Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0019204 (hepatocellular carcinoma)
 71,386 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The selective and long-term deposition of iodized oil in the hepatocellular carcinoma (HCC) and its gradual drainage were clinicopathologically analyzed in 13 cases. All patients were Japanese and had an intrahepatic arterial injection of Lipiodol (LIP) mixed with Mitomycin C. The comparison among the follow-up computerized tomography (CT) findings, the observation of the soft x-ray radiogram, and histopathologic studies of the surgical or autopsy materials revealed that the selective deposition of LIP in HCC lasted for a long term, particularly in cases treated by LIP combined with transcatheter arterial embolization (TAE). Also revealed was an extremely gradual decrease of LIP from the HCC. It was thus postulated that, mainly, the accumulated macrophages surrounding LIP around the necrotic cancer tissue and, partially, the intrahepatic lymphatic system itself contributed to this drainage. Further, in histologic sections with lipid staining, x-ray microanalysis proved that the lipid droplets in the cancer tissue included highly concentrated iodine, as a deposition of LIP.
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PMID:Selective and persistent deposition and gradual drainage of iodized oil, Lipiodol in the hepatocellular carcinoma after injection into the feeding hepatic artery. 245 57

Reported is a case that was treated successfully with a percutaneous intratumoral injection of a CDDP-PC-Lipiodol Suspension (CPLS) of the viable tumor cells of a hepatoma after arterial injection therapy. Although the size of the viable tumor cells remained almost unchanged, a marked reduction in the level of the plasma AFP (484 ng/ml-35 ng/ml) was obtained after the percutaneous injection. No major complication was encountered except for minimal vomiting and mild transient abnormalities of the liver functions.
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PMID:[A case of hepatoma treated successfully with a percutaneous intratumoral injection of CDDP-PC-lipiodol suspension]. 246 10

Plasma abnormal prothrombin (protein induced by vitamin K absence or antagonist-II: PIVKA-II) was evaluated as a serological marker for hepatocellular carcinoma (HCC). Its plasma levels were measured by enzyme immunoassay using an anti-PIVKA-II monoclonal antibody in 1010 patients with various diseases. Of 192 patients with HCC, 116 (60%) had abnormal PIVKA-II levels greater than 0.1 AU/ml. Elevation of PIVAK-II levels was observed rarely in chronic hepatitis, liver cirrhosis and other malignant tumors. Plasma PIVKA-II levels in HCC increased with tumor size. Normal levels were observed in patients with tumors measuring 2 cm or less in diameter. As a result, diagnostic application of plasma PIVKA-II levels to small liver tumors is limited. The sensitivity of PIVKA-II in the diagnosis and monitoring of HCC was increased by serial and simultaneous determinations of AFP, because high PIVKA-II levels were observed more often in low AFP-producing HCC patients. In some patients with HCC, plasma PIVKA-II levels decreased after surgical resection of the tumor or chemoembolization with cisplatin suspended in Lipiodol (LPS), but later rose again with recurrence of the disease. Elevated plasma PIVKA-II levels were not related to low vitamin K concentration in the serum. In fact, in many patients vitamin K administration resulted in only a moderate reduction of PIVKA-II levels. From these results, plasma PIVKA-II assay by the EIA method using a monoclonal antibody is a useful tool for the diagnosis and monitoring of HCC, particularly in HCC patients with low AFP levels.
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PMID:[Clinical usefulness of plasma PIVKA-II assay and its limitations in patients with hepatocellular carcinoma]. 247 53

