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Liver cancer is one of the most common malignancies in the world, with approximately 1,000,000 cases reported every
year. This ranges from 15,000 cases in the United States to more than a 250,000 in China. About 80% of people with
primary liver cancer are male. Although two-thirds of people have advanced liver disease when they seek medical help,
one third of the patients have cancer that has not progressed beyond the liver. Primary liver cancer (hepatocellular
carcinoma, or HCC) is associated with liver cirrhosis 60-80% of the time. HCC may metastasize to the lung, bones,
kidney, and many other organs. Surgical resection, liver transplantation, chemotherapy and radiation therapy are the
foundation of current HCC therapies. However the outcomes are
poor-the survival rate is almost zero for metastatic
HCC patients. Molecular mechanisms of HCC metastasis need to be understood better and new therapies must be
developed to selectively target to unique characteristics of HCC cell growth and metastasis. We have developed the "in
vivo microscopy" to study the mechanisms that govern liver tumor cell spread through the microenvironment in vivo in
real-time confocal near-infrared fluorescence imaging. A recently developed "in vivo flow cytometer" and optical
imaging are used to assess liver tumor cell spreading and the circulation kinetics of liver tumor cells. A real-time
quantitative monitoring of circulating liver tumor cells by the in vivo flow cytometer will be useful to assess the
effectiveness of the potential therapeutic interventions.
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