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Objective: Progesterone is a signaling molecule synthesized by the adrenal glands and ovaries and is structurally the precursor of many different hormones. Vitamin D, unlike other vitamins, is a steroid hormone that can be synthesized endogenously as well as supplied exogenously. Vitamin D deficiency is a matter of considerable controversy in the world of medicine. The objective of this study was to investigate the impact of progesterone on the proliferation and liver enzyme activities of HepG2 cells, as well as to assess the potential of vitamin D in mitigating the cytotoxic effects induced by progesterone. Material and Method: Cytotoxicity studies were conducted on HepG2 hepatocellular cancer cells to determine the appropriate doses of progesterone and vitamin D when applied alone or in combination. The hormones were administered to the experiment and control groups, either alone or in combination at specific doses. Subsequently, HepG2 cell viability, morphology and liver enzyme activities were measured comparatively between the groups. Results: The results indicated a decrease in cell viability in the cells treated with 1 mM and 2 mM progesterone when compared to the control group. In addition, AST and LDH activity values were significantly lower with 1 mM and 2mM progesterone. Vitamin D was found not to have a cytotoxic effect on HepG2 cells between doses of 0.008 µM and 166.667 µM. Therefore, a dose of 2.5 µM was selected for further applications. No significant difference in ALT, AST, and LDH enzyme activity values was observed when only vitamin D was administered. Similar cell viability and enzyme activities were demonstrated when progesterone was administered alone or in combination with vitamin D. Conclusion: At the doses and incubation periods used in the current study, vitamin D was found to be ineffective in preventing the cytotoxic effects caused by progesterone. [ABSTRACT FROM AUTHOR]

A 73-year-old woman with known diagnosis of chronic hepatitis B infection referred for 18F-fluorodeoxyglucose positron emission tomography/ computed tomography 18F-FDG PET/CT) and magnetic resonance imaging (MRI) after detection of a liver mass with 9 cm diameter in contrast enhanced CT. However, 18F-FDG PET/CT and MRI revealed diffuse infiltrating hepatocellular carcinoma lesions other than previously defined mass. After 9 months of Sorafenib treatment serum alpha feto protein levels dropped from 60,500 ng/mL to 801 ng/mL. Later, 18F-FDG PET/MRI was performed for evaluation of response to treatment and revealed marked response to treatment. [ABSTRACT FROM AUTHOR]

Aim: Survival data for patients with hepatocellular carcinoma (HCC) is heterogeneous. We aimed to analyze the survival and cost of treatment in cirrhotic patients with HCC. Materials and methods: From May 1998 to March 2015, 157 patients with HCC diagnosed and treated in a single center were assessed retrospectively. Etiology, biopsy findings, Child-Pugh-Turcotte (CPT) scores, Barcelona Clinical Liver Cancer (BCLC) stages, treatment response, cost, and prognostic factors were recorded. Deaths due to complications of cirrhosis or other diseases were excluded. Results: 157 patients (82.8% male) with a mean age of 62.2±11.4 years at diagnosis were included. Etiology was HBV (56%), HCV (26.1%), cryptogenic (11.5%), and others (6.4%). Median lesion diameter was 4 (0.5-28) cm. 1, 2, and =3 lesions were present in 46.5%, 19.1%, and 34.2% of patients, respectively. Treatments were as follows: palliative (n: 53), transarterial chemoembolization-TACE (n: 53), radiofrequency ablation-RF (n: 14), radioembolization (n: 3), alcohol (n: 5), and chemotherapy (n: 14). Resection (n: 9) and transplantation (n: 6) were amenable in few patients. Before treatment, 114 (72.6%) patients were in the CPT A/B group, but 93 (59.3%) of all patients were initially staged as BCLC-C/D. Overall survival was 11.6±0.9 months, with 32% probability of surviving one year. Kaplan-Meier analysis revealed that pre-treatment CPT score, BCLC stage, TACE, and resection significantly affect survival. Cox regression defined BCLC stage (stage B: HR=9.58, 95% CI=1.03-88.98, p=0.047; stage C: HR=13.41, 95% CI=1.37-130.85, p=0.026, stage D: HR=24.72, 95% CI=2.33-262.46, p=0.008) and TACE (HR=2.36, 95% CI=1.18-4.71, p=0.015) as independent predictors of survival. Conclusion: Treatment modalities were not significantly different in terms of cost (p=0, 656). Hepatocellular carcinoma was usually diagnosed late, and treatment modalities were similar in cost. Barcelona clinical liver cancer stage and TACE were predictive of survival. [ABSTRACT FROM AUTHOR]

