研究者詳細 - 水口　徹

論文 - 水口　徹

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Soluble Lutheran/basal cell adhesion molecule is detectable in plasma of hepatocellular carcinoma patients and modulates cellular interaction with laminin-511 in vitro

Yamato Kikkawa, Takahiro Miwa, Naoki Tanimizu, Yuichi Kadoya, Takaho Ogawa, Fumihiko Katagiri, Kentaro Hozumi, Motoyoshi Nomizu, Toru Mizuguchi, Koichi Hirata, Toshihiro Mitaka

Experimental Cell Research ( Academic Press Inc. ) 328 ( 1 ) 197 - 206 2014年10月

Lutheran (Lu), an immunoglobulin superfamily transmembrane receptor, is also known as basal cell adhesion molecule (B-CAM). Lu/B-CAM is a specific receptor for laminin α5, a subunit of laminin-511 (LM-511) that is a major component of basement membranes in various tissues. Our previous study showed that Lu/B-CAM was cleaved by MT1-MMP and released from cell surfaces. In this study we examined the soluble Lu/B-CAM in culture media and in plasma of mice bearing HuH-7 hepatocellular carcinoma (HCC) cells and patients with HCC. Two HCC cell lines, HepG2 and HuH-7, released Lu/B-CAM into the culture media. Although Lu/B-CAM was cleaved by MT1-MMP in HuH-7 cells, HepG2 cells released Lu/B-CAM in a MMP-independent manner. The concentration of Lu/B-CAM released into mouse plasma correlated with tumor size. Moreover the soluble Lu/B-CAM in plasma of HCC patients was significantly decreased after resection of the tumor. Immunohistochemical studies showed that although the expression of Lu/B-CAM was observed in most HCCs, MT1-MMP was not always expressed in tumor tissues, suggesting that a part of Lu/B-CAM in plasma of HCC patients was also released in a MMP-independent manner. In vitro studies showed that the soluble Lu/B-CAM released from HCC cells bound to LM-511. Moreover the soluble Lu/B-CAM influenced cell migration on LM-511. These results suggest that soluble Lu/B-CAM serves as not only a novel marker for HCC but also a modulator in tumor progression.

DOI PubMed

プロペンシティ解析を用いた膵頭十二指腸切除術後アウトカムの比較研究

安田尚美, 木村康利, 今村将史, 伊東竜哉, 沖田憲司, 水口徹, 古畑智久, 平田公一

日本臨床外科学会雑誌 ( 日本臨床外科学会 ) 75 ( 9 ) 2643 - 2643 2014年09月

Saline Injection Method for Facilitating the Liver Hanging Maneuver During Hepatectomy for a Large Right Liver Tumor

Toru Mizuguchi, Masaki Kawamoto, Makoto Meguro, Kenji Okita, Toshihiko Nishidate, Tomohisa Furuhata, Thomas T. Hui, Koichi Hirata

JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS ( ELSEVIER SCIENCE INC ) 219 ( 2 ) E11 - E14 2014年08月 [査読有り]

DOI

Highest intraoperative lactate level could predict postoperative infectious complications after hepatectomy, reflecting the Pringle maneuver especially in chronic liver disease

Makoto Meguro, Toru Mizuguchi, Masaki Kawamoto, Toshihiko Nishidate, Masayuki Ishii, Hiroomi Tatsumi, Yasutoshi Kimura, Tomohisa Furuhata, Koichi Hirata

JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES ( SPRINGER JAPAN KK ) 21 ( 7 ) 489 - 498 2014年07月 [査読有り]

