Objective To explore the research progress in molecular mechanisms, clinical diagnosis and treatment of single cell sequencing (SCS) techniques in the progression of colorectal cancer liver metastasis (CRLM). Method The literatures on SCS in CRLM at home and abroad in recent years were reviewed. Results SCS technology could perform high-throughput sequencing on the genetic information of different cell subsets at the single-cell level, which was helpful to explore the molecular mechanism of action in the occurrence, development, metastasis, immune escape and drug resistance of colorectal cancer liver metastasis. Thus making the clinical diagnosis, treatment, and prognosis of colorectal cancer more accurate. Conclusion SCS technology, as an emerging sequencing technology, can provide us with updated ideas and more perspectives to explore the occurrence and development of tumors and the prevention and treatment of tumors.
Objective To investigate the risk factors of liver metastasis in patients with middle and low rectal cancer of Ⅱ–Ⅲ stage after preoperative short course radiotherapy combined with chemotherapy. MethodsThe clinical data of 89 patients with middle and low rectal cancer of Ⅱ–Ⅲ stage admitted to the Dongnan Hospital of Xiamen University from January 2019 to June 2020 were retrospectively analyzed. All patients were treated with short-course radiotherapy combined with chemotherapy before operation. The risk factors of postoperative liver metastasis were analyzed by multivariate logistic regression. ResultsThe 89 patients were followed up for 7–53 months, with a median follow-up time of 33 months. During the follow-up period, 25 patients developed liver metastasis, the onset time was 7–35 months, and the median time of liver metastasis was 17 months. Among them, 5 patients (5.6%) developed liver metastasis in the first year after surgery, 15 patients (16.8%) developed liver metastasis at the second year after surgery, 5 patients (5.6%) developed liver metastasis at the 3rd year after surgery. Multivariate logistic regression results showed that lymph node metastasis [OR=3.550, 95%CI (1.425, 8.953), P=0.041], vascular invasion [OR=3.335, 95%CI (1.011, 11.001), P=0.048], maximum tumor diameter ≥5 cm [OR=4.477, 95%CI (1.273, 15.743), P=0.019], and peri-tumor diameter ≥1/2 [OR=4.633, 95%CI (1.387, 15.475), P=0.013] were risk factors for liver metastasis. ConclusionsLymph node metastasis, vascular invasion, maximum tumor diameter ≥5 cm, and circumferential tumor diameter ≥1/2 are risk factors for liver metastasis in patients with middle and low rectal cancer of Ⅱ–Ⅲ stage after preoperative short course radiotherapy combined with chemotherapy.
ObjectiveTo understand the latest progress of transcatheter arterial chemoembolization (TACE)-based combination therapies for unresectable liver metastasis from colorectal carcinoma, and to explore the safe and effective combination therapies in order to controlling the rapid progress of disease and improving the quality of life of patients.
MethodsThe literatures about TACE-based combination therapies of liver metastasis from colorectal carcinoma and the latest advance in researches of this field at home and abroad were collected, and the application of combination therapies, the advantages and features of the combined treatments were reviewed.
ResultsTACE was a safe and effective therapeutic modality in treating primary liver cancer or secondary liver cancer.Compared with a single treatment, TACE-based combination therapies had distinct advantages to patients with liver metastasis from colorectal carcinoma not only improved the quality of life but also prolonged the survival time.With the emerging of various kinds of new drugs and the rapid development of a variety of interventional treatments, it could bring long-term survival benifit for patients with liver metastasis from colorectal carcinoma.
ConclusionsDoctors should pay attention to the combined treatments of patients with liver metastasis from colorectal carcinoma, improve the knowledge of personalized medication about advanced tumors and actively promote more usage of combination therapies.
ObjectiveTo summarize the molecular mechanisms and clinical treatment of gastric cancer with liver metastasis (GCLM), in order to provide new ideas for future treatment. MethodThe literatures about mechanism and treatment strategy of GCLM in recent years were searched and reviewed. ResultsMost patients with gastric cancer were in advanced stage or had developed distant metastases when they were first diagnosed, among which liver was the common site of metastasis. The complex molecular mechanisms of GCLM had not been fully clarified. Molecular mechanisms at different levels, including non-coding RNA, circulating tumor cells, exosomes, tumor microenvironment and signaling pathways, were relatively independent and interacted with each other, providing potential biomarkers and therapeutic targets for GCLM. At present, the best treatment method for patients with GCLM was mainly divided into local and systemic treatment. The local treatment included surgical treatment, radiofrequency ablation and proton beam therapy, while the systemic treatment included systemic chemotherapy, targeted therapy and immunotherapy, among which the targeted therapy and immunotherapy were the focus of recent research. ConclusionsThe mechanism of GCLM is the result of the interaction between tumor cells and the microenvironment at the site of metastasis. Understanding them is of great significance to guide clinical treatment and prognosis. At present, there is no unified treatment standard for GCLM. To achieve the ideal treatment effect, we should not only rely on single therapy, but also adopt multi-disciplinary and individual therapy according to the specific disease status of patients and the nature of tumors.
