Taniguchi Masahiko, Okizaki Atsutaka, Watanabe Kenji, Imai Koji, Uchida Koichiro, Einama Takahiro, Shuke Noriyuki, Miyokawa Naoyuki, Furukawa Hiroyuki
Masahiko Taniguchi, Kenji Watanabe, Koji Imai, Koichiro Uchida, Takahiro Einama, Hiroyuki Furukawa, Division of Gastroenterologic and General Surgery, Department of Surgery, Asahikawa Medical College, Asahikawa 078-8510, Japan.
World J Gastroenterol. 2014 Nov 28;20(44):16714-20. doi: 10.3748/wjg.v20.i44.16714.
To evaluate the clinical utility of hepatic clearance (HC) measured with technetium-99m-diethylenetriaminepenta-acetic acid-galactosyl human serum albumin ((99m)Tc-GSA) single-photon emission computed tomography (SPECT) to estimate the degree of liver fibrosis.
Seventy-eight consecutive patients who underwent initial hepatectomy due to hepatocellular carcinoma were enrolled in this study. Indocyanine green clearance (ICG R15), quantitative indices estimated by (99m)Tc-GSA [the receptor index (LHL15 and HH15) and HC via SPECT analysis], and conventional liver function tests were performed before hepatectomy. Correlations among the quantitative indices for liver functional reserve, conventional liver function tests, and the degree of liver fibrosis were evaluated.
The degree of liver fibrosis was correlated with ICG R15, HH15, LHL15, and HC. HC showed the best correlation with conventional liver function tests. According to multivariate analysis, HC and LHL15 were significant independent predictors of severe fibrosis. HC was the most valuable index for predicting severe fibrosis.
HC measured with (99m)Tc-GSA SPECT is a reliable index for assessing liver fibrosis before hepatectomy.
评估用锝-99m-二乙三胺五乙酸-半乳糖基人血清白蛋白（（99m）Tc-GSA）单光子发射计算机断层扫描（SPECT）测量的肝清除率（HC）来估计肝纤维化程度的临床实用性。
本研究纳入了78例因肝细胞癌首次接受肝切除术的连续患者。在肝切除术前进行吲哚菁绿清除率（ICG R15）、由（99m）Tc-GSA估算的定量指标[受体指数（LHL15和HH15）以及通过SPECT分析得出的HC]和常规肝功能检查。评估肝功能储备的定量指标、常规肝功能检查与肝纤维化程度之间的相关性。
肝纤维化程度与ICG R15、HH15、LHL15和HC相关。HC与常规肝功能检查的相关性最佳。根据多因素分析，HC和LHL15是严重纤维化的显著独立预测因素。HC是预测严重纤维化最有价值的指标。
用（99m）Tc-GSA SPECT测量的HC是肝切除术前评估肝纤维化的可靠指标。
