Background: Aldehyde dehydrogenase 2 (ALDH2) and cytochrome p450 2E1 (CYP2E1) are important alcoholmetabolizing enzymes. The aim of this meta-analysis was to evaluate the association of ALDH2 rs671 and CYP2E1 rs2031920 polymorphisms with hepatocellular carcinoma (HCC) susceptibility in East Asians. Methods: A systematic search strategy was implemented in MEDLINE, PubMed, Scopus, Embase, and China Academic Journals databases. Nineteen case-control studies were selected for inclusion. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated through random-effects or fixed-effects models. Subgroup analysis, meta-regression, sensitivity analysis, cumulative meta-analysis, and evaluation of publication bias were performed. Results: The overall meta-analysis did not find a significant association of ALDH2 rs671 and CYP2E1 rs2031920 genotypes with HCC susceptibility in East Asians. In addition, stratified analysis by country, Hardy-Weinberg equilibrium status, and source of controls also did not identify any association. Conclusion: The ALDH2 rs671 and CYP2E1 rs2031920 polymorphisms are not associated with HCC susceptibility in East Asians.
The purpose of this systematic review and meta-analysis was to investigate the relationship between liver transplantation and kidney cancer. Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines were followed. PubMed, the Web of Science, and the Cochrane databases were searched for peer-reviewed cohort studies in which standardized incidence of kidney cancer post-transplant was compared to the general population by means of standardized incidence ratio (SIR) with 95% confidence interval (CI). No limits were placed on language or year of publication. A fixed-effects model was used for pooling the data. Of the 937 citations identified from the electronic databases, we included nine cohort studies with 53913 liver transplant patients, a male percentage of 56.8% and a minimum follow-up of 12.4 months and more. The meta-analysis revealed that liver transplant recipients faced a significantly higher risk of developing kidney cancer than the general population with the pooled SIR of 2.02 (95% CI, 1.64–2.50; P < 0.001). No significant between-study heterogeneity was observed (I 2 = 0, P het = 0.553). On sensitivity analysis after removing the study by Engles et al. with the largest sample size (37 888 liver transplant recipients), the SIR remained stable (SIR 2.75; 95% CI, 1.85–4.10; P < 0.001). Overall, our synthesis of the literature indicates that an increased risk of kidney cancer exists after liver transplantation. Future studies should evaluate the potential risk factors associated with kidney cancer.
Castleman disease (CD) rarely presents with obstructive jaundice, which poses a diagnostic and therapeutic challenge to the management of the disease. A 40-year-old man was referred to our hospital for emergent management of upper abdominal pain. An abdominal mass was removed, and the postoperative pathology showed retroperitoneum CD, which was subsequently managed by adjuvant therapy of combination chemotherapy and steroids. One month later, a biliary metal stent was placed due to the presentation of obstructive jaundice. After ~3 months, the patient experienced another episode of obstructive jaundice, and SpyGlass DS cholangioscopy was performed via the biliary tract for biopsy, which pathologically showed biliary malignancies. Radiofrequency ablation was performed with a probe, and another uncovered metal stent was placed within the existing metal stent. No stent occlusion occurred during a 6-month follow-up period. In conclusion, CD rarely presents with obstructive jaundice, and a combination of radiofrequency ablation with metal stent implantation under cholangioscopy can prolong the stent patency time and the survival time of patients.
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