Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Worldwide, hepatocellular carcinoma (HCC) is one of the most common and deadly solid cancers. At least one million new patients are diagnosed annually with this cancer. Incidence in non-Western countries is related to infections of hepatitis B virus and dietary ingestion of aflatoxins, whereas in Western countries alcohol-related cirrhosis and chronic hepatitis C virus infection are leading causes of HCC. In the United States, approximately 155,000 new cases of cancer of the liver and bile duct occur annually, with the majority being colorectal metastases.
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PMID:Radiofrequency ablation of primary and metastatic liver tumors. 1238 70

Four cases of brain metastasis from hepatocellular carcinoma (HCC) associated with hepatitis B virus (HBV) are reported in an area not endemic for HBV infection. Two cases are unusual, since cerebral metastases were the only secondary localization. In these cases, no other sites of metastasization were detected either before or immediately following neurosurgical treatment. In all cases the expression of pRB, p53 and p16 tumor suppressor protein was studied with immunohistochemistry, both, in the primary and metastatic lesions. The pRB expression was as follows: in two cases, lack and moderate expression were observed both, in the primary and in the metastases; in the other two, pRB was not detected. In all cases p53 expression was negative both, in the primary and the metastases. P16 expression was moderately expressed in three cases, both in the primary and the metastases. In one case it was absent. Hepatocarcinogenesis is a multistep process, in which several oncogenes and oncosuppressor genes are involved. In four unusual cases of spread to the brain, we evidenced that tumor suppressor protein expression of p16, p53, and particularly pRB (its aberrated expression is usually associated with metastasis) were altered. We also suggest that HBV and its X protein (HBX) might play an important role in such aggressive behavior of the neoplasia.
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PMID:Brain metastasis from hepatocellular carcinoma associated with hepatitis B virus. 1238 72

The purpose of this study was to determine the molecular relationship between multiple tumour nodules in hepatocellular carcinoma (HCC) within individual patients and to evaluate their clonality, which may bear prognostic significance. In 25 HCC nodules from 11 patients with multiple HCCs, the clonal relationships of the nodules within individual patients were determined using DNA fingerprinting with loss of heterozygosity (LOH) assay, comparative genomic hybridization (CGH), and hepatitis B virus (HBV) integration pattern. Both LOH assay and CGH indicated that in four (36%) of the 11 patients, the multiple HCCs had different clonalities and hence were of multicentric origin, whereas in the remaining seven (64%) patients, the multiple HCCs had similar clonal relationships and were intrahepatic metastases. In selected cases, the HBV integration pattern helped to confirm the clonality results. Gross appearance, size, location, and histology of the tumours could not accurately predict their clonal origin in every case. Assessment of DNA alterations allows precise determination of the clonality of multiple HCCs within one patient. Of these molecular methods, LOH analysis can be used to evaluate tumour clonality in most patients even before surgical resection, since this assay can be readily applied routinely to either liver biopsies or fine needle aspirates.
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PMID:Determination of the molecular relationship between multiple tumour nodules in hepatocellular carcinoma differentiates multicentric origin from intrahepatic metastasis. 1257 36

Current surgical treatments for hepatocellular carcinoma (HCC) include radio-frequency ablation (RFA), resection, and orthotropic liver transplant (OLT). RFA is particularly attractive in these high-risk patients because surgery is associated with high mortality and there is a relative scarcity of organs available for those in need of transplants. This study was performed to evaluate the management of cirrhotic patients with HCC undergoing RFA at a single Western institution. A retrospective study from March 1999 to June 2002 was performed to evaluate the clinicopathologic and treatment-related variables in cirrhotic patients with HCC. Forty-nine lesions in 26 patients with HCC and cirrhosis underwent RFA. Data was analyzed for safety and overall survival as the main endpoints. The mean age was 60.4 +/- 11 years, 19 patients were male, 5 had hepatitis B virus, and 19 had hepatitis C virus. The Child classification was 26 per cent, 39 per cent, and 35 per cent for A, B, and C; the number of lesions was 1 in 62 per cent, 2 in 23 per cent, and more than 2 in 15 per cent. The approach was laparoscopic in 58 per cent, percutaneous in 15 per cent, and open in 27 per cent. There were no mortalities and only 1 complication. Average hospital stay was 2.7 +/- 2 days. Subsequent to RFA, 9 patients underwent an OLT within a median of 4.1 months. The median follow-up of the whole group was 13 months and the disease-free survival 9.3 months. Tumor recurrence was identified in 3 previously ablated lesions, nonablated liver in 11, and as pulmonary metastases in 3. Overall survival (P = 0.03) was prolonged for those treated with RFA + OLT over RFA alone. We conclude that RFA is a safe ablative technique in high-risk cirrhotic patients with HCC. This technique may provide a bridge to OLT; however, it remains to be proven whether it prolongs survival in those who do not undergo OLT.
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PMID:Radio-frequency ablation in cirrhotic patients with hepatocellular carcinoma. 1470 Feb 92