Antitumor effect and reduction of tumor size by some cytokines as Biological Response Modifier have been demonstrated by various studies. Endogenous tumor necrosis factor is produced from macrophage. To increase the antitumor effect of transcatheter arterial embolization (TAE) in hepatocellular carcinoma (HCC), we treated 7 HCC patients with endogenous tumor necrosis factor (ETNF) which was induced by hepatic arterial injection of gamma-IFN (1.0-3.0 X 10(6) IU) as priming agent and OK-432 (2-5 KE) as triggering agent. TAE was performed with Lipiodol, ADM and gelatin sponge on 3-10 days after the induction of ETNF. TNF activity was detected in 2 cases and suspected to depend on the dose of gamma-IFN and OK-432. Serum alpha-Fetoprotein levels after the injection of ETNF began to decrease from 3-30 days in 5 patients and remained unchanged in 2 cases. Serum alpha-Fetoprotein levels after TAE with the induction of ETNF were decreased 1-5 months in 5 cases. Reduced size and low-density area on CT scan in 3 advanced cases after these procedures were no different from those of HCC patients treated with TAE alone. In one of two inoperable cases with a single mass lesion in the liver, CT scan after one more added TAE following these procedures showed a low-density area around the Lipiodol uptaking tumor, indicating obstruction of the peripheral portal vein. CT scan of another case revealed low density around Lipiodol in the tumor, which showed complete necrotic change. In all cases, middle-grade fever and hypotension were seen transiently, but these subsided by symptomatic treatment. The antitumor effect of TAE in HCC might be enhanced with ETNF induced by hepatic arterial injection of a low dose of gamma-INF and OK-432.
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PMID:[Transcatheter arterial embolization with hepatic arterial induction of endogenous TNF in hepatocellular carcinoma]. 247 66

Twenty-seven patients with unresectable hepatocellular carcinoma (HCC) were treated with Cisplatin-Phosphatidyl-choline-Lipiodol (CPL) suspension. PR was obtained in two of ten cases (20%) by one shot therapy. AFP decreased in 9 of 10 patients by one shot therapy with a 62.1% rate of decrease. In all of 13 patients by TAE, AFP decreased and the rate of decrease was 64.8%. The concentration of CDDP in the peripheral venous blood was lower and continued longer than that of CDDP on the market. Nausea, vomiting and fever were noted in most cases as adverse effects, but they were slight. These results suggest that CPL agents were very chemotherapeutic for unresectable HCC.
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PMID:[Chemotherapy with Cisplatin-Phosphatidyl-choline-Lipiodol (CPL) suspension in unresectable hepatocellular carcinoma]. 247 69

A method to prepare cisplatin suspended in an oily lymphographic agent, Lipiodol (LPS), has been established to deliver cisplatin to hepatocellular carcinoma (HCC) by the hepatic artery. Seventy-one patients, one Stage I, 16 Stage II, 16 Stage III, and 38 Stage IV, were treated with LPS therapy. A partial response was obtained in 33 cases (46.5%), a minor response in 20 cases (28.2%), and no change in 18 cases (25.3%). In 34 patients whose serum alpha-fetoprotein (AFP) levels were greater than 400 ng/ml, the serum AFP levels decreased in 31 patients (91.2%). The AFP decreased by more than 50% in 25 cases (73.5%) and more than 75% in 19 cases (55.9%). The plasma des-gamma-carboxy prothrombin (DCP) levels decreased in all of the 26 DCP-positive patients. The survival rate was 77% at 6 months and the 1-year survival rate was estimated to be 55%. The patients treated with LPS therapy survived longer compared with patients given Lipiodol containing neocarzinostatin by the hepatic artery. Complications such as acute gastroduodenal mucosal lesions (24%), cholecystitis (2.8%), pancreatitis (7%), delayed jaundice (7%), and hepatic encephalopathy (4.2%) were observed after therapy. The peak plasma platinum (Pt) concentrations determined as ultrafilterable Pt occurred 5 to 20 minutes, and 5 to 60 minutes as total Pt after the end of LPS injection. The Pt concentrations in the tumor tissues were 42 times higher in four operated cases and 7.1 times higher in six autopsy cases than those in the nontumorous tissue. These results suggest that LPS selectively accumulates in the HCC, is long-lasting and gradually releases the drug. In addition it is effective as a new anti-cancer therapy for hepatocellular carcinoma.
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PMID:Hepatic arterial injection chemotherapy with cisplatin suspended in an oily lymphographic agent for hepatocellular carcinoma. 247 31

