Navegando por Palavras-chave "Hepatocellular carcinoma"

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    Apresentações incomuns do hepatocarcinoma: ensaio iconográfico
    (Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2006-04-01) D'Ippolito, Giuseppe [UNIFESP]; Abreu Junior, Luiz de; Borri, Maria Lucia [UNIFESP]; Galvão Filho, Mário de Melo; Hartmann, Luiz Guilherme C.; Wolosker, Angela Maria Borri; Ribeiro, Marcelo [UNIFESP]; Salem, Marcelo Zindel; Misiara, Adriano; Universidade Federal de São Paulo (UNIFESP); Hospital São Luiz - Itaim Serviço de US/TC/RM; Hospital São Luiz Setor de Diagnóstico por Imagem; Universidade de São Paulo (USP)
    In order to evaluate atypical aspects of hepatocellular carcinoma at computed tomography and magnetic resonance imaging, we have retrospectively evaluated 100 patients with diagnosed hepatocellular carcinoma, based on combined imaging studies, laboratory results, biopsy and surgery. We have selected those cases with atypical findings at computed tomography or magnetic resonance imaging, including cystic lesions, bleeding tumors, with calcifications, with spontaneous regression, pedunculated tumors, hypovascular lesions, giant hepatocellular carcinomas, and those with unusual local invasiveness. The hepatocellular carcinoma is the most usual primary malignant lesion of the liver and usually it has a typical aspect and is associated with hepatic cirrhosis. However, in a significant number of cases, some uncommon findings can be responsible for a delayed diagnosis.
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    Avaliação de sobrevida dos portadores de carcinoma hepatocelular: análise comparativa entre sistemas prognósticos
    (Universidade Federal de São Paulo (UNIFESP), 2018-07-19) Tannus, Roberta Kazan [UNIFESP]; Silva, Ivonete Sandra de Souza e [UNIFESP]; http://lattes.cnpq.br/5846912595934815; http://lattes.cnpq.br/4727419413250670; Universidade Federal de São Paulo (UNIFESP)
    Background and Aim: There are several prognostic systems that address different aspects of the patient and the tumour and can guide the management of patients with hepatocellular carcinoma (HCC). This study aimed to evaluate and compare the eight staging systems for a group of patients in a public service in Brazil. Methods: Patients with HCC were retrospectively analysed between 2000 and 2012. The prognostic systems Okuda, The Cancer of the Liver Italian Program (CLIP), the Chinese University Prognostic Index (CUPI), Groupe d'Etude et de Traitément du Carcinome Hepatocellulaire (GRETCH), the modified TNMbased Japan Integrated Score (JIS) combined with alphafetoprotein and ChildTurcottePugh (CTP), the TNM system, and the Barcelona Clinic Liver Cancer Classification (BCLC) were applied to these patients and compared through model fit measurements, likelihood scores, and the Akaike Information Criterion (AIC). Results: A total of 247 patients were studied. The average survival time was 60 months. The TNM, Okuda, CLIP, GRETCH, modified JIS, and BCLC systems were well correlated with one another and individually important to the prediction of survival among the patients studied. However, in the statistical analysis, the CUPI delivered the best predictive performance (AIC = 566; loglikelihood = 281,240). Conclusion: Although the CUPI system was demonstrated to be the most appropriate HCC staging system for the studied population, the choice of an ideal system is a controversial subject, and future studies with larger numbers of patients are necessary for the validation of the CUPI system as the method of choice for other populations.
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    Casearin D inhibits ERK phosphorylation and induces downregulation of cyclin D1 in HepG2 cells
    (Pergamon-Elsevier Science Ltd, 2017) Ferreira-Silva, Guilherme Alvaro; Lages, Carla Carolina Lopes; Sartorelli, Patricia [UNIFESP]; Hasegawa, Flavia Rie [UNIFESP]; Soares, Marisi Gomes; Ionta, Marisa
    Cancer is a public health problem which represents the second cause of death in the world. In this framework, it is necessary to identify novel compounds with antineoplastic potential. Plants are an important source for discovering novel compounds with pharmacological potential. In this study, we aimed to investigate the antiproliferative potential of isolated compounds from Casearia sylvestris on tumor cell lines. Crude extract effectively reduced cell viability of 4tumor cell lines (HepG2, A549, U251-MG, and HT-144) after 48 h treatment. HepG2 and HT-144 were the most responsive cells. Three fractions (aqueous ethanol, n-hexane and ethyl acetate) were tested against HepG2 and HT-144 cells and we observed that compounds with antiproliferative activity were concentrated in n-hexane and ethyl acetate fractions. The casearins A, G and J were isolated from n-hexane fraction, while casearin D was obtained from ethyl acetate fraction. We demonstrated that casearin D significantly inhibited the clonogenic capacity of HepG2 cells after 24 h exposure indicating its antiproliferative activity. In addition, G1/S transition cell cycle arrest in HepG2 cells was also observed. These effects are related, at least in part, to ability of the casearin D in reducing ERK phosphorylation and cyclin D1 expression levels. (C) 2016 Elsevier Ltd. All rights reserved.
