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吲哚菁绿清除试验评估超选择性经导管肝动脉化疗栓塞后肝储备功能的恢复情况。

Indocyanine green clearance in evaluating the recovery of liver reserve function after superselective transarterial chemoembolization.

机构信息

Department of Oncology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.

出版信息

Hepatobiliary Pancreat Dis Int. 2013 Dec;12(6):656-60. doi: 10.1016/s1499-3872(13)60103-4.

Abstract

Transarterial chemoembolization (TACE) may ravage normal liver tissues apart from the neoplastic nodules which offset the anti-tumor effect. This study aimed to evaluate the recovery of liver reserve function (LRF) after TACE by indocyanine green (ICG) clearance test and other routine liver function tests. Forty-six newly diagnosed HCC patients who had undergone TACE as the initial treatment from January 2011 to January 2012 were enrolled in this study. The effects of age, basic ICG clearance rate and interval time between two assessments on the recovery of LRF were analyzed. We found that ICG retention rate at the 15 minutes (ICGR15) was significantly increased after TACE (12.3+/-8.1% vs 16.8+/-12.1%, P<0.01) in all the 46 patients. In particular, the ICGR15 value was increased in older patients (age>55 years, 20.3+/-12.5% vs 13.7+/-7.2%, P<0.01). The interval of ICG test also affected the ICGR15 value (≤47 days, 17.8+/-11.4% after vs 12.1+/-7.1% before TACE, P<0.01). Our data suggested that TACE decreased LRF, especially in older patients. ICG test was more sensitive to evaluate the recovery of LRF after TACE than the Child-Pugh grade and routine liver function tests.

摘要

经动脉化疗栓塞术(TACE)除了破坏肿瘤结节外,还可能破坏正常肝组织,从而抵消抗肿瘤作用。本研究旨在通过吲哚菁绿(ICG)清除试验和其他常规肝功能检查评估 TACE 后肝储备功能(LRF)的恢复情况。本研究纳入了 2011 年 1 月至 2012 年 1 月期间接受 TACE 作为初始治疗的 46 例新诊断 HCC 患者。分析了年龄、基础 ICG 清除率和两次评估之间的间隔时间对 LRF 恢复的影响。我们发现,46 例患者的 ICG 滞留率在 15 分钟(ICGR15)在 TACE 后明显升高(12.3+/-8.1%比 16.8+/-12.1%,P<0.01)。特别是在年龄较大的患者中(年龄>55 岁,20.3+/-12.5%比 13.7+/-7.2%,P<0.01),ICGR15 值升高。ICG 检测的间隔时间也影响 ICGR15 值(≤47 天,TACE 后为 17.8+/-11.4%,TACE 前为 12.1+/-7.1%,P<0.01)。我们的数据表明,TACE 降低了 LRF,尤其是在年龄较大的患者中。与 Child-Pugh 分级和常规肝功能检查相比,ICG 试验更能敏感地评估 TACE 后 LRF 的恢复情况。

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