Hepatocellular carcinoma is a relatively common tumor that etiologically is closely linked to previous hepatitis B infection. Oral metastatic hepatocellular carcinoma is very rare, with only 61 cases reported in the literature. We describe a case of hepatocellular carcinoma metastatic to the anterior mandibular gingivae of a 60-year-old man. The patient also exhibited tumor metastases to the lungs, left knee, little finger of the left hand, scalp, and the skin of the neck. He died 6 months after the diagnosis of the oral metastasis because of systemic tumor dissemination.
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PMID:Oral metastasis of a hepatocellular carcinoma. 1502 61

Reactivation of hepatitis B virus (HBV) after cytotoxic chemotherapy is a serious problem, and it occurred to 41% of breast cancer patients carrying HBV. Previous studies have demonstrated that lamivudine was effective for HBV flare-up during cytotoxic chemotherapy. We aimed to monitor the HBV status of breast cancer patients undergoing chemotherapy with preemptive lamivudine over time. Six breast cancer patients carrying hepatitis B surface antigen (HBsAg) were monitored during chemotherapy, five in the adjuvant setting and one with metastatic disease. Preemptive lamivudine was given throughout the chemotherapy course. HBsAg, HBV envelope antigen (HBeAg), anti-HBV envelope antibody (HBe Ab), serial serum alanine transaminase (ALT), quantitative HBV viral DNA analysis, and HBV DNA precore promoter and precore sequence were monitored. One patient carried wild type and the other five precore mutant strain of HBV by examination of HBV sequence in precore promoter and precore region. No evident HBV reactivation developed, and all patients tolerated lamivudine well. During the 6-to-8-month follow-up after cessation of cytotoxic therapy and withdrawal of lamivudine, serum ALT remained unchanged, although an increase of HBV DNA levels in four patients was found. No emergence of the tyrosine-methionine-aspartate-aspartate (YMDD) lamivudine-selective resistant strain was observed in the six patients. Preemptive use of lamivudine can effectively prevent reactivation of HBV in breast cancer patients receiving postoperative adjuvant chemotherapy. Lamivudine can be discontinued safely without emergence of lamivudine-resistant HBV strain or rebound HBV flare-up. The candidate for the use of preemptive lamivudine in HBV carriers who need short-term chemotherapy remained to be investigated
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PMID:Preemptive use of lamivudine in breast cancer patients carrying hepatitis B virus undergoing cytotoxic chemotherapy: a longitudinal study. 1507 16

Matrix metalloproteinases (MMPs) play a major role in the turnover of extracellular matrix (ECM) during cancer invasion and metastasis, and tissue inhibitors of metalloproteinases (TIMPs) control MMPs, thus maintaining a balanced ECM catabolism under physiological conditions. The aim of this study was to assess the behavior of some MMPs (FASEB J., 7, 1993, 1434; Cancer Metastasis Rev., 9(4) 1990, 289) and TIMPs (Biochem. Biophys. Res. Commun., 301, 2003, 1069; FASEB J., 7, 1993, 1434; Nature, 370, 1994, 61). Competitive RT-PCR, gelatin-substrate zymography, and ELISA techniques were used for quantification. The hepatitis B virus (HBV)-DNA-containing hepatocellular carcinoma cell lines, Hep3B, HepG2-HBV and HFF-T2 contain highly activated matrix metallproteinase-9 (MMP-9), which is rarely found in normal liver cell lines such as the Chang lines. MMP-9 activities of HFH-T2, HepG2-HBV and Hep3B were significantly higher than that of non-HBV-hepatocellular carcinoma SK-Hep1 and HepG2 (HCC origin, HBV not detected), as assayed by gelatin zymography. Low levels of TIMP-1 and TIMP-3 were observed in HFH-T2, HepG2-HBV and Hep3B, while the TIMP-2 level was high, as evidenced by reverse zymography. In contrast, 3 TIMP-1, -2 and -3 were largely detected in Chang, HepG2 and SK-Hep1 cells. To investigate the nature of the quantitative regulation of MMPs and TIMPs for these cell lines at the transcriptional levels, a reverse transcriptase-polymerase chain reaction (RT-PCR) was carried out. Not only MMP-9 mRNAs of HFH-T2, HepG2-HBV and Hep3B but also MMP-9 mRNA of SK-Hep1 and HepG2 were highly expressed with no major differences among these four cell lines. However, TIMP-1 and TIMP-3 mRNAs of HFH-T2, HepG2-HBV and Hep3B were markedly reduced, while those of SK-Hep1, HepG2 and Chang cells were maintained at high levels. Finally, an invasion assay using matrigel indicated in an increase in invasiveness in HFH-T2, HepG2-HBV and Hep3B cells, but a decrease in invasiveness of Chang, HepG2 and SK-Hep1 cells. These results indicate that the overexpression of MMP-9 mRNAs and the suppression of TIMP-1 and TIMP-3 in HFH-T2, HepG2-HBV and Hep3B were the result of HBV transfection. Based on these results, it is concluded that HBV affects the malignance of hepatocellular cancer by elevating MMP-9 activity, and suppressing TIMP-1 and TIMP-3.
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PMID:Association of a high activity of matrix metalloproteinase-9 to low levels of tissue inhibitors of metalloproteinase-1 and -3 in human hepatitis B-viral hepatoma cells. 1531 74