Background The Pringle maneuver is used to minimize blood loss during liver transection; however, it may cause reperfusion injury, which can cause increased intraoperative lactate levels and an immune compromised state. This may further lead to infectious complications. Methods Here, we divided 77 patients who underwent hepatectomy between December 2007 and August 2010 into two groups: the chronic hepatitis and liver cirrhosis (CH + LC) group and normal liver (NL) group. We investigated the effect of the highest intraoperative lactate level on occurrence of infectious complications after hepatectomy by assessing the correlations of the highest intraoperative lactate level with total Pringle time, operative factors, and various parameters in serum after surgery. Parameters showing significant correlations with postoperative complications of Clavien-Dindo grade III or higher, with a wound or intra-abdominal infection, were analyzed by using interactive dot diagrams to determine cut-off values with the highest sensitivity and specificity. Results We noted that, to prevent postoperative infectious complications, the highest lactate level during liver resection should be maintained at <44.0mg/dL in the NL group and <29.0mg/dL in the CH + LC group. Conclusions Minimizing the highest intraoperative lactate level may be important to prevent increase in postoperative infectious complications after hepatectomy, reflecting the Pringle maneuver especially in chronic liver disease.

DOI

Propensity score analysis demonstrated the prognostic advantage of anatomical liver resection in hepatocellular carcinoma

Masayuki Ishii, Toru Mizuguchi, Masaki Kawamoto, Makoto Meguro, Shigenori Ota, Toshihiko Nishidate, Kenji Okita, Yasutohsi Kimura, Thomas T. Hui, Koichi Hirata

World Journal of Gastroenterology ( Baishideng Publishing Group Co ) 20 ( 12 ) 3335 - 3342 2014年

AIM: To compare the prognoses of hepatocellular carcinoma (HCC) patients that underwent anatomic liver resection (AR) or non-anatomic liver resection (NAR) using propensity score-matched populations. METHODS: Between January 2002 and December 2010, 268 consecutive HCC patients, including 110 and 158 patients that underwent AR and NAR, respectively, were retrospectively enrolled in this study. Forty-four patients from each group were selected and matched using logistic multivariate analysis followed by propensity score analysis. RESULTS: In the whole analysis set, the histologi-cal background of the liver, liver function, and tumor marker levels differed significantly among the groups. Although the overall survival (OS) and recurrence-free survival rates of the two groups did not differ significantly in the whole analysis set, the OS of the AR group was significantly longer than that of the NAR group after propensity matching (76.2 ± 6.3 mo vs 58.9 ± 6.3 mo P = 0.0039). Although AR (HR = 0.456, P = 0.039) was found to be a prognostic factor in the univariate analysis, only vascular invasion (HR = 0.228, P = 0.002) and the hepatocyte growth factor level (HR = 52.366, P = 0.035) were subsequently found to be independent prognostic factors. CONCLUSION: AR conveys a survival advantage over NAR in specific subpopulations of HCC patients with tumors of less than 5 cm in diameter, single tumor, and good liver function. © 2014 Baishideng Publishing Group Co., Limited. All rights reserved.

DOI PubMed

Preoperative hepatocyte transplantation improves the survival of rats with nonalcoholic steatohepatitis-related cirrhosis after partial hepatectomy

Yukio Nakamura, Toru Mizuguchi, Naoki Tanimizu, Norihisa Ichinohe, Hidekazu Ooe, Masaki Kawamoto, Makoto Meguro, Koichi Hirata, Toshihiro Mitaka

Cell Transplantation ( Cognizant Communication Corporation ) 23 ( 10 ) 1243 - 1254 2014年

Liver failure after liver resection for cirrhosis is a critical problem, and no effective therapy except liver transplantation is currently available. The objective of this study was to examine whether hepatocyte transplantation (HT) reduces the poststandard liver resection mortality rate of rats with nonalcoholic steatohepatitis (NASH)- related cirrhosis. Liver resection for hepatocellular carcinoma (HCC) combined with NASH-related cirrhosis has become increasingly common. We developed a rat model of acute liver failure after two-thirds partial hepatectomy (PH) for NASH-related cirrhosis. The mechanism by which HT improved the survival of the model rats was examined in short- and long-term investigations. Female DPPIV- recipient F344 rats were fed the cholinedeficient l-amino acid (CDAA)-defined diet for 12 weeks. Some of the rats were transplanted with male F344 DPPIV + rat hepatocytes 24 h before undergoing PH. The overall post-PH survival of each group was evaluated, and short- and long-term pathological and molecular biological evaluations were also performed. Overall survival was significantly longer in the HT group than the non-HT group (7-day survival rates: 46.7% and 7.7%, respectively). Compared with the recipient livers of the non-HT group, numerous Ki-67 + hepatocytes and few TUNEL + hepatocytes were observed in the livers of the HT group. At 6 months after the HT, the DPPIV + hepatocytes had partially replaced the recipient liver and formed hepatocyte clusters in the spleen. Preoperative HT might improve the survival of rats with NASH-related cirrhosis after PH by preventing the host hepatocytes from accelerating their growth and falling into apoptosis.

