门静脉结扎后肝硬化大鼠未来肝残余的肝细胞功能改善：除了体积变化之外的额外益处。

Improved hepatocyte function of future liver remnant of cirrhotic rats after portal vein ligation: a bonus other than volume shifting.

作者信息

Lin Kun-Ju, Liao Chien-Hung, Hsiao Ing-Tsung, Yen Tzu-Chen, Chen Tse-Ching, Jan Yi-Yin, Chen Miin-Fu, Yeh Ta-Sen

机构信息

Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.

出版信息

Surgery. 2009 Feb;145(2):202-11. doi: 10.1016/j.surg.2008.10.006.

DOI:10.1016/j.surg.2008.10.006

PMID:19167976

Abstract

BACKGROUND

Preoperative portal vein embolization is increasingly employed for those with hepatocellular carcinoma and cirrhosis to gain a volume-shifting effect. However, the alterations of histologic architecture and hepatocyte function of future liver remnant (FLR) remain unexplored.

METHODS

Portal vein ligation (PVL) was performed in cirrhotic and noncirrhotic rats. Regeneration indices that include the DNA synthesis index, restituted liver mass, and the redistributed volume ratio were measured. The indocyanine green 15' retention test (ICG-R15), histologic changes, total Knodell score, and activated hepatic stellate cells (HSCs) were measured before and after PVL. Tc-99m sulfur-colloid liver single photon emission computed tomography (SPECT) and diisopropyl iminoacetic acid (DISIDA) SPECT were conducted.

RESULTS

The redistributed volume ratio of cirrhotic rats was less than noncirrhotic rats (63% vs 80%, P < .01). The ICG-R15 of cirrhotic rats at day 7 after PVL was improved compared with baseline (6.0 +/- 4.1% vs 15.8 +/- 4.6%, P < .01). The total Knodell score and activated HSCs of FLR in cirrhotic rats both were decreased compared with those of baseline. The redistributed volume ratio of noncirrhotic and cirrhotic rats based on 99mTc sulfur-colloid SPECT were 79% and 64%, respectively. The clearance T(1/2) of FLR in cirrhotic rats based on DISIDA SPECT was decreased compared with baseline (5.2 +/- 1.9 min vs 8.6 +/- 3.1 min).

CONCLUSION

The regenerated functional liver mass of cirrhotic rats after PVL is less than noncirrhotic rats, whereas the hepatocyte function of FLR in cirrhotic rats is improved relevant to tissue remodeling.

摘要

背景

术前门静脉栓塞术越来越多地应用于患有肝细胞癌和肝硬化的患者，以获得容积转移效应。然而，未来肝残余组织（FLR）的组织学结构和肝细胞功能的改变仍未得到探索。

方法

对肝硬化和非肝硬化大鼠进行门静脉结扎（PVL）。测量包括DNA合成指数、恢复的肝脏质量和重新分布的容积比在内的再生指标。在PVL前后测量吲哚菁绿15分钟滞留率（ICG-R15）、组织学变化、总Knodell评分和活化的肝星状细胞（HSCs）。进行锝-99m硫胶体肝脏单光子发射计算机断层扫描（SPECT）和二异丙基亚氨基二乙酸（DISIDA）SPECT检查。

结果

肝硬化大鼠的重新分布容积比低于非肝硬化大鼠（63%对80%，P <.01）。与基线相比，肝硬化大鼠在PVL后第7天的ICG-R15有所改善（6.0±4.1%对15.8±4.6%，P <.01）。与基线相比，肝硬化大鼠FLR的总Knodell评分和活化的HSCs均降低。基于99mTc硫胶体SPECT的非肝硬化和肝硬化大鼠的重新分布容积比分别为79%和64%。基于DISIDA SPECT，肝硬化大鼠FLR的清除半衰期（T(1/2)）与基线相比降低（5.2±1.9分钟对8.6±3.1分钟）。