We studied one case in which the application of RFA was used for colorectal liver metastases with cirrhosis. The patient was a 51-year-old male. Sigmoid colon cancer and hepatocellular cancer (S5, S6, S8) were diagnosed before surgery. RFA was planned, as resection was determined to be impossible, because of reduced reserve liver function due to hepatitis B and cirrhosis. Resection of the Sigmoid colon was performed. Rapid pathological diagnosis was performed on the liver tumor and it was determined to be metastases from the sigmoid colon cancer. RFA was performed on the liver tumor with the expectation of local control. After the operation, WHF arterial infusion was performed as an outpatient, but the blood platelet count decreased and that resulted in impaired liver function making the continuation of WHF arterial infusion at a regular pace difficult. After 11 months from the operation, multiple recurrences appeared and the infusion was restarted. Consequently, the tumor size was reduced. Following the infusion, however, the liver function became impaired and there was no choice but to discontinue the infusion. After one year and 9 months from the operation, multiple recurrences appeared in the residual liver and WHF arterial infusion was restarted. The tumor size gradually reduced after the infusion and only S3 currently remains with good local control. Because this example was a case with multiple metastases along with a high level of liver function impairment, RFA was tested and good local control was achieved. In cases such as these where liver resection is not possible, local ablation therapies including RFA are applicable.
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PMID:[The use of radio frequency ablation (RFA) for colorectal liver metastases in one patient]. 1555 48

This 44-year-old woman developed multifocal hepatocellular carcinoma (HCC) within hepatitis B-induced liver cirrhosis. At the time of listing for transplantation the HCC had progressed beyond the Milan criteria. Due to her young age, high grade of histological differentiation according to biopsy, and lack of therapeutic alternatives, she was listed for transplantation. She received an organ from the Eurotransplant marginal liver list. Immunosuppression was reduced to tacrolimus monotherapy within 4 months. Five months after transplantation bilateral bulky ovarian metastases were seen on computed tomography (CT) scan. A bilateral salphingo-oophorectomy was performed and immunosuppression switched to sirolimus monotherapy. Fourteen months after this procedure and 19 months after transplantation, the patient is asymptomatic with stable liver function. She is free of recurrence as judged by CT scan, bone scan, and alpha-fetoprotein. In conclusion, radical surgical treatment and immunosuppression using sirolimus may achieve tumor-free survival in selected patients with advanced or recurrent HCC.
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PMID:Successful use of sirolimus in a patient with bulky ovarian metastasis of hepatocellular carcinoma after liver transplantation. 1596 74

The use of conformal radiotherapy (RT) and the follow-up of patients for radiation liver toxicities has led to a quantitative understanding of partial liver RT tolerance. The most common toxicity is radiation-induced liver disease (RILD), a syndrome of anicteric ascites and hepatomegaly. Elevation of transaminases and reactivation of viral hepatitis have also been reported after liver RT. The Lyman normal tissue complication probability (NTCP) model and a local damage-organ injury NTCP model have been used to describe the partial tolerance of the liver to RT. The liver exhibits a large volume effect and a low threshold volume for RILD. The RT tolerance of the liver is reduced in patients with primary liver cancer versus metastases. Elevated transaminases are more common in the presence of poor liver function and hepatitis B infection. If the effective liver volume irradiated is less than 25%, very high RT doses may be delivered with little risk of liver toxicity. The mean liver doses associated with a 5% risk of classic RILD for primary and metastatic liver cancer are 28 Gy and 32 Gy, respectively, in 2 Gy per fraction.
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PMID:Partial volume tolerance of the liver to radiation. 1618 82


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