Objective
To explore the clinicopathologic features and treatment of desmoplastic small round cell tumor (DSRCT).
Methods
By summarizing the diagnosis and treatment of a DSRCT patient with liver metastasis, who was admitted to Department of Liver Surgery in West China Hospital in October 2017, and exploring its clinicopathologic features and treatment by reviewing literatures.
Results
This patient was generally in good condition, after the multi-disciplinary discussion between the imaging physician, the oncologist, and the liver surgeon, it was considered that there were indications of operation, and after communicating with the patient’ families, actively chose surgical treatment. The performance was successful, and this patient was treated with adjuvant chemotherapy postoperatively. The operative time for this patient was 5 hours, and blood loss was 600 mL. There was no complication occurred, such as bleeding, bile leakage, and intestinal fistula, and discharged on 8 days after surgery. This patient was followed up for 10 months, without tumor recurrence and metastasis occurred. The results of literatures showed that, DSRCT was more common in young male population, the mean age was 12–27 years old, the longest median survival time was 39.2 months, and 3-year survival rate was 20.8%–71%. Those patients who received surgery, had longer median survival time.
Conclusions
DSRCT is a rare aggressive soft tissue sarcoma, which is usually diagnosed with multiple organ metastases. The treatment is mainly multi-mode treatment based on surgical resection combined with radiotherapy and chemotherapy, but the overall prognosis is poor.
Objective
To investigate the mechanism, manifestation, diagnosis and treatment of liver metastasis from breast cancer.
Methods
The literatures on liver metastasis of breast cancer in PubMed and CNKI Journal Full-text Database were reviewed.
Results
There are many related studies on the liver metastasis of breast cancer. The diagnosis methods of breast cancer with liver metastasis include CT, B-ultrasound, magnetic resonance imaging, inspection related serological index, pathological biopsy, etc. In the treatment, including systemic treatment and local treatment. However, the transfer mechanism has not been fully clarified, and the clinical manifestations are more prominent.
Conclusions
Although the liver metastasis of breast cancer incidence is relatively low, but seriously affected the quality of life of patients with breast cancer and prognosis, it is needed to further study and explore the mechanism, provide the basis for the diagnosis and treatment of liver metastasis of breast cancer, achieve long-term prognosis better.
ObjectiveTo evaluate effect of RAS gene mutation after liver metastasis resection on overall survival (OS) and disease-free survival (DFS) for patients with colorectal cancer combined with liver metastasis. MethodsA comprehensive and systematic literature search in the PubMed and other databases was conducted, with the final search ending on January 5, 2022. The impact of RAS gene mutation after liver metastasis resection on survival of patients with colorectal cancer combined with liver metastasis was analyzed by the Stata 12.0 software and Review Manager version 5.3 software, meanwhile which were analyzed according to subgroups, including study type (retrospective and prospective studies), region (Asian and European), and number of RAS gene mutation sites (>2 and ≤2). ResultsA total of 26 studies with 13 356 patients were included. The integrated analysis results showed that the patients with RAS mutations had statistically shorter OS [HR=1.54, 95%CI (1.43, 1.65), P<0.001] and DFS [HR=1.32, 95%CI (1.19, 1.44), P<0.001] as compared with RAS wild-type. Except the 1-year overall survival rate, the 2–5-year overall survival rate and 1–5-year disease-free survival rate of patients with RAS gene mutation were statistically lower than those of patients with RAS wild-type (P<0.05). The results of subgroup analysis showed that no matter retrospective and prospective studies, as well as studies in Asian and European countries, it was found that the OS and DFS for patients with RAS gene mutation were shorter than those of patients with wild-type (P<0.05); At the same time, subgroup analysis of the number of RAS gene mutation sites showed that OS and DFS of patients with number of mutation sites >2 were shortened as compared with ≤2 (P<0.05). ConclusionFrom the overall analysis results, the survival of patients with RAS gene mutation after liver metastasis resection is worse than that of patients with RAS wild-type for patients with colorectal cancer combined with liver metastasis.