Amaç: MikroRNA'lar, hepatosellüler karsinomun (HCC) gelişiminde ve ilerlemesinde anahtar düzenleyicilerdir. Yakın tarihli bir çalışmada, miR-4746'nın HCC’de aşırı ifade edildiği bulunmuş olsa da miR-4746’nın HCC’deki farklı seviyelerde ifade edilmesi ve klinikopatolojik önemi belirsizliğini korumaktadır. Bu çalışmada miR-4746’nın gen ifade özelliğini, klinikopatolojik rolünü ve kestirim değerini hesaplamalı yaklaşımlar kullanarak değerlendirmeyi amaçladık. Gereç ve Yöntemler: Çeşitli insan kanserlerinde miR-4746’nın gen ifade özelliği dbDEMC veri tabanı kullanılarak belirlendi. Ayrıca, HCC’de miR-4746 gen ifade seviyesini analiz etmek için ENCORI/Starbase v2 ve UALCAN veri tabanlarını kullandık. Ayrıca UALCAN veri tabanını kullanarak miR-4746’nın klinikopatolojik işlevini araştırdık. Son olarak, miR-4746’nın HCC’deki kestirim özelliğini belirleyebilmek için Kaplan-Meier plotter ve ENCORI/Starbase v2 veri tabanları aracılığıyla sağ kalım analizi ile gerçekleştirdik. Bulgular: miR-4746, çeşitli insan kanserlerinde farklı gen ifade değerlerine sahipti ve normal örneklere kıyasla HCC dokularında önemli ölçüde arttığı gözlemlenmiştir. Klinikopatolojik analiz, miR-4746’nın kanser evresi, tümör derecesi, lenf bezi metastaz durumu, TP53 mutasyon durumu ve hastanın yaşı dahil olmak üzere farklı klinik parametrelerde farklı gen ifade seviyelerine sahip olduğunu koydu. Ek olarak, miR-4746’nın yüksek ifadesi, HCC’de kötü prognoz ile önemli ölçüde ilişkili olduğu bulunmuştur. Sonuç: Bulgularımız, miR-4746’nın kötü kestirim ve çok kötü klinikopatolojik çıktılarla ilişkilendirilen onkojenik bir miRNA olabileceğini gösterdi. Ayrıca miR-4746, HCC’nin tümorogenezinde önemli bir role sahip olabilir ve potansiyel kestirim biyobelirteç olarak hizmet edebilir.

Copyright of Acibadem Saglik Bilimleri Dergisi is the property of Acibadem University Medical School and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Hepatocellular cancer (HCC) is the most common malignancy of the hepatobiliary system. There are significant differences in the global spread of HCC. It is the major cause of death in patients with cirrhosis. Its molecular pathogenesis is highly complex and heterogeneous. Major risk factors for the development of HCC are chronic hepatitis B virus (HBV) infection, chronic hepatitis C virus (HCV) infection and alcoholrelated liver cirrhosis. Hepatocellular cancer is rarely seen in the first 4 decades of life, except in communities where HBV infection is hyperendemic. Methods: The study was conducted by retrospectively scanning the files of 204 patients diagnosed with HCC who applied to Organ Transplantation Center between 21.09.2014 and 13.04.2019. Patients were transplanted liver by being classified according to Milan criteria, San Francisco [University of California San Francisco (UCSF)] criteria, and Barcelona Clinic Liver Cancer (BCLC) criteria. Results: The median age of the patients was 58.03 (range 31 to 72). 170 of the patients were men and 34 of them were female. Liver transplantation (LT) was performed from cadaveric donors to 31 patients and from living donors to 173 patients. There is a significant relationship between the life span of the patients and their gender. Female patients have a longer life expectancy [t (202) = 2.963, p =0.003]. A significant relationship was found between life expectancy and surgical classification [F (3) = 3.008, (p =0.031)]. Conclusions: In patients diagnosed with HCC and undergoing LT; the gender being female and the classification method before transplantation affect life expectancy. [ABSTRACT FROM AUTHOR]

