ObjectiveTo evaluate the effect and safety of sorafenib in patients with advanced hepatocellular carcinoma(HCC). MethodsThe computer-based search in Pubmed, Embase, Science Citation Index, and Cochrane for phaseⅡandⅢclinical trial related to sorafeinib in advanced HCC were conducted. Data abstraction and quality assessment were conducted according to enrolled criteria. Meta-analysis was performed by REVMAN 5.2 version, evidence recommendation was conducted by GRADE 3.6 version, which classify evidence level into:extremely low quality evidence, low quality evidence, moderate quality evidence, and high quality evidence. ResultsFive studies were included, 4 randomization control trial(RCT), 1 prospective no-randomization control clinical trial. Meta-analysis indicated that overall survival, time to progression, and disease control rate in sorafenib treatment group were higher than those in control group(P < 0.05). In addition, the incidence of hand-foot skin reaction, rash/desquamation, hypertention, and dirrahea in soafeinib treatment group were higher than those in control group(P < 0.05). ConclusionSorafeinib can prolong the overall survival, time to progression, and disease control rate in patients with advanced HCC, but there is still no evidence that sorafenib can improve tumor response in these patients.
ObjectiveTo identify the risk factors of central lymph nodal (CLN) metastasis in papillary thyroid carcinoma (PTC) and indicate central neck dissection. MethodsFifty cases were analyzed retrospectively. The BRAFV600E gene mutation was analyzed by sequencing and expression of VEGF-C was analyzed by using immunohistochemically. The clinicopathologic and molecular marker factors relating to CLN metastasis were analyzed. ResultsThe BRAFV600E gene mutation was found in 30 of 50 (60.0%) patients of PTC. Univariate analysis showed that BRAFV600E gene mutation of PTC patients was significantly correlated with high expression of VEGF-C (87.5% vs. 34.6%,P=0.000), not with clinicopathologic factors. High expression of VEGF-C was significantly correlated with CLN metastasis in PTC (87.5% vs. 57.7%, P=0.019). Multivariate analysis showed that invasion of the surrounding tissues (P=0.009,OR=9.082,95% CI:1.748-47.185) and the high expression of VEGF-C (P=0.009,OR=9.082,95% CI:1.748-47.185) were independent risk factors for the presence of CLN metastases. Conclusions①The BRAFV600E gene mutation for PTC patients is significantly correlated with high expression of VEGF-C, not with CLN metastasis in PTC. ②High expression of VEGF-C is significantly correlated with CLN metastasis in PTC. ③Tumor extrathyroidal extension, especially invasion of the surrounding tissues is significantly correlated with CLN metastasis in PTC.