Wen T F
Zhonghua Wai Ke Za Zhi. 1989 Oct;27(10):597-600, 638.
To investigate the predictive value of oral glucose tolerance test (O-GTT) and insulin secretion test (IST) on the risk of hepatectomy in liver cancer patients, we through double-blind method, compared the results of these two tests, clinical course of the patients, and the pathological findings. It was found that: 1) The positive prediction value, negative prediction value, and accuracy of O-GTT were 79.2%, 94.4%, and 85.7%, the corresponding figures of IST were 55.6%, 100%, and 61.9%, respectively. 2) Pattern of the curve of O-GTT believed to depend on roughly normal hepatic energy metabolism and islet secretion capacity suggested better tolerance for hepatectomy. 3) A part of the patients with advanced HCC had a depressed islet secretion capacity. 4) The delta IST/delta O-GTT showed an accurate negative prediction for hepatectomy when the ratio was less than 50 x 10(-9). 5) Apart from O-GTT and delta IST/delta O-GTT, the severity of the hepatitis and cirrhosis should be taken into account in the decision of carrying out hepatectomy.
为探讨口服葡萄糖耐量试验（O-GTT）和胰岛素分泌试验（IST）对肝癌患者肝切除风险的预测价值，我们采用双盲法，比较了这两项检查的结果、患者的临床病程及病理结果。结果发现：1）O-GTT的阳性预测值、阴性预测值及准确率分别为79.2%、94.4%和85.7%，IST的相应数值分别为55.6%、100%和61.9%。2）O-GTT曲线模式被认为大致取决于正常的肝脏能量代谢和胰岛分泌能力，提示对肝切除的耐受性较好。3）部分晚期肝癌患者存在胰岛分泌能力下降。4）当δIST/δO-GTT比值小于50×10⁻⁹时，对肝切除有准确的阴性预测。5）除O-GTT和δIST/δO-GTT外，在决定是否进行肝切除时还应考虑肝炎和肝硬化的严重程度。