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    Contribuição da quimioembolização de hepatocarcinomas em pacientes cirróticos na espera pelo transplante hepático
    (Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2005-02-01) Langer, Luís Francisco [UNIFESP]; Gonzalez, Adriano Miziara [UNIFESP]; Amorim, Jorge Eduardo de [UNIFESP]; Ajzen, Sergio Aron [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To evaluate the results of hepatocellular carcinoma arterial chemoembolization in cirrhotic patients awaiting liver transplantation. MATERIALS AND METHODS: Twenty-three cirrhotic patients with hepatocellular carcinoma awaiting liver transplantation were submitted to multiple sessions of chemoembolization using mitomycin C and lipiodol. A prospective evaluation of the following factors was performed: a) serum levels of alpha-fetoprotein; b) tumor size; c) maintenance of the viability criteria for hepatic transplantation; d) degree of liver dysfunction. RESULTS: The mean serum levels of alpha-fetoprotein were reduced by 43% during the first 13 months. The mean tumor size, as measured by the long axis, after a mean follow-up period of 13.5 months was 3.2 cm, which is considered stable for the period according to the World Health Organization criteria. The mean survival rate was 14 months. CONCLUSION: In this trial, pre-transplantation use of chemoembolization in combination with an adequately chosen therapy showed few complications and contra-indications as well as a considerable anti-tumor efficacy. Despite the fact that the adopted therapy increased survival rates in comparison to historical evolution data in hepatocellular carcinoma, this increase had not the same dimension if the median waiting time for transplantation is taken into consideration. Therefore, other strategies need to be associated to either make survival rate longer or to reduce transplantation waiting time.
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    Hepatocellular carcinoma and food contamination: Ochratoxin A as a great prompter
    (Baishideng Publ Grp Co Ltd, 2013-06-28) Felizardo, Raphael José Ferreira [UNIFESP]; Câmara, Niels Olsen Saraiva [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
    Ochratoxin A (OTA) is a secondary metabolite of Aspergillus and Penicillium, microorganisms that can be hazardous to health when present as food contaminants. OTA is a potent member of a group of mycotoxins. Prolonged exposure to mycotoxins in the diet is related to cancer, among other diseases. Hepatocellular carcinoma (HCC) accounts for 70%-90% of primary liver cancers and is the third leading cause of cancer-related deaths worldwide. in a recent study, Ibrahim et al proposed a correlation between the incidence of HCC and contamination with OTA. Analysis of OTA in serum samples showed that HCC patients had the highest incidence of OTA of the subjects examined (5-fold higher than that of the control group). OTA levels were significantly increased in HCC patients. This study demonstrates that chronic exposure to high levels of OTA may be associated with a high risk of liver cancer development. Future epidemiologic studies of HCC should focus on good practices in food preparation, food storage and the consumption of OTA-containing foods. (C) 2013 Baishideng. All rights reserved.