Copyright of Sakarya Tıp Dergisi is the property of Sakarya Tip Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: The aim of this study was to evaluate the efficacy of transarterial chemoembolization (TACE) with drug-eluting beads in hepatocellular carcinoma (HCC). Material and Methods: Twenty-nine patients with HCC who were treated with TACE with drug-eluting beads between 2019 and 2021 were included in the study. The success of the TACE procedure was evaluated using pre- and post-operative contrast-enhanced computed tomography/magnetic resonance images. Patient characteristics, embolizing-bead sizes, procedure-related complications, and pre- and post-procedure alpha-fetoprotein (AFP) levels were recorded. Results: The mean age of the patients was 65.6±10.4 years, and the objective response rate was 17.2% (5/29). 100-300 μm particles were used in 11 (37.9%) patients, and 300-500 μm particles were used in 18 (62.1%). The median target lesion number was 1 (range, 1-6). Six (20.7%) patients had non-target lesions. There were newly developed lesions in four (13.8%) patients. A significant decrease was found in the median target lesion size after (41; range, 0-116 mm) the procedure compared to the pre- (42; range, 22-188 mm) procedure (p

Copyright of Osmangazi Journal of Medicine / Osmangazi Tip Dergisi is the property of Eskisehir Osmangazi University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: This study aimed to classify open-access gene expression data of patients with hepatitis B virus-related hepatocellular carcinoma (HBV + HCC) and chronic HBV without HCC (HBV alone) using the XGBoost method, one of the machine learning methods, and reveal important genes that may cause HCC. Methods: This case-control study used the open-access gene expression data of patients with HBV + HCC and HBV alone. Data from 17 patients with HBV + HCC and 36 patients with HBV were included. XGBoost was constructed for the classification via 10-fold cross-validation. Accuracy, balanced accuracy, sensitivity, selectivity, positive-predictive value, and negative-predictive value performance metrics were evaluated for model performance. Results: According to the feature-selection method, 18 genes were selected, and modeling was performed with these input variables. Accuracy, balanced accuracy, sensitivity, specificity, positive-predictive value, negative-predictive value, and F1 score obtained from XGBoost model were 98.1%, 98.6%, 100%, 97.2%, 94.4%, 100%, and 97.1%, respectively. Based on the predictor importance findings acquired from XGBoost, the RNF26, FLJ10233, ACBD6, RBM12, PFAS, H3C11, and GKP5 can be employed as potential biomarkers of HBV-related HCC. Conclusions: In this study, genes that may be possible biomarkers of HBV-related HCC were determined using a machine learning-based prediction approach. After the reliability of the obtained genes are clinically verified in subsequent research, therapeutic procedures can be established based on these genes, and their usefulness in clinical practice may be documented. [ABSTRACT FROM AUTHOR]