DOI PubMed

Pancreaticoduodenectomy for biliary tract carcinoma with situs inversus totalis: difficulties and technical notes based on two cases.

Kyuno Daisuke, Kimura Yasutoshi, Imamura Masafumi, Uchiyama Motonobu, Ishii Masayuki, Meguro Makoto, Kawamoto Masaki, Mizuguchi Toru, Hirata Koichi

World journal of surgical oncology 11 312 - 312 2013年12月 [査読有り] [国際誌]

Situs inversus totalis (SIT) denotes complete right-left inversion of the thoracic and abdominal viscera. Diagnosis and surgical procedures for abdominal pathology in patients with SIT are technically more complicated because of mirror-image transposition of the visceral organs. Moreover, SIT is commonly associated with cardiovascular and hepatobiliary malformations, which make hepatobiliary-pancreatic surgery difficult. Two cases of pancreaticoduodenectomy for biliary tract carcinoma in patients with SIT are presented. Both patients had an anomaly of the hepatic artery. Advanced diagnostic imaging techniques were very important for careful preoperative planning and to prevent misunderstanding of the arrangement of the abdominal viscera. This facilitated the surgical team's adaptation to the mirror image of the standard procedure and helped avoid intraoperative complications due to cardiovascular and hepatobiliary malformations associated with SIT. Pancreaticoduodenectomy in patients with SIT can be performed successfully with detailed preoperative assessment, use of effective techniques by the surgeon, and appropriate support by assistants.

DOI PubMed

腹腔鏡補助下腹会陰式直腸切断術後の会陰ヘルニアの1例

及能拓朗, 古畑智久, 植木知身, 沖田憲司, 秋月恵美, 川本雅樹, 西舘敏彦, 目黒誠, 信岡隆幸, 木村康利, 水口徹, 平田公一, 久木田和晴

北海道外科雑誌 ( 北海道外科学会 ) 58 ( 2 ) 177 - 178 2013年12月

Hepatic biliary epithelial cells acquire epithelial integrity but lose plasticity to differentiate into hepatocytes in vitro during development

Naoki Tanimizu, Yukio Nakamura, Norihisa Ichinohe, Toru Mizuguchi, Koichi Hirata, Toshihiro Mitaka

JOURNAL OF CELL SCIENCE ( COMPANY OF BIOLOGISTS LTD ) 126 ( 22 ) 5239 - + 2013年11月 [査読有り]

In developing organs, epithelial tissue structures are mostly developed by the perinatal period. However, it is unknown whether epithelial cells are already functionally mature and whether they are fixed in their lineage. Here we show that epithelial cells alter their plasticity during postnatal development by examining the differentiation potential of epithelial cell adhesion molecule (EpCAM)(+) cholangiocytes (biliary epithelial cells) isolated from neonatal and adult mouse livers. We found that neonatal cholangiocytes isolated from 1-week-old liver converted into functional hepatocytes in the presence of oncostatin M and Matrigel (R). In contrast, neither morphological changes nor expression of hepatocyte markers were induced in adult cholangiocytes. The transcription factors hepatocyte nuclear factor 4 alpha and CCAAT/enhancer binding protein alpha (C/EBP alpha), which are necessary for hepatocytic differentiation, were induced in neonatal cholangiocytes but not in adult cells, whereas grainyhead-like 2 (Grhl2) and hairy-enhance of slit 1 (Hes1), which are implicated in cholangiocyte differentiation, were continuously expressed in adult cells. Overexpression of C/EBPa and Grhl2 promoted and inhibited hepatocytic differentiation, respectively. Furthermore, adult cholangiocytes formed a monolayer with higher barrier function than neonatal ones did, suggesting that cholangiocytes are still in the process of epithelial maturation even after forming tubular structures during the neonatal period. Taken together, these results suggest that cholangiocytes lose plasticity to convert into hepatocytes during epithelial maturation. They lose competency to upregulate hepatocytic transcription factors and downregulate cholagiocytic ones under conditions inducing hepatocytic differentiation. Our results suggest that a molecular machinery augmenting epithelial integrity limits lineage plasticity of epithelial cells.

