5 research outputs found
Platelets and hepatocellular cancer: Bridging the bench to the clinics
Growing interest is recently being focused on the role played by the platelets in favoring hepatocellular cancer (HCC) growth and dissemination. The present review reports in detail both the experimental and clinical evidence published on this topic. Several growth factors and angiogenic molecules specifically secreted by platelets are directly connected with tumor progression and neo-angiogenesis. Among them, we can list the platelet-derived growth factor, the vascular endothelial growth factor, the endothelial growth factor, and serotonin. Platelets are also involved in tumor spread, favoring endothelium permeabilization and tumor cells\u2019 extravasation and survival in the bloodstream. From the bench to the clinics, all of these aspects were also investigated in clinical series, showing an evident correlation between platelet count and size of HCC, tumor biological behavior, metastatic spread, and overall survival rates. Moreover, a better understanding of the mechanisms involved in the platelet\u2013tumor axis represents a paramount aspect for optimizing both current tumor treatment and development of new therapeutic strategies against HCC
Platelets and Hepatocellular Cancer: Bridging the Bench to the Clinics
Growing interest is recently being focused on the role played by the platelets in favoring hepatocellular cancer (HCC) growth and dissemination. The present review reports in detail both the experimental and clinical evidence published on this topic. Several growth factors and angiogenic molecules specifically secreted by platelets are directly connected with tumor progression and neo-angiogenesis. Among them, we can list the platelet-derived growth factor, the vascular endothelial growth factor, the endothelial growth factor, and serotonin. Platelets are also involved in tumor spread, favoring endothelium permeabilization and tumor cells' extravasation and survival in the bloodstream. From the bench to the clinics, all of these aspects were also investigated in clinical series, showing an evident correlation between platelet count and size of HCC, tumor biological behavior, metastatic spread, and overall survival rates. Moreover, a better understanding of the mechanisms involved in the platelet-tumor axis represents a paramount aspect for optimizing both current tumor treatment and development of new therapeutic strategies against HCC
The role of elastography in non-Alcoholic fatty liver disease
Non-Alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide and its prevalence is even higher in patients with risk factors such as type 2 diabetes and obesity. Liver biopsy is the gold standard for diagnosis of non-Alcoholic steatohepatitis (NASH), particularly for the assessment of fibrosis stage that is a key prognostic factor. Noninvasive methods for assessment of liver fibrosis are a huge need in contemporary hepatology in order to stratify patient s risk of advanced and progressive liver disease. In this perspective different imaging techniques have been developed in last decades and showed high performance in liver fibrosis evaluation. Strengths and weaknesses of all imaging methods are summarized in this review. (Cite this article as: Liguori A, Ainora ME, Riccardi L, De Matthaeis N, Pizzolante F, Gasbarrini A, et al. The role of elastography in non-Alcoholic fatty liver disease. Minerva Gastroenterol
Liver Transplantation in Alcoholic Patients: Impact of an Alcohol Addiction Unit Within a Liver Transplant Center
Background: Many concerns about liver transplantation in alcoholic patients are related to the risk
of alcohol recidivism. Starting from 2002, an Alcohol Addiction Unit (AAU) was formed within the
liver transplant center for the management of alcoholic patients affected by end-stage liver disease and
included in the waiting list for transplantation. We evaluated retrospectively the impact of the AAU on
alcohol recidivism after transplantation. The relationship between alcohol recidivism and the duration
of alcohol abstinence before transplant was evaluated as well.
Methods: Between 1995 and 2010, 92 cirrhotic alcoholic patients underwent liver transplantation.
Clinical evaluation and management of alcohol use in these patients was provided by psychiatrists with
expertise in addiction medicine not affiliated to the liver transplant center before 2002 (n = 37; group
A), or by the clinical staff of the AAU within the liver transplant center starting from 2002 (n = 55;
group B).
Results: Group B, as compared with group A, showed a significantly lower prevalence of alcohol
recidivism (16.4 vs. 35.1%; p = 0.038) and a significantly lower mortality (14.5 vs. 37.8%; p = 0.01).
Furthermore, an analysis of group B patients with either 6 or <6 months of alcohol abstinence before
transplantation showed no difference in the rate of alcohol recidivism (21.1 vs. 15.4%; p = ns).
Conclusions: The presence of an AAU within a liver transplant center reduces the risk of alcohol
recidivism after transplantation. A pretransplant abstinence period <6 months might be considered, at
least in selected patients managed by an AAU
Hepatocellular carcinoma recurrence in patients with curative resection or ablation: impact of HCV eradication does not depend on the use of interferon
Background: In HCV-infected cirrhotic patients with successfully treated early hepatocellular carcinoma (HCC), the time to HCC recurrence and the effects of sustained viral eradication (SVR) by interferon (IFN)-based or IFN-free regimens on HCC recurrence remain unclear. Aim: To perform an indirect comparison of time to recurrence (TTR) in patients with successfully treated early HCC and active HCV infection with those of patients with SVR by IFN-based and by IFN-free regimens. Methods: We evaluated 443 patients with HCV-related cirrhosis and Barcelona Clinic Liver Cancer Stage A/0 HCC who had a complete radiological response after curative resection or ablation. Active HCV infection was present in 328, selected from the Italian Liver Cancer group cohort; 58 patients had SVR achieved by IFN-free regimens after HCC cure, and 57 patients had SVR achieved by IFN-based regimens after HCC cure. Individual data of patients in the last two groups were extracted from available publications. Results: TTR by Kaplan–Meier curve was significantly lower in patients with active HCV infection compared with those with SVR both by IFN-free (P = 0.02) and by IFN-based (P < 0.001) treatments. TTR was similar in patients with SVR by IFN-free or by IFN-based (P = 0.49) strategies. Conclusion: In HCV-infected, successfully treated patients with early HCC, SVR obtained by IFN-based or IFN-free regimens significantly reduce tumour recurrence without differences related to the anti-viral strategy used