ObjectiveTo understand advances in diagnostic value of long non-coding RNA (LncRNA) in hepatocellular carcinoma (HCC) and to find a useful tumor marker for early diagnosis of HCC.MethodThe recent literatures relevant the LncRNA in the HCC were reviewed and summarized.ResultsThe LncRNA could be detected in the blood and urine of the patients by the RNA immunoprecipitation, sequencing technology, gene chip, real-time quantitative PCR, and other techniques. With the rise of RNA sequencing technology, the number of identified LncRNAs had increased rapidly, and the remarkable progress had been made in the field of liver diseases. At present, the LncRNA related to HCC mainly included the urothelial cancer associated 1, highly up-regulated in liver cancer, metastasis-associated lung adenocarcinoma transcript 1, HOXA transcript at the distal tip, H19, SPRY4 intronic transcript 1, plasma-cytoma variant translocation gene 1, uc002mbe.2, uc007biz.1, etc., which were stable in the blood or urine and abnormally expressed in the HCC, alone or as a supplement to alpha-fetoprotein could obviously improve the sensitivity and specificity of diagnosis of HCC, even increased the sensitivity to 100%.ConclusionsLncRNA is specifically expressed in HCC and is expected to be a novel biomarker for early diagnosis of HCC. However, LncRNA has many types, diverse structures, and complex molecular regulation mechanisms. It is very difficult to find a strong combination or combinations to replace or supplement traditional biomarkers and to be clinically useful further efforts. It is believed that with deepening of LncRNA research in HCC, it will have a broader prospect in early screening, diagnosis, and prognosis of HCC.
ObjectiveTo summarize the research progress of risk factors related to early recurrence and late recurrence of hepatocellular carcinoma (HCC) after radical resection.MethodsReviewed and summarized recent literatures on factors related to early and late recurrence of HCC after radical resection.ResultsRadical resection was the most effective treatment for HCC, but the postoperative recurrence rate was high, which seriously affected the treatment effect. Current research divided the recurrence after radical resection of HCC into early recurrence (≤2 years) and late recurrence (>2 years). Early recurrence was considered to be mainly caused by intrahepatic metastasis (IM), which was related to the tumor itself, while late recurrence was mainly caused by multicentric occurrence (MO) and was related to background liver factors. Factors of the tumor itself, including tumor diameter and number, invasion of tumor large vessels and microvessels, anatomical and non-anatomical resection, tumor margin, residual liver ischemia (RLI), intermittent total entry hepatic blood flow interruption method (IPM), the expression level of circulating microRNA in serum and long-chain non-coding RNA, circulating tumor cells, and circulating tumor DNA were related to early recurrence; background liver factors, including liver cirrhosis, high viral load, and liver inflammatory activity, were associated with late recurrence.ConclusionsBoth the tumor factors associated with early recurrence and the background liver factors associated with late recurrence can affect the recurrence after radical resection of HCC.
ObjectiveTo summarize the key technical points, applicability, feasibility, and safety of laparoscopic spleen-preserving distal pancreatectomy (LSPDP).MethodA retrospective analysis was performed for the clinical data of 22 patients who were admitted to the Affiliated Hospital of North Sichuan Medical College from September 2016 to November 2019, all patients planned to receive LSPDP.ResultsTwenty of the 22 patients successfully completed LSPDP, and 2 patients converted to laparotomy. One patient was transferred to laparotomy to suture the damaged splenic artery. The spleen was observed to have no ischemia and the spleen preservation operation was continued. One patient was converted to laparotomy due to the difficulty of dissecting the tail of the pancreas which caused by severe abdominal adhesion. The operation time of LSPDP patients was (191±86) minutes (170–480 min), intraoperative blood loss was (365±50) mL (200–1 000 mL), and postoperative hospital stay was (9.9±2.6) days (7–16 d). Six patients of pancreatic fistula occurred after operation, including 3 cases of biochemical fistula, which were cured and discharged after symptomatic treatment, 3 cases of grade B pancreatic fistula, who all improved after anti-inflammatory, acid suppression, enzyme suppression, and double catheter drainage. Twenty patients were interviewed after the operation, and the follow-up time was 3–24 months (median of 15 months). During the follow-up period, no patient had recurrence or metastasis.ConclusionsUnder the conditions of strict screening of suitable cases, adequate preoperative imaging evaluation, intraoperative fine manipulation, and the application of appropriate operating instruments and cutting closure devices, LSPDP is safe and feasible to treat benign tumors of the pancreatic body and tail and some borderline tumors. During the operation, attention should be paid to the reasonable treatment and protection of splenic arteries and veins.