Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Department of Radiology Department, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
BMC Surg. 2020 Nov 12;20(1):283. doi: 10.1186/s12893-020-00952-z.
The indocyanine green (ICG) clearance test is the main method of evaluating the liver reserve function before hepatectomy. However, some patients may be allergic to ICG or the equipment of ICG clearance test was lack, leading to be difficult to evaluate liver reserve function. We aim to find an alternative tool to assist the clinicians to evaluate the liver reserve function for those who were allergic to the ICG or lack of equipment before hepatectomy.
We retrospected 300 patients to investigate the risk factors affecting the liver reserve function and to build an equivalent formula to predict ICG 15 min retention rate (ICG-R15) value.
We found that the independent risk factors affecting ICG clearance test were total bilirubin, albumin, and spleen-to-non-neoplastic liver volume ratio (SNLR). The equivalent formula of the serological index combining with SNLR was: ICG-R15 = 0.36 × TB (umol/L) - 0.78 × ALB(g/L) + 7.783 × SNLR + 0.794 × PT (s) - 0.016 × PLT(/10) - 0.039 × ALT (IU/L) + 0.043 × AST (IU/L) + 23.846. The equivalent formula of serum index was: ICG-R15 = 24.665 + 0.382 × TB (umol/L) - 0.799 × ALB(g/L) - 0.025 × PLT(/10) + 0.048 × AST(IU/L) - 0.045 × ALT(IU/L). And the area under the ROC curve (AUC) of predicting ICG-R15 ≥ 10% was 0.861 and 0.857, respectively.
We found that SNLR was an independent risk factor affecting liver reserve function. Combining with SNLR to evaluate the liver reserve function was better than just basing on serology.
吲哚菁绿（ICG）清除试验是肝切除术前评估肝储备功能的主要方法。然而，有些患者可能对 ICG 过敏，或者缺乏 ICG 清除试验设备，导致难以评估肝储备功能。我们旨在寻找一种替代工具，以协助临床医生评估那些对 ICG 过敏或在肝切除术前缺乏设备的患者的肝储备功能。
我们回顾性分析了 300 例患者，以探讨影响肝储备功能的危险因素，并建立预测 ICG 15 分钟滞留率（ICG-R15）值的等效公式。
我们发现，影响 ICG 清除试验的独立危险因素是总胆红素、白蛋白和脾与非肿瘤性肝体积比（SNLR）。结合 SNLR 的血清学指标的等效公式为：ICG-R15=0.36×TB（umol/L）-0.78×ALB（g/L）+7.783×SNLR+0.794×PT（s）-0.016×PLT（/10）-0.039×ALT（IU/L）+0.043×AST（IU/L）+23.846。血清学指标的等效公式为：ICG-R15=24.665+0.382×TB（umol/L）-0.799×ALB（g/L）-0.025×PLT（/10）+0.048×AST（IU/L）-0.045×ALT（IU/L）。预测 ICG-R15≥10%的 ROC 曲线下面积（AUC）分别为 0.861 和 0.857。
我们发现 SNLR 是影响肝储备功能的独立危险因素。结合 SNLR 评估肝储备功能优于单纯基于血清学。
