结直肠癌肝转移患者剖腹手术或部分肝切除术后门静脉和全身血清生长因子及急性期反应：C反应蛋白和肝细胞生长因子的预后作用

Portal and systemic serum growth factor and acute-phase response after laparotomy or partial hepatectomy in patients with colorectal liver metastases: a prognostic role for C-reactive protein and hepatocyte growth factor.

作者信息

de Jong K P, Hoedemakers R M J, Fidler V, Bijzet J, Limburg P C, Peeters P M J G, de Vries E G E, Slooff M J H

机构信息

Department of Surgery, Division of Hepato-Pancreato-Biliary Surgery & Liver Transplantation, University Hospital and Medical Faculty of the University of Groningen, 9700 RB Groningen, The Netherlands.

出版信息

Scand J Gastroenterol. 2004 Nov;39(11):1141-8. doi: 10.1080/00365520410009609.

DOI:10.1080/00365520410009609

PMID:15545174

Abstract

BACKGROUND

Growth factors play a role in wound healing and tumour growth. The aim of this study was to compare the effect of partial hepatectomy (PH) and laparotomy on serum levels of growth factors and acute-phase proteins in patients with colorectal liver metastases and to correlate these levels with prognosis after PH.

METHODS

Epidermal growth factor (EGF), hepatocyte growth factor (HGF), insulin like growth factor-I (IGF-I), insulin, interleukin-6 (IL-6), C-reactive protein (CRP) and serum amyloid-A (SAA) were determined in portal and systemic serum in 24 PH patients and 9 laparotomy patients.

RESULTS

No differences were found in the clinicopathological characteristics of PH and laparotomy patients with the exception of the number of metastases, blood loss and operation time. The response of SAA, CRP and IGF-I was lower in PH patients than in laparotomy patients (P < 0.02). PH was associated with a higher IL-6 (P = 0.02) and HGF (P = 0.055) response than laparotomy. A higher HGF and CRP response was associated with a poorer prognosis. Total IGF-I was negatively correlated with the resected liver volume (r = -0.48, P < 0.05).

CONCLUSIONS

PH is associated with a lower acute-phase and total IGF-I response and a higher HGF and IL-6 response compared with laparotomy. HGF and CRP responses had an influence on the prognosis.

摘要

背景

生长因子在伤口愈合和肿瘤生长中发挥作用。本研究旨在比较肝部分切除术（PH）和剖腹术对结直肠癌肝转移患者血清生长因子和急性期蛋白水平的影响，并将这些水平与PH术后的预后相关联。

方法

测定了24例接受PH的患者和9例接受剖腹术的患者门静脉和全身血清中的表皮生长因子（EGF）、肝细胞生长因子（HGF）、胰岛素样生长因子-I（IGF-I）、胰岛素、白细胞介素-6（IL-6）、C反应蛋白（CRP）和血清淀粉样蛋白A（SAA）。

结果

除转移灶数量、失血量和手术时间外，PH患者和剖腹术患者的临床病理特征未发现差异。PH患者中SAA、CRP和IGF-I的反应低于剖腹术患者（P < 0.02）。与剖腹术相比，PH与更高的IL-6反应（P = 0.02）和HGF反应（P = 0.055）相关。更高的HGF和CRP反应与更差的预后相关。总IGF-I与切除的肝脏体积呈负相关（r = -0.48，P < 0.05）。