Koch Dominik Thomas, Koliogiannis Dionysios, Drefs Moritz, Schirren Malte, von Ehrlich-Treuenstätt Viktor, Nieß Hanno, Renz Bernhard, Ilmer Matthias, Andrassy Joachim, Guba Markus O, Werner Jens, Kühn Florian
Department of General, Visceral and Transplantation Surgery, LMU University Hospital, LMU Munich, Munich, Germany.
Transplantation Center Munich, LMU University Hospital, LMU Munich, Munich, Germany.
Visc Med. 2024 Jan;39(6):184-192. doi: 10.1159/000535627. Epub 2023 Dec 27.
Liver (hepatic) fibrosis (LF) is characterized by impaired function and regenerative capacity of the liver and can lead to significantly increased morbidity and mortality in the context of surgical liver resection (LR). For this reason, it is crucial to identify the extent of LF preoperatively. Interleukin-6 (IL-6) is known to play a key role in the pathogenesis of LF, but its exact value as a preoperative marker is unknown. This study aimed to investigate the correlation between preoperatively determined IL-6 and the presence of LF.
In this prospective study, IL-6 was determined in 134 consecutive patients undergoing LR. Patients with liver cirrhosis (LC) and patients with clinical or laboratory signs of inflammation were excluded. LF was graded by a blinded pathologist with regard to the degree of LF according to the Desmet classification (0-4). Baseline IL-6 and degree of LF were correlated.
A total of 134 patients were prospectively included prior to LR. For 104 patients, LF was graded and inflammatory parameters were available. Thirty-five of these patients showed LC (Desmet 4), and another 33 patients showed preoperatively elevated inflammatory markers. Two of the remaining patients were liver transplant patients. These patients were excluded from the final analysis. According to Desmet, the remaining 34 patients had LF grade 0 or 1 (none or minimal LF) in 26 cases and LF grade 2 or 3 (moderate-to-severe LF) in 8 cases. Correlation of LF with preoperatively determined IL-6 yielded significantly higher IL-6 levels in the group of patients with moderate-to-severe LF (Desmet 2 or 3) compared to the group with none or minimal LF (Desmet 0 or 1; = 0.0495).
In the context of LR, our results showed a correlation of preoperatively determined IL-6 with the extent of LF present. Higher serum baseline IL-6 concentrations were associated with a higher degree of LF, whereas no other blood parameter or score was that predictive for LF. Our results suggest that baseline IL-6 might serve as a valuable parameter to assess LF prior to LR. More patients need to be analyzed to further evaluate and confirm the predictive accuracy of IL-6 for LF.
肝纤维化（LF）的特征是肝脏功能和再生能力受损，在肝切除术（LR）的情况下可导致发病率和死亡率显著增加。因此，术前确定LF的程度至关重要。已知白细胞介素-6（IL-6）在LF的发病机制中起关键作用，但其作为术前标志物的确切价值尚不清楚。本研究旨在探讨术前测定的IL-6与LF存在之间的相关性。
在这项前瞻性研究中，对134例连续接受LR的患者测定了IL-6。排除肝硬化（LC）患者以及有临床或实验室炎症迹象的患者。由一名盲法病理学家根据Desmet分类（0-4）对LF的程度进行分级。将基线IL-6与LF程度进行相关性分析。
共有134例患者在LR前被前瞻性纳入研究。104例患者的LF进行了分级且有炎症参数数据。其中35例患者为LC（Desmet 4级），另外33例患者术前炎症标志物升高。其余患者中有2例是肝移植患者。这些患者被排除在最终分析之外。根据Desmet分类，其余34例患者中，26例为LF 0级或1级（无或轻度LF），8例为LF 2级或3级（中度至重度LF）。与无或轻度LF组（Desmet 0或1级）相比，中度至重度LF组（Desmet 2或3级）患者术前测定的IL-6水平显著更高（P = 0.0495）。
在LR的背景下，我们的结果显示术前测定的IL-6与存在的LF程度相关。血清基线IL-6浓度越高，LF程度越高，而没有其他血液参数或评分对LF有如此强的预测性。我们的结果表明，基线IL-6可能是LR术前评估LF的一个有价值的参数。需要分析更多患者以进一步评估和确认IL-6对LF的预测准确性。