Copyright of Ege Journal of Medicine is the property of Ege University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: The aim of this study was to evaluate the efficacy of transarterial chemoembolization (TACE) with drug-eluting beads in hepatocellular carcinoma (HCC). Material and Methods: Twenty-nine patients with HCC who were treated with TACE with drug-eluting beads between 2019 and 2021 were included in the study. The success of the TACE procedure was evaluated using pre- and post-operative contrast-enhanced computed tomography/magnetic resonance images. Patient characteristics, embolizing-bead sizes, procedure-related complications, and pre- and post-procedure alpha-fetoprotein (AFP) levels were recorded. Results: The mean age of the patients was 65.6±10.4 years, and the objective response rate was 17.2% (5/29). 100-300 μm particles were used in 11 (37.9%) patients, and 300-500 μm particles were used in 18 (62.1%). The median target lesion number was 1 (range, 1-6). Six (20.7%) patients had non-target lesions. There were newly developed lesions in four (13.8%) patients. A significant decrease was found in the median target lesion size after (41; range, 0-116 mm) the procedure compared to the pre- (42; range, 22-188 mm) procedure (p<0.001). A significant difference was found between the median AFP levels before (343; range, 1.44-2000 ng/mL) and after (52; range, 0.95-1435 ng/mL) the procedure (p<0.001). Conclusion: Since most patients with HCC are diagnosed in the intermediate stage, curative treatment is not possible. TACE is an important treatment option for the local control of the disease in this patient group. However, the success of TACE treatment may vary depending on the cancer stage, number of patients, follow-up period, and type and size of the microsphere used. [ABSTRACT FROM AUTHOR]

Copyright of Anatolian Clinic Journal of Medical Sciences is the property of Hayat Saglik ve Sosyal Hizmetler Vakfi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Surgery & Medicine (JOSAM) is the property of Journal of Surgery & Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A 57-year-old male with history of thalassemia intermedia and hepatocellular carcinoma underwent a positron emission tomography/computed tomography (PET/CT) scan with 18F-choline before radioembolization procedure with 90Y-microspheres. The PET/CT scan with 18F-choline demonstrated highly increased tracer incorporation within a gross lesion in the hepatic dome coupled with diffuse activity in bone marrow, this latter aspect was probably due to the compensatory hematopoiesis stimulation induced by chronic hemolysis. This pattern of skeletal 18F-choline uptake should be considered as a peculiar PET/CT finding in thalassemic patients. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC) is the most common form of primary liver cancer and causes significant morbidity and mortality. Y-90 radioembolization has been shown to be a safe and efficacious loco-regional treatment with longterm results for patients with HCC. Based on Barcelona Clinic Liver Cancer classification, Y-90 radioembolization is a solution in unresectable and unablatable cases in early stages, in intermediate-late stages as an alternative to transarterial chemoembolization, and in patients with portal vein invasion. Y-90 is a versatile tool with multiple uses including downstaging of patients for curative treatments, providing tumor control as a bridge to transplant or resection, curative therapy when used as segmentectomy, and left lobar hypertrophy in the setting of radiation lobectomy. [ABSTRACT FROM AUTHOR]

Metastasis to the oral region is an uncommon characteristic of hepatocellular carcinoma. As such, diagnosis of these malignancies can be challenging due to clinical similarities with benign lesions. This report describes a 70-year-old woman with a rare case of oral metastasis of hepatocellular carcinoma that manifested in the anterior maxilla. The diagnosis of hepatitis Band C-related hepatocellular carcinoma was made one year before presentation to the authors' clinic. At the time of admission, the patient was undergoing medication with Sorafenib. An erythematous, haemorrhagic, painless lesion exhibited rapid growth in the maxilla over a two-month period. Based on clinical characteristics, the lesion was considered a pyogenic granuloma before pathological examination. After surgical intervention, the healing process in the eight-month follow-up period was uneventful, with no evidence of recurrence. This report highlights the importance of meticulous clinical and pathological evaluations in patients with suspected oral metastatic lesions that may mimic benign conditions. [ABSTRACT FROM AUTHOR]

