RESUMEN
OBJECTIVE: To assess the effect of the intraoperative application of the Aquamantys® system to treat the hepatic resection margin on local and overall recurrence of HCC. METHODS: We retrospectively analyzed 101 patients admitted from November 2016 to June 2018 who underwent hepatectomy using the Aquamantys® as hemostatic device, who were matched with 101 patients (control group) using conventional hemostatic devices through PSM. Univariate and multivariate analyses of recurrence-free survival (RFS) and local recurrence-free survival (LRFS) were performed using the Cox proportional hazard model. RESULTS: There were no significant differences in baseline data and surgical procedures between the two groups. The Aquamantys® group showed less blood loss (P = 0.005) and a lower blood transfusion rate (P = 0.036), while the incidences of postoperative complications of the two groups showed no difference (P = 0.266). OS rates of the Aquamantys® group and the control group were 82.6% and 84.2%, respectively (P = 0. 446), and RFS rates were 65.5% and 58.2%, respectively (P = 0.153), with no significant differences. The Aquamantys® group and the control group had two cases and 11 cases of local recurrence, respectively, with LRFS rates of 98% and 87.9%, respectively, in the follow-up period, corresponding to a significant difference (P = 0.011). Multivariate analysis showed that microvascular invasion (MVI), tumor diameter > 5 cm, and the control group were independent risk factors for LRFS. CONCLUSION: Our results indicate that application of the Aquamantys® system in hepatectomy can reduce local recurrence, but it can neither reduce overall recurrence nor improve OS.
Asunto(s)
Carcinoma Hepatocelular/cirugía , Electrocirugia/instrumentación , Hemostasis Quirúrgica/instrumentación , Hepatectomía , Neoplasias Hepáticas/cirugía , Recurrencia Local de Neoplasia , Pérdida de Sangre Quirúrgica/prevención & control , Transfusión Sanguínea/estadística & datos numéricos , Carcinoma Hepatocelular/prevención & control , Estudios de Casos y Controles , Supervivencia sin Enfermedad , Femenino , Hemostasis Quirúrgica/métodos , Humanos , Neoplasias Hepáticas/prevención & control , Masculino , Márgenes de Escisión , Persona de Mediana Edad , Recurrencia Local de Neoplasia/prevención & control , Puntaje de Propensión , Modelos de Riesgos Proporcionales , Análisis de Regresión , Estudios RetrospectivosRESUMEN
Many developmental genes play important roles in regeneration. Here, we cloned the two developmental genes, Wnt6 and Hox6, from Apostichopus japonicus by rapid amplification of cDNA ends (RACE) polymerase chain reaction (PCR). The Wnt6 full-length cDNA is 1140 bp long with a 1029-bp open reading frame encoding 342 amino acids. The deduced Wnt6 protein contained a 22-amino acid signal peptide and a 274-amino acid mature peptide. The Hox6 (AjHBOX6) full-length cDNA contained 1312 bp with a 966-bp open reading frame encoding 321 amino acids. Its deduced amino acid sequence included one homeodomain (60 amino acids) and three domains with low compositional complexity. Comparison and phylogenetic analysis revealed that Wnt6 and Hox6 in A. japonicus had the nearest relationship to those in sea urchins. Further expression analysis by real-time PCR showed that Wnt6 and Hox6 were apparently upregulated during intestine regeneration, which suggested that they were involved in the intestinal regeneration of sea cucumbers.