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Biomedical subjects

Z Y Tang

Publications and source records attributed to Z Y Tang.

At least 145 records · Page 8Linked to original sources
PubMed1980

Screening and early treatment of primary liver cancer--with special reference to the east part of China.

The discovery of tumor marker alpha-foetoprotein (AFP) in hepatocellular carcinoma (HCC) and its application in screening has greatly contributed to early diagnosis. Of the more than five million natural population screened in our country since 1971, over one thousand cases of HCC have been detected. The percentage of subclinical cancer has been increased to 60.7% since passive reverse hemagglutination test was employed as initial screening in 1974. Diagnosis of subclinical HCC by AFP depends upon its absolute value, its serial change and interrelationship between serial change of AFP and SGPT. Subclinical HCC only amounted to 0.4-0.9% in clinical cases, but it went up to 44.7-71.2% in mass survey patients. Small HCC also rarely occurred in literature, however, the number of cases of small HCC resected has exceeded one hundred in our country, it amounting to 56.8-72.7% of the resected cases in mass survey patients. Results of a comparative study of mass survey and clinical patients demonstrated that 1-year, 2-year and 3-year survival being 14.8%, 7.4% and 5.5% and in clinical patients; 45.2%, 16.4% and 4.1% in mass survey patients who received conservative treatment; and 79.1%, 67.8% and 61.6% who received surgical resection. Unsolved problems and future prospects were also discussed.

Alanine Transaminase↗
PubMed1980

Treatment of primary liver cancer -- with special reference to the east part of China.

Despite the poor prognosis of primary liver cancer (PLC), encouraging progress in treatment of PLC has been observed in China. It is mainly due to the discovery of "subclinical" and small hepatocellular carcinoma in mass screening by alphafoetoprotein (AFP) detection that the role of surgical resection, the most effective therapeutic modality, has become greater. When mass survey patients were compared with clinical cases, percentage of resection in the whole series was three times higher (56.1% vs. 17.7%), operative mortality further decreased (2.7% vs. 5.1%), and 3-year survival after resection double that of the clinical group (61.6% vs. 26.0%). In an attempt to further increase the resectability rate, new techniques such as bloodless operation (total vascular occlusion with or without hypothermic perfusion) have been employed. Cryosurgery as well as radiotherapy was recognised as effective approaches for the control of localized tumour. A combination of various therapeutic modalities including hepatic artery perfusion, hepatic artery ligation, radiotherapy, chemotherapy, Chinese traditional medicine and immunotherapy was helpful in improving the ultimate outcome of PLC. Early detection, radical resection and combination treatment are some of the important aims to reduce the mortality rate of PLC.

Carcinoma, Hepatocellular↗
PubMedDate not supplied

Evolution of surgery in the treatment of hepatocellular carcinoma from the 1950s to the 1990s.

In the 1950s, hepatic lobectomy for huge hepatocellular carcinoma (HCC) has benefited 5-10% of HCC patients; in the 1970s, limited resection for small HCC and reresection for recurrence have benefited another 5-10% HCC patients. Cytoreduction and sequential resection for unresectable HCC might be of benefit to a further 5-10% HCC patients in the 1990s. Analysis of 1,642 patients with pathologically proven HCC in 1959-1991 demonstrated that the series 5-year survival has increased from 3.0% (n = 136) in the 1960s, to 12.2% (n = 440) in the 1970s, to 40.2% (n = 1,066) in the 1980s, which was correlated to the increasing number of limited resections for small HCC, reresections for subclinical recurrence, and cytoreductions and sequential resections for portions of unresectable HCC. With the advances in early detection, multimodality treatment, and changing concepts in surgical oncology, the role of surgery in the treatment of HCC has increased.

Adolescent↗
PubMedDate not supplied

Experience with resection of segment VIII of liver for hepatocellular carcinoma.

Hepatic segment VIII is located at the dome of the right liver lobe, next to the intrahepatic inferior vena cava (IVC) and is situated between the right and the middle hepatic veins. Its close relation to the IVC inferior medially makes liver cancer resection in this particular segment extremely difficult and hazardous. A personal series of 32 cases of segment VIII resection for hepatocellular carcinoma performed during the period January 1970-May 1992 is being presented. Most resections could be performed with occlusion of the porta hepatis only but some cases required total hepatic vascular exclusion. Since segment VIII is surrounded by major vessels, the extent of resection is limited in this region. Furthermore, tumor cells are easily disseminated along the vascular route. The long-term results are far from ideal. One-, 3-, and 5-year survival rates were 93.33%, 57.14%, and 28.5%, respectively. However, eight patients in this series have survived 180, 168, 104, 78, 53, 43, 43, and 36 months, respectively, and some of them have returned to work. Therefore, despite the technical difficulties involved in segment VIII resection, it is still worthwhile adopting an aggressive operative approach to this group of patients.

Adult↗
PubMedDate not supplied

Microwave surgery in the treatment of hepatocellular carcinoma.