Background: Comparing gene expression profiles using gene expression datasets of different types of tumors is frequently used to identify molecular mechanisms of cancer. This study aimed to find shared and type specific gene expression profiles of hepatocellular carcinoma (HCC) and B-cell chronic lymphocytic leukemia (B-CLL). Material and methods: Gene expression microarrays for HCC and B-CLL and RNA-sequencing expression data for liver HCC and lymphoid neoplasm diffuse large B-cell lymphoma (DLBC) were analyzed and differentially expressed probe sets or genes for each cancer type were detected. Probe sets and genes that were shared or specifically expressed in both cancer types were identified. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway and Gene Ontology (GO) terms for Biological Process (BP) annotations were performed. Results: According to our analysis shared upregulated genes were mainly annotated in cell cycle processes. Some of the genes that changed only in HCC were annotated in cell cycle and metabolic processes, and some of the genes, altered only in B-CLL, were annotated in immune response and hemopoiesis. Conclusion: These results contribute to cancer research that aim to find the conserved gene expression profiles in different cancer types and widen the knowledge of HCC and B-CLL specific mechanisms. [ABSTRACT FROM AUTHOR]

Objective: Despite the recent advances in diagnosis and treatment of hepatocellular carcinoma (HCC), it is still amajor health problem. Therefore, understanding the molecular mechanism is very important. Our aim is to investigate the molecular basis of aflatoxin B1 (AFB1) induced HCC other than the hotspot TP53 p.Arg249Ser (c.747G>T) (R249S) mutation. Methods: 525 genes previously reported to be involved in carcinogenesis with mutations in different cancer types were analyzed by next generation sequencing for 525 cancer-gene panel (Roche/NimbleGen) in one tumor sample (T29) and one cell line (MAHLAVU) carrying TP53 R249S mutation. Additionally, ARID2 and BCORL1 genes were analyzed by Sanger sequencing for MAHLAVU and Primary Liver Carcinoma/Poliomyelitis Research Foundation/5 (PLC/PRF/5) cell lines. Results: No other common gene mutations were found in the analyzed T29 and MAHLAVU samples and also no genetic variation possibly associated with AFB1 was detected in PLC/PRF/5 cell line and 68 COSMIC HCC samples. Likewise, no pathogenic mutation was detected in ARID2 and BCORL1 genes of MAHLAVU and PLC/PRF/5 cell lines. Conclusion: No fingerprint mutations were detected in the analyzed genes. To the best of our knowledge, other hotspot mutations appear to be absent if not at a very low frequency in HCC carrying TP53 R249S mutation. [ABSTRACT FROM AUTHOR]

Radyolojik görüntülemenin amacı hepatosellüler karsinomu erken evrede tespit etmektir. Bunun amacı lezyonu küratif tedavi evre- sinde yakalayabilmektir. Son yıllarda özellikle küçük karsinomların erken tespit edilebilmesi için fazlaca çaba sarf edilmektedir. Bu derlemenin amacı hepatosellüler karsinomların tespiti ve tanımlanmasında ultrasonografi, bilgisayarlı tomografi, manyetik rezonans görüntüleme, radyonüklid görüntüleme, pozitron emisyon tomografi ve dijital subtraksiyon anjiografi gibi invaziv olmayan görüntü- leme yöntemlerinin etkinliğini belirlemektir

Objective: Primary liver cancer is one of the most common and lethal type of tumors in the world. Hepatocellular forms compose about 80% of all primary liver tumors. Our aim is to evaluate the patients with hepatocellular carcinoma admitted to our clinic retrospectively. Methods: First we identified viral hepatitis serology and whether antiviral treatment was administered before the diagnosis and the period until the development of hepatocellular carcinoma for each case with hepatocellular carcinoma. Child-Pugh stage in cirrhotic cases, the stage of viral hepatitis in non-cirrhotic cases, and the treatment method suggested for hepatocellular carcinoma and the average life expectancy (for the patients whose life expectancy is known) were evaluated. Alpha-feto protein levels and computerized tomography, ultrasound, magnetic resonance imaging findings were evaluated retrospectively. Correlation between alpha-feto protein levels and tumor numbers were evaluated statistically. Results: Total of 69 patients were evaluated. The median age at presentation was 62.8 (ranging from 25 to 80) years. Median (overall survival) OS was 7.0 (ranging from 0 to 145) months in all patients. 18 patients (41.9%) were Child-Pugh Class A, 12 (27.9%) patients were Child-Pugh Class B and 13 (30.2%) patients were Child-Pugh Class C. It was found that patients with severely high alpha-feto protein levels (>200 ng/ml), have 4 fold risk of multiple liver masses (OR: 4.05, 95% CI: 1.22-13.42). For the characterization of a liver mass as hepatocellular carcinoma, the diagnostic effectiveness of computerized tomography was 54.3%, and that of magnetic resonance imaging was 55.8%. Conclusion: As a result the patients with hepatocellular carcinoma can be diagnosed with combination of laboratory findings and imaging techniques. Alpha-feto protein levels are important for follow up of such patients and identifying the multiple mass presences. [ABSTRACT FROM AUTHOR]