Objective
To determine feasibility of texture analysis of CT images for the discrimination of hepatic epithelioid hemangioendothelioma (HEHE) and liver metastases of colon cancer.
Methods
CT images of 9 patients with 19 pathologically proved HEHEs and 18 patients with 38 liver metastases of colon cancer who received treatment in West China Hospital of Sichuan University from July 2012 to August 2016 were retrospectively analyzed.
Results
Thirty best texture parameters were automatically selected by the combination of Fisher coefficient (Fisher)+classification error probability combined with average correlation coefficients (PA)+mutual information (MI). The 30 texture parameters of arterial phase (AP) CT images were distributed in co-occurrence matrix (22 parameters), run-length matrix (1 parameter), histogram (4 parameters), gradient (1 parameter), and autoregressive model (2 parameters). The distribution of parameters in portal venous phase (PVP) were co-occurrence matrix (18 parameters), run-length matrix (2 parameters), histogram (7 parameters), gradient (2 parameters), and autoregressive model (1 parameter). In AP, the misclassification rates of raw data analysis (RDA)/K nearest neighbor classification (KNN), principal component analysis (PCA)/KNN, linear discriminant analysis (LDA)/KNN, and nonlinear discriminant analysis, and nonlinear discriminant analysis (NDA)/artificial neural network (ANN) was 38.60% (22/57), 42.11% (24/57), 8.77% (5/57), and 7.02% (4/57), respectively. In PVP, the misclassification rates of RDA/KNN, PCA/KNN, LDA/KNN, and NDA/ANN was 26.32% (15/57), 28.07% (16/57), 15.79% (9/57), and 10.53% (6/57), respectively. The misclassification rates of AP and PVP images had no statistical significance on the misclassification rates of RDA/KNN, PCA/KNN, LDA/KNN, and NDA/ANN between AP and PVP (P>0.05).
Conclusion
The texture analysis of CT images is feasible to identify HEHE and liver metastases of colon cancer.
ObjectiveTo investigate the clinicopathologic features of intracranial anaplastic solitary fibrous tumor (SFT)/hemangiopericytoma (HPC) and diagnosis and treatment after liver metastasis.MethodThe clinicopathologic data of patients with intracranial anaplastic SFT/HPC who had metastasized to the liver and other organs after surgery were collected from 2003 to 2019 in the Second Hospital of Lanzhou University.ResultsAll 3 patients with intracranial anaplastic SFT/HPC underwent surgical resection and supplemented with conventional radiotherapy after operation. After the initial intervention treatment, 2 patients relapsed at 10 years and 7 years after the operation, and 3 patients had liver metastases at 11, 7, and 6 years after the initial intervention treatment. One of them was accompanied by uterus, lung, and vertebral body metastases.ConclusionsIntracranial anaplastic SFT/HPC has a high risk of recurrence and extracranial metastasis. Liver is a common target organ for metastasis of anaplastic SFT/HPC, liver metastasis is delayed after initial intervention of intracranial anaplastic SFT/HPC, it requires a long-term close follow-up.
ObjectiveThis study aims to systematically review the dynamic evolution mechanisms of the tumor microenvironment (TME) in colorectal cancer liver metastasis (CRLM), to provide a theoretical basis for developing early diagnostic biomarkers and novel therapeutic targets for CRLM. MethodsBy integrating the present research, this review focuses on the key multi-step processes involved in CRLM-TME formation. And elaborates the complex interactions among tumor cells, stromal cells, immune components, and key signaling pathways during this process. ResultsThe formation of the CRLM-TME involves several key steps: remote regulation by the primary tumor, specific recruitment of immune cells, adaptive remodeling of the liver microenvironment, and final colonization of the metastatic sites. This process is collectively driven by various factors such as tumor-derived metabolites, specific immune cell subsets, stromal components, and neovascularization, ultimately acts on the entire cascade of cancer cell invasion, migration, and colonization to the liver. ConclusionsThe CRLM-TME plays a critical role in the development, progression, treatment and drug resistance of CRLM. In-depth exploration of its mechanisms can provide direction for the development of early diagnostic biomarkers and therapies targeting the CRLM-TME, thereby aiming to improve the prognosis of CRLM patients.
