1. Department of Hepatobiliary Oncology,SYSUCC Anti-liver cancer team Shengping Li, M.D., Ph.D

3. Liver cancer PLC (Primary Liver Cacner) Secondary Liver Cancer HCC(Hepatocellular carcinoma) CCC(Cholangiocellular carcinoma) HCC and CCC mixed HCC

6. Trend of Death rate of malignant tumor in China Lung Liver Stomach 128 2004-2005 Stomach Liver Lung 106 1990-1992 Stomach Esophagus Liver 80 1973-1974 Three leading causes of Ca. death Death Rate (per100,000) Period(years)

8. HBV 80% (Asia and Africa), 100 million china HCV 70% (Japan,West countries) Hepatitis virus infection

9. Alcoholism: alcoholic cirrhosis

10. Food contaminated with aflatoxin Decayed peanut,corn Turkey Liver cancer

11. Liver Flukes (Clonorchis sinensis )

12. Liver Flukes Infestation

13. Mutation of oncogene and tumor suppressor gene （癌基因和抑癌基因的突变） N-ras,c-myc,cfms,CSF-1R, IGF-II ， p53 ， TTR, DLC-1, LPTS, WFDC1, HCCS1, HCRP1, 17HSDB2 Chromosomal alterations ( 染色体改变） Gain （获得） :1q,8q and 20q Lose （缺失） : 4q,8p,13q,16q, and 17p ( Li SP, et al . J Hepatology 2001) Molecular and cytogenetic aberration （分子和细胞遗传学变异）

18. Tumor markers for HCC Most common used

19. Diagnostic Imaging for HCC

30. Pregnancy with HCC Delivery baby and resection of HCC simultaneously

31. Hepatic haemangioma

32. Colon cancer liver metastasis

33. Focal Nodular Hyperplasia (FNH)

34. Hepatic Abscess

35. Hepatic Hydatidosis

37. Therapeutic Option for HCC

41. TNM Staging System

44. Child Pugh Classification

46. 5-year survival 26-50%, mean 30% 5 years recurrence rate is about 70% A critical clinical problem Hepatectomy

47. 6 m Pre-op

48. Cutting edge recurrence

52. Percutanous intervention PEI: percutanous ethanol injection RF: Radiofrequency ablation MCT: microwave coagulation thermotherapy LT: Laser thermotherapy Cryoablation Best option for small unresectable HCC

53. 将 10 枚象“弹头”一样的小电极通过穿刺针管送入癌组织，多枚小电极从不同的角度和方向“锁定”癌症组织区域，由计算机测算出射频治疗所需的最佳温度，时间，功率和阻抗，由小电极发出高能射频波，在 100—120℃ 的高温下，使癌组织蛋白发生凝固性坏死，达到杀灭癌组织的效果。 3.5cm/15G 10 electrodes Lee Veen needle

58. Tumor shrinkage post-TACE

61. HCC metastasis

63. Thank you!