Transarterial chemoembolization (TACE) with drug-eluting beads (DEB) is a new palliative treatment method for patients with hepatocellular carcinoma (HCC). Little is known about the efficiency of DEB-TACE for patients with HCC. The purpose of our study was to evaluate the treatment efficacy (survival rate, tumor response) and safety of DEB-TACE for inoperable HCC and to identify the predictors of survival in patients with unresectable HCC. Twenty-six patients (18 Child-Pugh A, 8 Child-Pugh B) underwent chemoembolization with doxorubicin DEB, including 5 women and 21 men with a mean age of 67.04 years (range 40-86 years). Twenty patients had one DEB-TACE procedure, while the remaining six had two procedures. Overall median survival and survival at 6 and 12 months were calculated. Meanwhile, the response rate was assessed using response evaluation criteria in solid tumors criteria on computed tomography /magnetic resonance imaging at 1 and 6 months. Overall survival rates at 6 months and 1 year from the first administration of doxorubicin DEB-TACE were 80% and 57%, respectively. At 1 and 6 months, objective tumor response rates were 46.2% and 57.1%, respectively. Child-Pugh class, Okuda staging, Cancer of the Liver Italian Programme score, Barcelona Clinic Liver Cancer staging, serum albumin level, Eastern Cooperative Oncology Group performance status, and tumor morphology and volume were found to be prognostic factors for survival. All of the procedures were technically successful, and there were no major complications. Eighteen patients died during the study period and eight survived. Transarterial chemoembolization with DEB is safe and well tolerated in patients with inoperable HCC. Additional prospective randomized controlled studies are required to assess the efficiency of DEB-TACE. [ABSTRACT FROM AUTHOR]

The purpose of diagnostic imaging is to detect HCC at an early stage, when curative options are available. In recent years, there have been many efforts to improve early detection of small HCC. The purpose of this review is to describe the pertinent findings of HCCs in non-invasive, diagnostic imaging, including ultrasound, computed tomography, magnetic resonance, radionuclide scanning, positron emission tomography and digital subtraction angiography imaging techniques. [ABSTRACT FROM AUTHOR]

A female Terrier dog with the age of 11 was brought to our hospital with complains of anorexia, loss of weight, lethargy and abdominal swelling. In the abdominal palpation, a mass extending towards the caudal in the right quadrant was identified. Presence of a mass was confirmed in the direct radiographic examination, which supports the clinical finding. In the abdominal ultrasonography it was determined that the liver had lost its homogenous structure, there was free fluid in the abdomen, and the liver borders were irregular. The ALP, total protein, ALB and GGT were identified as 328 IU/L, 2.74 g/dl, 1.85 g/dl and 12.2 U/I respectively in the biochemical analysis. Experimental laparotomy was applied to the case and a diffused mass was identified in the liver. Samples were taken from the neoplastic masses during the operation and the abdomen was closed after identifying diffused neoplastic formations in all lobes. Following the histo-pathological examination of the sample, the patient was diagnosed with hepatocellular carcinoma. In this paper, it was aimed to report the clinical, radiological, ultrasonographic, biochemical and haematological findings of a hepatocellular carcinoma observed in a dog. [ABSTRACT FROM AUTHOR]

