Objective To evaluate the value of MRI and MDCT in detecting both inferior vena cava tumor thrombus and vena cava wall invasion in renal cell carcinoma. Methods Databases including PubMed, EMbase, The Cochrane Library, MEDLINE (Ovid), CBM, CNKI, VIP and WanFang Data were searched from January 2000 to February 2012. Relevant studies were screened on the basis of the inclusion and exclusion criteria, and then quality assessment and data extraction were conducted. Then heterogeneity test and meta-analysis were conducted using RevMan 5 and Meta-disc 1.4. Results A total of 6 trials involving 244 patients and 246 cases of renal cell carcinoma were included. The results of meta-analysis showed that, for the MRI group and the MDCT group, the sensitivity was 0.963 and 0.952, the specificity was 0.969 and 0.979, the value of +LR was 9.759 and 15.57, the value of −LR was 0.091 and 0.108, and the dOR was 198.71 and 251.54, respectively. There were no significant differences in pooled effect-size among groups (Pgt;0.05). The area under curve (AUC) of summary ROC curve analysis as well as Q index of the MDCT group were 0.981 8 and 0.940 7, respectively. Conclusion There is no significant difference in the value of MRI and MDCT in detecting inferior vena cava tumor thrombus induced by renal cell carcinoma. More original studies on vena cava wall invasion by tumor thrombus should be conducted in the future due to the limitation of current materials.
Objective To investigate the expressions of platelet derived growth factor (PDGF) and survivin in hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) and to evaluate the relationships among the expressions of PDGF, survivin and the proliferation of cancer cells. Methods The expression of PDGF mRNA in 16 cases in HCC with PVTT group was observed by in situ hybridization and the results were compared with that in HCC tissue group. The expressions of PDGF and survivin protein in 36 cases in HCC with PVTT group were detected with immunohistochemistry and it was found that there was a correlation between them. Flow cytometry (FCM) was used to measure the proliferation of cancer cells and it was also used to analyze the relations among PDGF, survivin and the proliferation of cancer cells. Results The expression level of PDGF mRNA in HCC with PVTT group was significantly higher than that in HCC tissue group (P＜0.01). There was a positive correlation between the expressions of PDGF and survivin protein in HCC with PVTT (P＜0.01). The degree of proliferation of cancer cells in PDGF and survivin protein positive group was significantly higher than that in negative group (P＜0.01). Conclusion PDGF and survivin gene over-expressed in HCC with PVTT group and there is a positive correlation between the expressions of PDGF and survivin protein. The proliferation of cancer cells increases as the expressions of PDGF and survivin increase.
Objective To evaluate the effectiveness and prognosis of patients in advanced hepatocellular carcinoma (HCC) with portal vein (PV) tumor thrombus received external-beam radiation therapy (EBRT). Methods The clinical data of 126 HCC patients with PV tumor thrombus who were referred for EBRT at our institution from January 2000 to November 2009 were analyzed retrospectively. EBRT was designed to focus on the tumor thrombus with or without primary intrahepatic tumors， to deliver a median total conventional dose of 50 Gy (range of 30-60 Gy). Predictors of survival were identified using univariate and multivariate analysis. Results Unfavorable pretreatment predictors were associated by multivariate analysis with lower albumin and higher α-fetoprotein levels, poorer Child-Pugh liver function classification, poorer intrahepatic tumor control， lymph node metastases， and the two-dimensional EBRT technique. The dose of EBRT showed no significant in both univariate and multivariate survival analysis. Conclusions In patients with HCC， EBRT is effectively prevents progression in cases of PV tumor thrombus， but palliative dose of EBRT is not related to survival.EBRT is not related to survival.