Miyake Hidenori, Fujii Masahiko, Sasaki Katsuya, Ando Tsutomu, Ikeyama Shizuo, Iwata Takashi, Rokutan Kazuhito, Tashiro Seiki
Department of Digestive Surgery, University of Tokushima School of Medicine, 3-18-15 Kuramoto-cho, Tokushima 770-8503, Japan.
Hepatogastroenterology. 2003 Nov-Dec;50(54):2084-7.
BACKGROUND/AIMS: Preoperative right portal vein embolization enhances remnant liver function following massive hepatectomy. Several studies have reported an increase in the volume of the left hepatic lobe after right portal vein embolization, but little information exists regarding heat shock protein induction in hepatocytes after right portal vein embolization. The objective of this study is to determine whether heat shock protein is induced in hepatocytes after right portal vein embolization in patients who underwent extended right hepatic lobectomy.
Four patients with gallbladder cancer and one patient with intrahepatic cholangiocellular carcinoma who underwent extended right hepatic lobectomy combined with caudate lobectomy and resection of the extrahepatic bile duct after right portal vein embolization were enrolled in this study. Operation was performed 21-36 days after right portal vein embolization. At operation, small liver specimens were taken immediately after laparotomy from both the right anterior segment (embolized lobe) and lower part of the left medial segment (non-embolized lobe) and heat shock protein 70 was induction in these specimens was measured by Western blotting.
Heat shock protein 70 was induced in the left lobe relative to the right lobe in four patients, three of whom had an uneventful postoperative course.
This paper is the first report to show the induction of heat shock protein 70 in the non-embolized hepatic lobe after right portal vein embolization in the clinical cases.
背景/目的：术前右门静脉栓塞可增强大范围肝切除术后的残余肝功能。多项研究报道了右门静脉栓塞后左肝叶体积增加，但关于右门静脉栓塞后肝细胞中热休克蛋白诱导情况的信息较少。本研究的目的是确定在接受扩大右肝叶切除术的患者中，右门静脉栓塞后肝细胞是否会诱导产生热休克蛋白。
本研究纳入了4例胆囊癌患者和1例肝内胆管细胞癌患者，这些患者在右门静脉栓塞后接受了扩大右肝叶切除术联合尾状叶切除术及肝外胆管切除术。手术在右门静脉栓塞后21 - 36天进行。手术时，在剖腹手术后立即从右前叶（栓塞叶）和左内侧叶下部（非栓塞叶）采集小肝组织标本，并通过蛋白质印迹法检测这些标本中热休克蛋白70的诱导情况。
4例患者中，相对于右叶，左叶诱导产生了热休克蛋白70，其中3例术后恢复顺利。
本文是首篇报道临床病例中右门静脉栓塞后非栓塞肝叶诱导产生热休克蛋白70的研究。