Microwave surgery was employed for the treatment of 50 patients with hepatocellular carcinoma (HCC) and liver cirrhosis, including hepatectomy in 46 patients and in situ coagulation of tumor in 4 patients. In the study, 2,450 MHz microwaves were generated and transmitted to a monopolar needle electrode. For hepatectomy, the needle electrode was inserted into the liver parenchyma to coagulate the liver tissue and this was repeated at 1 cm intervals along the line where incision is anticipated. For unresectable HCC, the needle electrode was directly inserted into HCC to coagulate the cancer in situ. The average amounts of blood loss and blood transfusion for 46 hepatectomies using microwave were 215 +/- 189 ml and 274 +/- 261 ml, respectively. Eighteen patients (39.1%) did not need blood transfusion. A significant lower volume of blood loss and blood transfusion was observed in comparison with 46 matched conventional hepatectomies, 652 +/- 1,008 ml and 841 +/- 878 ml, respectively, all being P < 0.01. There were no operative mortality and complications, such as delayed bleeding, bile leakage, and abdominal infection. These results indicate that microwave surgery can be utilized safely and effectively in the field of liver surgery.

Adult↗
PubMedDate not supplied

Cytoreduction and sequential resection for surgically verified unresectable hepatocellular carcinoma: evaluation with analysis of 72 patients.

The poor prognosis of hepatocellular carcinoma (HCC) was partly a result of the majority of unresectable HCCs in clinical patients. Fortunately, with the progress of regional cancer therapies and multimodality treatment, some of the localized unresectable HCCs were converted to resectable ones. During the period 1960-1994, 72 of the 663 patients with surgically verified unresectable HCCs have been converted to resectable. Successful cytoreduction with median diameter reduced from 10 cm to 5 cm was mainly a result of the triple or double combination treatment with hepatic artery ligation, hepatic artery cannulation with infusion, radioimmunotherapy, and fractionated regional radiotherapy. The interval between the first operation and the sequential resection was 5 months. The operative mortality was 1.4% for sequential resection, and the 5-year survival was 62.1%. Analysis of factor influencing sequential resection rate revealed HCCs that were single nodule, well encapsulated, situated at right lobe or hepatic hilum, associated with micronodular cirrhosis, and treated with triple or double combination modalities had higher sequential resection rate as compared to their counterparts. Analysis of factors influencing survival after sequential resection revealed that HCCs with a solitary tumor confined in one lobe, without tumor embolus, and without residual cancer in specimen of sequential resection, had longer survival. It is suggested that localized unresectable, solitary, well encapsulated, right lobe or hilar HCC, associated with micronodular cirrhosis, will be good candidates for cytoreduction and sequential resection; and HCCs with unilateral involvement, without tumor embolus, and with complete necrosis of tumor after multimodality treatment favored better prognosis.

Adolescent↗
PubMedDate not supplied

Treatment of unresectable primary liver cancer: with reference to cytoreduction and sequential resection.

Unquestionably, progress has been made in the early detection and early treatment of primary liver cancers (PLCs), although most remain unresectable, mainly because the cancer is advanced and coexists with liver cirrhosis, particularly in Oriental patients. Thanks to the progress of regional cancer therapy, a multidisciplinary approach, and changing concepts about surgical oncology, it has been proved that some unresectable but not far advanced PLCs are potentially convertible to being resectable, particularly those cancers confined to the right lobe of a cirrhotic liver. A retrospective analysis of 571 unresectable PLCs revealed the following: (1) There was an increase in 5-year survivals in the series, from 0% during the 1960s (n = 61), to 4.8% during the 1970s (n = 163), to 21.2% during the 1980s (n = 347). It might be a result of the increase in double- or triple-modality treatments in these series (from 9.8%, to 19.6%, to 70.3%, respectively) and in the sequential resection rate after cytoreduction (from 0%, to 2.5%, to 14.7%). (2) The combination of hepatic artery ligation, hepatic artery cannulation and infusion, and intrahepatic arterial radioimmunotherapy has resulted in better shrinkage of the tumor, a higher sequential resection rate, and a higher 5-year survival (28.2%). (3) Of the 55 patients who had initially unresectable PLCs and yielded "cytoreduction and sequential resection," the 5-year survival was 58.5%. It is concluded that cytoreduction and sequential resection might be an important approach to improving the prognosis of patients with unresectable PLCs.

Adolescent↗
PubMedDate not supplied

Resection of hepatocellular carcinoma: oligocentric origin of recurrent and multinodular tumours.

The structure of integrated hepatitis B virus (HBV) DNA was analysed to determine the origin of recurrent and multinodular hepatocellular carcinoma (HCC). In 5 cases, recurrent tumours were compared with the respective primary tumours, all of which had chromosomally integrated viral DNA. In only one of these cases, an identical HBV DNA integration pattern was found, indicating a monocentric origin of primary and secondary tumour. In all other cases a polycentric origin was deduced. Particular features observed were: (i) the apparent absence of integrated viral DNA in a recurrent tumour; and (ii) an integration pattern identical to that of the primary tumour and a distinct new pattern in two different foci of multinodular recurrent HCC. For multinodular primary HCC one case was analysed and found to be of independent origin.

Blotting, Southern↗