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KMID : 0371320080740040267
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Journal of the Korean Surgical Society
2008 Volume.74 No. 4 p.267 ~ p.273
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Indocyanine Green Clearance Rate and Underlying Hepatic Inflammation and Fibrosis in Patients with Hepatocellular Carcinoma
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Park Seong-Jun
Moon Hyung-Gon
Kim Dong-Chul
Jeong Chi-Young
Ju Young-Tae
Jung Eun-Jung
Lee Young-Joon
Choi Sang-Kyung
Ha Woo-Song
Park Soon-Tae
Hong Soon-Chan
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Abstract
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Purpose: The indocyanine clearance rate has been identified as an independent prognostic factor in patients with hepatocellular carcinoma (HCC). However, in contrast to its well-documented value in measuring hepatic reserve function, the mechanism by which it exerts its prognostic effect is not precisely understood.
Methods: We analyzed the clinical and pathological data, including preoperative ICG-R 15 and survival, of 80 patients with resectable HCC. The correlation between ICG-R15 and the degree of inflammation and fibrosis in non-cancerous liver tissue were investigated. The prognostic significance of ICG- R15 was also investigated in 67 patients with unresectable HCC who received transarterial chemoembolization.
Results: In patients with resectable HCC, the low ICG group (ICG-R15＜15%) showed an increased overall survival rate (P＜0.001) and disease-free survival rate (P＜0.01) compared to the high ICG group (ICG-R15≥15%). ICG-R15 was also a significant prognostic factor in the multivariate analysis. ICG-R15 showed a significant correlation with the degree of necroinflammation (P＜0.001) and the degree of fibrosis (P＜0.001). In patients with unresectable HCC, the low ICG group (ICG-R15＜30%) showed a significantly increased progression-free survival rate (P=0.037).
Conclusion: The results of the present study demonstrate that the ICG clearance rate can predict the degree of inflammation and fibrosis of non-cancerous hepatic parenchyma, and this capacity may explain the prognostic value of the ICG clearance rate in HCC patients. (J Korean Surg Soc 2008;74:267-273)
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KEYWORD
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Hepatocellular carcinoma, Indocyanine green clearance, Prognosis, Fibrosis, Inflammation
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