DOI PubMed

大腸癌転移性肝転移の術前化学療法症例の検討

西舘敏彦, 古畑智久, 沖田憲司, 植木知身, 秋月恵美, 久木田和晴, 小川宰司, 目黒誠, 川本雅樹, 信岡隆幸, 木村康利, 水口徹, 秦史壮, 佐々木一晃, 平田公一

日本消化器外科学会雑誌 ( (一社)日本消化器外科学会 ) 46 ( Suppl.2 ) 250 - 250 2013年10月

Continuous monitoring of central venous oxygen saturation predicts postoperative liver dysfunction after liver resection

Makoto Meguro, Toru Mizuguchi, Masaki Kawamoto, Yukio Nakamura, Shigenori Ota, Kazuharu Kukita, Masayuki Ishii, Hiroomi Tatsumi, Koichi Hirata

SURGERY ( MOSBY-ELSEVIER ) 154 ( 2 ) 351 - 362 2013年08月 [査読有り]

Background. We examined whether the data obtained by monitoring central venous oxygen saturation (ScvO(2)) and/or stroke volume variation (SVV) during hepatectomy, as measured with the FloTrac/Vigileo system, can predict postoperative liver dysfunction. Methods. This study included 33 patients with normal liver function who underwent hepatectomy between December 2007 and August 2010. Baseline ScvO(2) and baseline SVV, as control values, were defined as the mean of ScvO(2) and SVV, respectively, measured with the FloTrac/Vigileo system before hepatectomy. ScvO(2) decrease (Delta ScvO(2)) was defined as the difference between the baseline ScvO(2) and the lowest intraoperative ScvO(2) and SVV increase (Delta SVV) was defined as the difference between the baseline SVV and the highest intraoperative SVV Moreover, mean ScvO(2) and mean SVV were defined as the means of all ScvO(2) and SVV values measured during surgery, respectively. We examined correlations of the new parameters with the highest postoperative values of total bilirubin (T. Bil). Results. The cutoff values for Delta ScvO(2) and mean SVV for predicting the highest postoperative T. Bil level to be >= 3.0 mg/dL with the highest sensitivity and specificity were found to be 10.2% and 13.6%, respectively. The areas under curve in receiver-operating-characteristic analysis of Delta ScvO(2) and mean SVV were 0.797 and 0.757, respectively, showing significant differences. Conclusion. Our results suggest that Delta ScvO(2) and mean SVV can predict postoperative liver dysfunction. When Delta ScvO(2) and mean SVV exceed 10.2% and 13.6%, respectively, we advocate that adequate attention be paid to postoperative liver dysfunction, and that early intraoperative general circulatory management measures be implemented as needed.

DOI

下部直腸癌における腹腔鏡下側方リンパ節郭清術

古畑智久, 沖田憲司, 西舘敏彦, 植木知身, 秋月恵美, 久木田和晴, 信岡隆幸, 木村康利, 水口徹, 平田公一

日本消化器外科学会総会 ( (一社)日本消化器外科学会 ) 68回 RV - 1 2013年07月

Asialoglycoprotein receptor scintigraphy with Tc-99m-galactosyl human serum albumin (Tc-99m-GSA) as an early predictor of survival in acute liver failure

H. Tatsumi, Y. Masuda, H. Imaizumi, S. Yoshida, K. Goto, N. Yama, T. Mizuguchi, K. Hirata

ANAESTHESIA AND INTENSIVE CARE ( AUSTRALIAN SOC ANAESTHETISTS ) 41 ( 4 ) 523 - 528 2013年07月 [査読有り]