Primary malignant tumors of the liver are rare in childhood and comprise 1-2% of all childhood malignancies. In this retrospective study the characteristics, treatment and outcome of childhood malignant hepatic tumors diagnosed and treated in a single center between 1996 and 2010 were evaluated. The pretreatment extent of disease (PRETEXT) system was used for staging and the SIOPEL- 3 or modified protocol for treatment. 20 children (13 male, 7 female), diagnosed and treated with primary malignant tumors of the liver (11 hepatocellular carcinoma [HCC], 9 hepatoblastoma [HBS]) were evaluated. In our series the cases with HCC were more than the cases with HBS. In cases with HCC, 8 had chronic hepatitis B infection. Serum alpha-fetoprotein levels were elevated in all cases with HBS and in six with HCC. According to the PRETEXT staging, 12 cases were stage (S) IV, 2 S III, 6 S II. Four had lung metastasis. Four cases with HBS, one patient with HCC are alive with no evidence of disease (19, 20, 21, 26, 102 months). The high incidence of hepatocellular carcinoma in our series is thought to be due to the high incidence of hepatitis B infection in Turkey. Children with chronic hepatitis B virus infection should be followed up keeping in mind the risk of HCC. Children with hemihypertrophia and other predisposing conditions should be followed up for the risk of liver tumors so that they can be diagnosed at early stages. [ABSTRACT FROM AUTHOR]

Objective: Although the clinical and histopathological findings of hepatocellular carcinoma are well described, there are few national studies. In this study, we aimed to investigate the relationship between these findings in total or partial hepatectomy specimens in our series. Material and Method: We first collected 190 cases of total or partial hepatectomies performed because of hepatocellular carcinoma, cirrhosis or other disorders from the archives of Pathology. After re-examining the histopathological and clinical features such as age, gender and etiology, the relationship between them and serology results were statistically analyzed using the chi square and Multiple Comparison Tests. Results: Among 190 cases, there were 168 (88.5%) total and 18 (9.5%) partial hepatectomies and 4 (2%) tumorectomy or metastasectomy cases. After gross and microscopic examination, 170 (89.5%) cases had a diagnosis of cirrhosis, 85 (44.7%) hepatocellular carcinoma, 3 parasitic cyst, 7 metastasis, 1 hepatoblastoma, 1 hepatocellular adenoma, 2 cholangiocarcinoma, 2 Budd Chiari Syndrome, 1 focal nodular hyperplasia, 1 cavernous hemangioma, and 2 acute fulminant hepatitis. Among the hepatocellular carcinoma cases, 53 had Hepatitis B virus, 15 Hepatitis C virus , 3 Hepatitis B virus and Hepatitis C virus, and 3 Hepatitis B virus and Hepatitis delta virus etiology, while 6 were alcoholic and 4 were due to other causes. Among cirrhosis patients, 84 (49.4%) had hepatocellular carcinoma. The male to female ratio of hepatocellular carcinoma cases was 74/11. The mean age was 55 and the median age 56.7. Conclusion: The results of this study demonstrated that the most common hepatic disorder was cirrhosis due to Hepatitis B virus in the hepatectomy specimens of our series that mostly consisted of total hepatectomies performed for transplantation where 50% had hepatocellular carcinoma. [ABSTRACT FROM AUTHOR]

Hepatocelluler carcinoma is common especially in Asia and Far East where the incidence of viral hepatitis is very high. Treatment of HCC includes the treatment of underlying chronic liver disease caused by viral hepatitis and the tumor itself. Although, surgical resection is the curative treatment procedure for the disease, presence of cirrhosis hinders the resection at about 90% of patients. Besides, owing to diffuse and multiple lesions, most of the patients are not suitable for the curative resection. Liver transplantation can cure both the underlying chronic liver disease and the HCC. Liver transplantation are performed according to expanded criteria and successful results have been obtained at our center. Local and ablative treatments are put on to the agenda in patients whom are not suitable for surgical intervention. Transarterial chemoembolisation (TACE), percutaneous alcohol injections (PAI) and radiofrequency ablation (RF) are the most common procedures that are effective in small solitary lesions. Systemic chemotherapies are used in the case of extrahepatic dissemination or in patients with unresectable disease. Cisplatin, doxorubicin, etoposite and 5-flourouracil have been used both as a single agent and in combinations but the response rates are limited between 8 to 18%. In this group of patients although the higher response rate was achieved with the combination of cisplatin, interferon-α-2b, doxorubicin and 5-flourouracil (PIAF), no survival advantage was obtained when compared with doxorubicin. This combination has not been accepted as a standard because of its severe morbidity. Recently sorefenib, a Raf kinase intibitor, was shown to be effective in HCC. Owing to survival advantage in a phase III trial when comparing to placebo, sorefenib seems to be proming agent in HCC. [ABSTRACT FROM AUTHOR]

