Kusaka Koji, Imamura Hiroshi, Tomiya Tomoaki, Makuuchi Masatoshi
Department of Surgery, Hepato-Biliary-Pancreatic Surgery Division, Graduate School of Medicine, University of Tokyo, Japan.
Hepatogastroenterology. 2004 Mar-Apr;51(56):532-5.
BACKGROUND/AIMS: The factors influencing the effect of portal vein embolization performed prior to hepatectomies are not clearly understood.
In 18 patients who underwent portal vein embolization, serum transforming growth factor-alpha levels and the nonembolized liver volume were studied after portal vein embolization. The increase in the nonembolized liver volume was compared with the change in serum transforming growth factor-alpha levels and several other clinical variables.
The volume of the nonembolized liver significantly increased from 430+/-114 cm3 to 521+/-113 cm3. The serum transforming growth factor-alpha levels significantly increased on the 7th day after portal vein embolization and peaked on the 18th day. The percentage increase in the nonembolized liver volume 14 days after portal vein embolization was significantly correlated with the nonembolized liver volume and the increase in the portal flow velocity, and it was independently and significantly correlated with the increase in the transforming growth factor-alpha level 14 days after portal vein embolization (r2=0.674, P=0.0014 and r=0.761, P<0.0005).
The increase in the transforming growth factor-alpha level 14 days after portal vein embolization was the only independent factor related to the hypertrophy of the nonembolized liver. Measurement of its serum level may be a useful indicator in the scheduling of subsequent extensive hepatectomies.
背景/目的：肝切除术前门静脉栓塞效果的影响因素尚不清楚。
对18例行门静脉栓塞的患者，研究门静脉栓塞后血清转化生长因子-α水平及未栓塞肝体积。将未栓塞肝体积的增加与血清转化生长因子-α水平的变化及其他几个临床变量进行比较。
未栓塞肝体积从430±114 cm³显著增加至521±113 cm³。门静脉栓塞后第7天血清转化生长因子-α水平显著升高，并在第18天达到峰值。门静脉栓塞后14天未栓塞肝体积的增加百分比与未栓塞肝体积及门静脉血流速度的增加显著相关，且与门静脉栓塞后14天转化生长因子-α水平的增加独立且显著相关（r² = 0.674，P = 0.0014；r = 0.761，P < 0.0005）。
门静脉栓塞后14天转化生长因子-α水平的增加是与未栓塞肝肥大相关的唯一独立因素。测定其血清水平可能是后续大范围肝切除手术安排中的一个有用指标。