This study evaluated the usefulness of asialoglycoprotein receptor scintigraphy with Tc-99m-galactosyl human serum albumin (Tc-99m-GSA scintigraphy) as an early predictor for prognosis of acute liver failure. Forty-eight patients with acute liver failure and without a past history of chronic liver disease were enrolled. Patients were divided into survival and non-survival groups by 28-day mortality. Tc-99m-GSA scintigraphy to detect uptake ratio of the heart at 15 minutes to that at three minutes (HH15) and uptake ratio of the liver at 15 minutes to the liver plus the heart at 15 minutes (LHL15), and measurements of serum total bilirubin, hepatocyte growth factor and prothrombin time were performed immediately after the diagnosis of acute liver failure. Areas under the receiver operating characteristic curves were used to compare the prognostic ability of total bilirubin, hepatocyte growth factor, prothrombin time, HH15 ratio, LHL15 ratio and the model for end-stage liver disease score. Clinical characteristics of patients in the survival group (n=20) and in the non-survival group (n=28) Were not significantly different. HH15 and LHL15 uptake ratios in the survival group were 0.670 and 0.875 and they were significantly lower and higher than those in the non-survival group, respectively. All patients with LHL15 <0.760 died, and the area under the receiver operating characteristic curve for LHL15 were significantly larger than the areas under the receiver operating characteristic curves of serum variables and model for end-stage liver disease score. In summary, in patients with acute liver failure without chronic liver disease, HH15 and LHL15 of Tc-99m-GSA scintigraphy are more useful variables in predicting prognosis than serum variables and model for end-stage liver disease score.

Prognosis and Predictors of Surgical Complications in Hepatocellular Carcinoma Patients With or Without Cirrhosis after Hepatectomy

Toru Mizuguchi, Masaki Kawamoto, Makoto Meguro, Yukio Nakamura, Shigenori Ota, Thomas T. Hui, Koichi Hirata

WORLD JOURNAL OF SURGERY ( SPRINGER ) 37 ( 6 ) 1379 - 1387 2013年06月 [査読有り]

Although poor liver function is associated with a high morbidity rate and poor prognosis in hepatocellular carcinoma (HCC) patients, the exact effects of liver pathology on the surgical outcomes of HCC patients are poorly understood. The purpose of this study was to assess how the liver pathology of HCC patients affects their prognosis and complications rate after liver resection. Between January 2006 and November 2010, 149 consecutive hepatocellular carcinoma patients, including 79 noncirrhosis patients and 70 cirrhosis patients, were enrolled in this study. Among the noncirrhotic patients, operative time, fresh frozen plasma (FFP) transfusion requirement, tumor size, and serum retinol binding protein (RBP) levels were significantly higher in the complications group than in the complications-free groups. On the other hand, in the cirrhotic patients the prothrombin time (PT) and indocyanine green retention value at 15 min (ICGR(15)) of the complications group were significantly lower and higher, respectively, than those of the complications-free group. In the noncirrhotic patients, recurrence-free survival and overall survival did not differ between the complications and complications-free groups. On the other hand, in the cirrhotic patients, the recurrence-free survival and overall survival of the complications-free group were significantly longer than those of the complications group. In the noncirrhotic patients, surgical complications had no prognostic effect, whereas they had a significant survival impact in the cirrhotic patients. The surgical strategy for HCC should be based on the patient's pathological background.

DOI

Differentiation capacity of hepatic stem/progenitor cells isolated from D-galactosamine-treated rat livers.

Norihisa Ichinohe, Naoki Tanimizu, Hidekazu Ooe, Yukio Nakamura, Toru Mizuguchi, Junko Kon, Koichi Hirata, Toshihiro Mitaka

Hepatology (Baltimore, Md.) 57 ( 3 ) 1192 - 202 2013年03月 [国際誌]