Giriş: Prostat spesifik membran antijen (PSMA) prostat epiteli tarafından eksprese edilen ve prostat kanserinde teranostik hedef olarak kullanılan bir transmembran glikoproteinidir. Tümör neovaskülaritesine bağlı prostat kanseri dışında birçok solid tümörde de eksprese edildiği bilinmektedir. Bu çalışmada hepatosellüler karsinomda (HSK) Ga-68-PSMA PET/ BT bulgularının değerlendirilmesi ve F-18-FDG PET/BT bulguları ile karşılaştırılması amaçlanmıştır. Yöntem: HSK tanısı ile yeniden evreleme amacıyla F-18-FDG PET/BT yapılan, öncesinde angiogenez inhibitör kullanımı bulunmayan toplam 19 hastaya (2 kadın, 17 erkek; ortalama yaş 57, aralık 47-69) eş zamanlı (±10 gün) Ga-68-PSMA PET/BT görüntüleme planlandı. PET/BT görüntüleri, SUVmax değerleri, biyokimyasal parametreler ve batın MR bulguları ile karşılaştırıldı. Hastaların görüntüleme sonrası ortalama 18 aylık radyolojikbiyokimyasal takipleri yapıldı. Bulgular: Hastaların birinde batın içerisinde metastatik lenf nodu izlenirken diğer hastalarda tümör karaciğere lokalize idi. Ga-68-PSMA PET/BT' de 16 hastada (%84) HSK lezyonları PSMA ekspresyonu ile uyumlu artmış aktivite tutulumu (ortalama SUVmax: 17,4; aralık 3,8-36,9) gösterirken F-18-FDG PET/BT' de 15 hastada (%78) HSK lezyonlarında artmış FDG tutulumu görüldü (ortalama SUVmax: 8,3; aralık 3-22) (Şekil 1). Lenf nodu metastazı her iki çalışmada da pozitif idi. Tümör/zemin (T/Z) aktivite oranları Ga-68- PSMA PET/BT için 3.3±2.2, F-18-FDG PET/BT için 2,3 ± 1,5 olarak hesaplandı. Lezyonların PSMA ve FDG SUVmax değerleri (p=0,42) ve T/Z oranları arasında (p=0,724) anlamlı fark saptanmadı. Takiplerde 11 hastada hastalığa bağlı ölüm izlendi. Hastaların ortalama sağkalımı 25 ay olarak hesaplandı (%95 CI: 18-32 ay). PSMA SUVmax (p=0,05) ve FDG SUVmax (p=0,012) değerleri ile sağkalım arasında anlamlı korelasyon bulundu. Sonuç: Ga-68-PSMA PET/BT ile HSK lezyonlarındaki PSMA ekspresyonu noninvazif olarak başarıyla gösterilebilmektedir. Çalışma sonuçlarına göre PSMA ekspresyonunun tespitinin, Ga-68-PSMA PET/BT nin prognostik değeri ve anjiogenez inhibitörü kullanacak hastaların seçimi konusunda klinik önemi olabileceği düşünülmektedir. Ayrıca sınırlı tedavi seçeneği olan ileri evre hepatosellüler kanserli hastalarda, PSMA hedefli tedaviler açısından Ga-68-PSMA-BT'nin yol gösterici olabileceği öngörülmektedir. [ABSTRACT FROM AUTHOR]