组在腹腔镜辅助下行穿孔修补术，开腹组行开腹穿孔修补术，比较两组患者手术时间、切口长度、术后下床活动时间、术后镇痛药物应用、术后胃肠道功能恢复、术后并发症发生率。 结果：腹腔镜组手术时间、切口长度、术后下床活动时间、术后镇痛药物应用情况均优于开腹组（P<0.05）；腹腔镜组术后肛门排气时间短于开腹组（P<0.05），术后胃肠道不良反应发生率低于开腹组（P<0.05）；腹腔镜组术后并发症的发生率明显低于开腹组（P<0.05）。 结论：腹腔镜辅助下胃十二指肠溃疡急性穿孔修补术具有手术时间短、创伤性小、术后胃肠道功能恢复良好等优点，可作为胃十二指肠溃疡急性穿孔的首选治疗方案。