UNLABELLED: Oval cells and small hepatocytes (SHs) are known to be hepatic stem and progenitor cells. Although oval cells are believed to differentiate into mature hepatocytes (MHs) through SHs, the details of their differentiation process are not well understood. Furthermore, it is not certain whether the induced cells possess fully mature functions as MHs. In the present experiment, we used Thy1 and CD44 to isolate oval and progenitor cells, respectively, from D-galactosamine-treated rat livers. Epidermal growth factor, basic fibroblast growth factor, or hepatocyte growth factor could trigger the hepatocytic differentiation of sorted Thy1(+) cells to form epithelial cell colonies, and the combination of the factors stimulated the emergence and expansion of the colonies. Cells in the Thy1(+) -derived colonies grew more slowly than those in the CD44(+) -derived ones in vitro and in vivo and the degree of their hepatocytic differentiation increased with CD44 expression. Although the induced hepatocytes derived from Thy1(+) and CD44(+) cells showed similar morphology to MHs and formed organoids from the colonies similar to those from SHs, many hepatic differentiated functions of the induced hepatocytes were less well performed than those of mature SHs derived from the healthy liver. The gene expression of cytochrome P450 1A2, tryptophan 2,3-dioxygenase, and carbamoylphosphate synthetase I was lower in the induced hepatocytes than in mature SHs. In addition, the protein expression of CCAAT/enhancer-binding protein alpha and bile canalicular formation could not reach the levels of production of mature SHs. CONCLUSION: The results suggest that, although Thy1(+) and CD44(+) cells are able to differentiate into hepatocytes, the degree of maturation of the induced hepatocytes may not be equal to that of healthy resident hepatocytes. (HEPATOLOGY 2013).

DOI PubMed

Soluble form of luthern/B-CAM in plasma as a potential maker for hepatocellular carcinoma

Kikkawa Yamato, Tanimizu Naoki, Miwa Takahiro, Mizuguchi Toru, Hirata Koichi, Nomizu Motoyoshi, Mitaka Toshihiro

GLYCOBIOLOGY 22 ( 11 ) 1601 2012年11月 [査読有り]

Area between the hepatic and heart curves of Tc-99m-galactosyl-human serum albumin scintigraphy represents liver function and disease progression for preoperative evaluation in hepatocellular carcinoma patients

Kohei Harada, Toru Mizuguchi, Yoshimi Katagiri, Masaki Kawamoto, Yukio Nakamura, Makoto Meguro, Shigenori Ota, Shigeru Sasaki, Koji Miyanishi, Tomoko Sonoda, Mitsuru Mori, Yasuhisa Shinomura, Junji Kato, Koichi Hirata

JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES ( SPRINGER JAPAN KK ) 19 ( 6 ) 667 - 673 2012年11月 [査読有り]

Background/purpose We developed software to calculate the pixels of interest in the area between the hepatic and heart curves (ABC) of Tc-99m-galactosyl human serum albumin (GSA) scintigraphy. The aim of this study was to examine the accuracy of the ABC to evaluate liver function before hepatectomy. Methods Between January 2005 and December 2010, 205 consecutive patients who underwent initial hepatectomy were enrolled in this study. The ABC was calculated using original computer software. The area under the receiver operating characteristic curve (AUC) was calculated for evaluation of Child-Pugh score grade B (Child B), pathological chronic hepatitis (CH), and liver cirrhosis (LC). Results The AUC of any indicator for Child B was more than 0.900 except bilirubin. The AUC of ABC for CH and LC (AUC 0.734 each) was comparable to those of HH15 (clearance index; AUC 0.704 and 0.700, respectively) and LHL15 (receptor index; AUC 0.703 and 0.706, respectively) in multiple receiver operating characteristic comparison. Conclusions We have developed a novel liver function indicator, the ABC, to count radioactivity in sequence. The ABC reflects liver function according to pathological deterioration of the liver. Although the ABC gave no significant advantage compared to HH15 and LHL15, it improved the AUC evaluation by 0.028-0.034.

