Gotohda Naoto, Iwagaki Hiromi, Ozaki Michitaka, Kinoshita Taira, Konishi Masaru, Nakagohri Toshio, Takahashi Shinichiro, Saito Shinya, Yagi Takahito, Tanaka Noriaki
Department of Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha Kashiwa, 277-8577 Chiba, Japan.
Hepatogastroenterology. 2008 Jul-Aug;55(85):1400-3.
BACKGROUND/AIMS: Liver damage after hepatectomy is still a serious concern. The present study was designed to clarify the relations between liver injury/surgical stress and cytokines after hepatectomy, in patients with viral hepatitis.
Ten consecutive patients undergoing hepatectomy were studied, all with hepatocellular carcinoma due to viral hepatitis. Blood samples for interleukin-6 (IL-6), soluble IL-6 receptor (sIL-6R), hepatocyte growth factor (HGF), soluble Fas (sFas), soluble Fas Ligand and soluble tumor necrosis factor receptor (sTNFR) assays were collected before the operation and at the end of the operation.
There was a significant and positive correlation between the change in the serum level of HGF and preoperative liver function (ICG-R15). Notably, there were significant correlations between surgical stress and IL-6, HGF and sFas, but not sIL-6R and sTNFR. Furthermore, there was significant correlation between postoperative liver function (total bilirubin, albumin) and HGF, IL-6.
There was a close relationship between surgical stress and HGF, IL-6 and sFas after hepatectomy in patients with viral hepatitis. It was useful for the evaluation of surgical stress of hepatectomy to estimate the serum level of HGF, IL-6 and sFas.
背景/目的：肝切除术后的肝损伤仍是一个严重问题。本研究旨在阐明病毒性肝炎患者肝切除术后肝损伤/手术应激与细胞因子之间的关系。
对连续10例行肝切除术的患者进行研究，所有患者均因病毒性肝炎患有肝细胞癌。在手术前和手术结束时采集血样，用于检测白细胞介素-6（IL-6）、可溶性IL-6受体（sIL-6R）、肝细胞生长因子（HGF）、可溶性Fas（sFas）、可溶性Fas配体和可溶性肿瘤坏死因子受体（sTNFR）。
HGF血清水平的变化与术前肝功能（吲哚菁绿滞留率15分钟，ICG-R15）之间存在显著正相关。值得注意的是，手术应激与IL-6、HGF和sFas之间存在显著相关性，但与sIL-6R和sTNFR无关。此外，术后肝功能（总胆红素、白蛋白）与HGF、IL-6之间存在显著相关性。
病毒性肝炎患者肝切除术后手术应激与HGF、IL-6和sFas之间存在密切关系。评估HGF、IL-6和sFas的血清水平有助于评估肝切除术的手术应激。