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    Liver Transplantation For Carcinoma Hepatocellular In Sao Paulo: 414 Cases By The Milan/Brazil Criteria
    (Colegio Brasileiro Cirurgia Digestiva-Cbcd, 2016) Sá, Gustavo Pilotto Domingues [UNIFESP]; Vicentine, Fernando Pompeu Piza [UNIFESP]; Salzedas-Netto, Alcides Augusto [UNIFESP]; Matos, Carla Adriana Loureiro de [UNIFESP]; Romero, Luis Ramiro Núñez [UNIFESP]; Tejada, Dario Fernandes Perdomo [UNIFESP]; Bosco Massarollo, Paulo Celso; Lopes Filho, Gaspar de Jesus [UNIFESP]; Gonzalez, Adriano Miziara [UNIFESP]
    Background: The criterion of Milan (CM) has been used as standard for indication of liver transplantation (LTx) for hepatocellular carcinoma (HCC) worldwide for nearly 20 years. Several centers have adopted criteria expanded in order to increase the number of patients eligible to liver transplantation, while maintaining good survival rates. In Brazil, since 2006, the criterion of Milan/Brazil (CMB), which disregards nodules <2 cm, is adopted, including patients with a higher number of small nodules. Aim: To evaluate the outcome of liver transplantation within the CMB. Methods: The medical records of patients with HCC undergoing liver transplantation in relation to recurrence and survival by comparing CM and CMB, were analyzed. Results: 414 LTx for HCC, the survival at 1 and 5 years was 84.1 and 72.7%. Of these, 7% reached the CMB through downstaging, with survival at 1 and 5 years of 93.1 and 71.9%. The CMB patient group that exceeded the CM (8.6%) had a survival rate of 58.1% at five years. There was no statistical difference in survival between the groups CM, CMB and downstaging. Vascular invasion (p<0.001), higher nodule size (p=0.001) and number of nodules >2 cm (p=0.028) were associated with relapse. The age (p=0.001), female (p<0.001), real MELD (p<0.001), vascular invasion (p=0.045) and number of nodes >2 cm (p<0.014) were associated with worse survival. Conclusions: CMB increased by 8.6% indications of liver transplantation, and showed survival rates similar to CM.
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    O transplante hepático por hepatocarcinoma na era MELD em São Paulo: avaliação de 414 casos transplantados pelo critério de Milão/Brasil
    (Universidade Federal de São Paulo (UNIFESP), 2015-11-30) Sá, Gustavo Pilotto Domingues [UNIFESP]; Gonzalez, Adriano Miziara [UNIFESP]; Salzedas Netto, Alcides Augusto [UNIFESP]; http://lattes.cnpq.br/2580534578039797; http://lattes.cnpq.br/6234829429056217; http://lattes.cnpq.br/9311192779485846; Universidade Federal de São Paulo (UNIFESP)
    Introdução: O critério de Milão (CM) vem sendo utilizado como padrão para indicação do transplante hepático (TxH) por hepatocarcinoma (HCC) em todo o mundo, há quase 20 anos. Diversos centros têm adotado critérios expandidos com o intuito de aumentar o número de pacientes candidatos ao TxH, mantendo bons índices de sobrevida. No Brasil, desde 2006, o critério de Milão/Brasil (CMB), que desconsidera nódulos menor que 2 cm, é adotado, incluindo maior número de pacientes com nódulos pequenos. O objetivo deste estudo foi avaliar o resultado do transplante hepático de acordo com o CMB e a forma de controle da fila de espera, enquanto os pacientes aguardam pelo transplante. Métodos: Foram analisados os prontuários dos pacientes com HCC submetidos ao TxH na cidade de São Paulo, entre 2007 e 2011, em relação à recidiva e sobrevida. Foram comparados os exames de imagens préoperatórios com o anatomopatológico do fígado explantado (BX) e sua relação com o resultado dos transplantes. Resultados: Em 414 TxH por HCC, a sobrevida em 1 e 5 anos foi de 84,1 e 72,7%. Destes, 7% atingiram o CMB através de Downstaging, com sobrevida em 1 e 5 anos, de 93,1 e 71,9%. O grupo de pacientes do CMB que excedeu o CM (8,6%) teve sobrevida de 58,1% em 5 anos. Não houve diferença estatística na sobrevida entre os grupos CM, CMB e Downstaging. A invasão vascular (p < 0,001), tamanho do maior nódulo (p = 0,001) e n de nódulos maiores que 2 cm (p = 0,028) se associaram com recidiva. A idade (p = 0,001), sexo feminino (p < 0,001), MELD real (p < 0,001), invasão vascular (p = 0,045) e o n de nódulos maiores que 2 cm (p < 0,014) estiveram associados a piora na sobrevida. Os exames de imagem diferiram da BX em cerca de 30% dos casos. 11,3% dos pacientes transplantados estavam fora do CMB de acordo com a BX. Conclusões: O CMB aumentou em 8,6% as indicações de TxH e apresentou índices de sobrevida semelhantes ao CM. A margem de erro na indicação e acompanhamento na fila de espera foi de 11,3%.