DOI PubMed

【Oncologic emergency】胆道閉塞

孫誠一, 木村康利, 今村将史, 今野愛, 鶴間哲弘, 目黒誠, 水口徹, 平田公一

消化器外科 ( (株)へるす出版 ) 35 ( 3 ) 301 - 309 2012年03月

Low-dose steroid pretreatment ameliorates the transient impairment of liver regeneration

Toshihito Shibata, Toru Mizuguchi, Yukio Nakamura, Masaki Kawamoto, Makoto Meguro, Shigenori Ota, Koichi Hirata, Hidekazu Ooe, Toshihiro Mitaka

WORLD JOURNAL OF GASTROENTEROLOGY ( BAISHIDENG PUBL GRP CO LTD ) 18 ( 9 ) 905 - 914 2012年03月 [査読有り]

AIM: To determine if liver regeneration (LR) could be disturbed following radiofrequency (RF) ablation and whether modification of LR by steroid administration occurs. METHODS: Sham operation, partial hepatectomy (PH), and partial hepatectomy with radiofrequency ablation (PHA) were performed on adult Fisher 344 rats. We investigated the recovery of liver volume, DNA synthetic activities, serum cytokine/chemokine levels and signal transducers and activators of transcription 3 DNA-binding activities in the nucleus after the operations. Additionally, the effects of steroid (dexamethasone) pretreatment in the PH group (S-PH) and the PHA group (S-PHA) were compared. RESULTS: The LR after PHA was impaired, with high serum cytokine/chemokine induction compared to PH, although the ratio of the residual liver weight to body weight was not significantly different. Steroid pretreatment disturbed LR in the S-PH group. On the other hand, low-dose steroid pretreatment improved LR and suppressed tumor necrosis factor (TNF)-alpha elevation in the S-PHA group, with recovery of STAT3 DNA-binding activity. On the other hand, low-dose steroid pretreatment improved LR and suppressed TNF-alpha elevation in the S-PHA group, with recovery of STAT3 DNA-binding activity. CONCLUSION: LR is disturbed after RF ablation, with high serum cytokine/chemokine induction. Low-dose steroid administration can improve LR after RF ablation with TNF-alpha suppression. (C) 2012 Baishideng. All rights reserved.

DOI PubMed

Serum Antithrombin III Level is Well Correlated with Multiple Indicators for Assessment of Liver Function and Diagnostic Accuracy for Predicting Postoperative Liver Failure in Hepatocellular Carcinoma Patients

Toru Mizuguchi, Masaki Kawamoto, Makoto Meguro, Seiichi Son, Yukio Nakamura, Kohei Harada, Toshihito Shibata, Shigenori Ota, Koichi Hirata

HEPATO-GASTROENTEROLOGY ( H G E UPDATE MEDICAL PUBLISHING S A ) 59 ( 114 ) 551 - 557 2012年03月 [査読有り]

Background/Aims: Evaluation of preoperative hepatic reserve is critical to avoid a fatal clinical course such as liver failure. We retrospectively evaluated 158 consecutive hepatocellular carcinoma (HCC) patients who underwent initial hepatectomy. The aim of this study was to determine the correlations of multiple indicators for assessment of liver function before hepatectomy. Furthermore, diagnostic probability for the pathological background and prediction of postoperative liver failure/dysfunction was compared between the antithrombin (AT) III level and indocyanine green retention] rate at 15 minutes (ICGR(15)). Methodology: Between January 2001 and March 2008, 158 HCC patients who underwent initial hepatectomy were enrolled in this study. Spearman's correlation coefficients (r values] were obtained for 15 clinical laboratory tests including ATIII and ICGR(15). Receiver operating characteristic (ROC) curve analysis was used for calculating the probability and predictive ability of the tests. Results: All 158 consecutive HCC patients were eligible for hepatectomy based on the Japanese guideline. ATIII is correlated with 13 of 14 other clinical tests, including albumin, bilirubin, prothrombin time, rapid turnover proteins, HGF, ICGR(15) and others. The diagnostic probabilities to distinguish between normal liver and other pathological backgrounds of ATIII and ICGR(15) were significantly different. The specificity of ATIII to predict postoperative liver failure/dysfunction was higher than that of ICGR(15). Conclusions: The serum ATIII level before hepatectomy is valuable to estimate the pathological background and predict postoperative liver failure/dysfunction. It should be possible to use ATIII as an additional indicator for liver function and substitute for ICGR(15) in the future.

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