[Changes in ketone body ratio and levels of pyruvate and lactate in arterial blood of patients with hepatocellular carcinoma after transcatheter arterial embolization].

The ketone body ratio (acetoacetate/3-hydroxybutyrate:KBR) and levels of pyruvate and lactate in arterial blood of patients with hepatocellular carcinoma (HCC) were examined. KBRs and levels of pyruvate and lactate in patients with HCC were similar to those in patients without liver diseases (1.57 +/- 0.88, 0.84 +/- 0.32, 11.4 +/- 4.5 vs 1.80 +/- 0.9, 0.89 +/- 0.48, 10.8 +/- 6.2). However, pyruvate to lactate ratios were significantly lower in HCC patients (7.45 +/- 1.57 vs 8.62 +/- 2.15, p less than 0.05). Among the HCC patients the levels of pyruvate and lactate were significantly higher in patients with liver cirrhosis (LC) than those in patients without LC. The sequential changes of KBRs and levels of pyruvate and lactate were examined before and after transcatheter arterial embolization (TAE). Although KBRs were transiently decreased immediately after TAE, they were at higher levels from the 3rd to 21st day in comparison with those before TAE. The levels of pyruvate and lactate showed no significant changes immediately after TAE. However, they followed a course similar to that of KBRs after TAE. Lower KBRs and higher levels of pyruvate and lactate tended to be observed in HCC patients with LC after TAE than in those without LC. This suggests a decrease of intrahepatic blood flow probably due to histological reconstruction. These results suggest that the presence of LC is one of the most important factors influencing the functional reserve of liver in HCC patients. In HCC patients without LC, the recovery from the overload of TAE may operate at mitochondrial levels at least the 3rd day after TAE.