Choice of treatment for HCC depends mainly on the size of tumor and patient's liver function because more than 80% of HCC patients are associated with liver cirrhosis. Percutaneous ethanol injection therapy (PEIT), transcatheter arterial embolization (TAE) and intraarterial infusion chemotherapy are, at present, commonly used treatments for HCC in Japan. PEIT is a safe and reliable treatment, in which absolute ethanol is injected to the tumor through a fine needle under US guide. PEIT is indicated for tumors of small size, which can not be removed surgically. The survival rate of PEIT for small liver cancer, less than 2 cm in diameter, is similar with the one of surgically removed cases. TAE is indicated for advanced HCC. Chemoembolization with Lipiodol is commonly used with good result. After TAE has been often performed, the survival rate of HCC patients was dramatically increased. In future, TAE combined with percutaneous transhepatic portal embolization or PEIT would be applied more often to obtain complete destruction of the lesion for advanced HCC. Intraarterial infusion chemotherapy is indicated for advanced HCC, in which TAE can not be performed. MMC, ADM and CDDP are commonly used anti-cancer drugs. Recently frequent infusion of these drugs has become possible by using implantable reservoir with good result. We have performed chemosensitivity test by SRCA for HCC specimens obtained by biopsy using a fine needle.
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PMID:[Non-surgical (medical) treatment of hepatocellular carcinoma (HCC)]. 253 69

Physicochemical properties of two types of adriamycin preparation, suspensions and emulsions prepared for i.a. chemotherapy of hepatocellular carcinoma, were investigated. A suspension was prepared by dispersing adriamycin directly into the lipid contrast medium, Lipiodol, whereas an emulsion was obtained by emulsifying an aqueous solution of adriamycin into Lipiodol. The dispersibility of the drug in each preparation was examined microscopically. The chemical stability of and drug release from the preparation were determined by high-performance liquid chromatography and spectrophotometry, respectively. The suspension was then given to ten patients with primary hepatocellular carcinoma. The suspension maintained good dispersibility without coagulation of drug particles, whereas coalescence of aqueous droplets and the resultant phase separation occurred 4 h after preparation of the emulsion. Both preparations maintained the initial drug content for at least 1 week at room temperature. The release of adriamycin was more prolonged in the suspension than in the emulsion. After i.a. administration of the suspension, a selective accumulation of Lipiodol in the tumor and decrease in serum alpha-fetoprotein (AFP) levels were found in most patients. A significant amount of adriamycin was still detected in hepatic specimens resected from two patients 1 and 2 months after treatment. These findings suggest that the adriamycin-Lipiodol suspension may be a useful preparation for targeting chemotherapy to hepatocellular carcinoma.
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PMID:Adriamycin-lipiodol suspension for i.a. chemotherapy of hepatocellular carcinoma. 253 50

We established a preparation method for the suspension of cisplatin in Lipiodol (LPS) and applied it by intra-hepatic artery injection for the treatment of advanced hepatocellular carcinoma. We defined that stage IV carcinoma as characterized by tumor spread more than one lobe (H4) or by tumor emboli in the major branches of the portal vein (Vp3) or by distant metastasis (M1). According to this definition, 20 patients of stage IV were treated by this therapy, and evaluated the survival using Kaplan-Meier method. A reduction in tumor size more than 25% was observed in 11 of 20 patients (55%). In 4 of these cases (20%), over 50% of tumor reduction was obtained. In 15 patients whose serum alpha-fetoprotein (AFP) levels were higher than 400 ng/ml, a decrease more than 50% was noted in 9 of the 15 patients (60%). Sixty per cent survival rate was obtained at 6 month. A statistical by significant difference was obtained in the survival patterns between this therapy and other intra-arterial chemotherapy. The factors that influenced on the survival significantly were AFP levels (over 10,000 ng/ml), Vp3 and M1. However, tumor size and intrahepatic metastasis, etc. were not significant factors. LPS therapy seemed to be effective to even stage IV hepatocellular carcinoma and could be applied further.
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PMID:[Intra-arterial injection of cisplatin suspension in lipiodol (LPS) for the treatment of advanced hepatocellular carcinoma (stage IV)]. 253 53

Eighteen patients with 22 hepatocellular carcinoma (HCC) lesions less than 2 cm in diameter were examined with conventional angiography, digital subtraction angiography (DSA), and computed tomography (CT) after intraarterial injection of iodized oil (Lipiodol CT). Eight lesions detected at ultrasound examination of eight patients were not identified at conventional angiography, DSA, or Lipiodol CT. At histologic examination, all eight lesions were found to consist of well-differentiated carcinoma of grade I or II on the Edmondson-Steiner scale, and four had fatty change in cancer cells. Percutaneous tissue-core biopsy was indispensable in the diagnosis of well-differentiated HCC lesions that could not be diagnosed with conventional angiography, DSA, and Lipiodol CT.
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PMID:Hypovascular hepatocellular carcinoma undetected at angiography and CT with iodized oil. 253 7


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