J Korean Surg Soc.
2008 Apr;74(4):267-273.
Indocyanine Green Clearance Rate and Underlying Hepatic Inflammation and Fibrosis in Patients with Hepatocellular Carcinoma
- Affiliations
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- 1Department of Surgery, Postgraduate School of Medicine, Gyeongsang National University, Jinju, Korea. schong@nongae.gsnu.ac.kr
- 2Department of Pathology, Postgraduate School of Medicine, Gyeongsang National University, Jinju, Korea.
- 3Department of Surgical Oncology, Gyeongnam Regional Cancer Center, Jinju, Korea.
Abstract
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PURPOSE: The indocyanine clearance rate has been identified as an independent prognostic factor in patients with hepatocellular carcinoma (HCC). However, in contrast to its well-documented value in measuring hepatic reserve function, the mechanism by which it exerts its prognostic effect is not precisely understood.
METHODS
We analyzed the clinical and pathological data, including preoperative ICG-R 15 and survival, of 80 patients with resectable HCC. The correlation between ICG-R15 and the degree of inflammation and fibrosis in non-cancerous liver tissue were investigated. The prognostic significance of ICG- R15 was also investigated in 67 patients with unresectable HCC who received transarterial chemoembolization.
RESULTS
In patients with resectable HCC, the low ICG group (ICG-R15<15%) showed an increased overall survival rate (P<0.001) and disease-free survival rate (P<0.01) compared to the high ICG group (ICG-R15> or =15%). ICG-R15 was also a significant prognostic factor in the multivariate analysis. ICG-R15 showed a significant correlation with the degree of necroinflammation (P<0.001) and the degree of fibrosis (P<0.001). In patients with unresectable HCC, the low ICG group (ICG-R15<30%) showed a significantly increased progression-free survival rate (P=0.037).
CONCLUSION
The results of the present study demonstrate that the ICG clearance rate can predict the degree of inflammation and fibrosis of non-cancerous hepatic parenchyma, and this capacity may explain the prognostic value of the ICG clearance rate in HCC patients.
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