ICGR15和OGTT预测肝癌患者肝脏储备功能的价值

Anticipated value of ICGR15 and OGTT for hepatic reserving function in patients with primary hepatic cancer

目的 研究吲哚氰绿 15min储留率 (ICGR15 )和口服糖耐量试验 (OGTT)对原发性肝癌 (PHC)肝脏储备功能预测的价值。方法 将 5 8例PHC病人按术后肝功能恢复情况分为肝功能代偿良好组 (A组 )、轻度不全组 (B组 )和重度不全组 (C组 ) ,术前做ICGR15 ,OGTT及常规肝功能检查。结果 C组ICGR 15 (2 4 17%± 6 5 9% )较A组 (11 42 %± 3 91% )、B组 (16 2 8%± 6 0 7% )显著升高 (P均 <0 .0 1) ;C组OGTT 12 0min血糖值 (9 91mmol/L±3 0 9mmol/L)明显高于A组 (5 42mmol/L± 0 83mmol/L)、B组 (6 6 8mmol/L± 1 6 1mmol/L)(P均 <0 .0 1) ;ICGR 15和OGTT的准确性 (86 2 % ,81 0 % )、阳性预测值 (93 5 % ,90 6 % )、阴性预测值 (74 4% ,72 5 % )均明显高于Pugh肝功能评分 (P <0 .0 1)。结论 ICGR15和OGTT可作为预测PHC肝脏储备功能的指标 。

Objective To study anticipated value of the retention rate of indocyanine green at 15 minutes after injection (ICGR15) and oral glucose tolerance test (OGTT) on hepatic function reserve in patients with primary hepatic cancer (PHC). Methods 58 patients with PHC were divided into 3 groups according to the recovery after operation for PHC. Of them, 29 cases showed good recovery (group A), 18 mild liver dysfunction (group B) and 11 severe liver dysfunction (group C) respectively. ICGR 15, OGTT, routine liver function tests were performed in all patients preoperatively. Results ICGR15 in group C(24.17%±6.59%) obviously increased than that in group A(11.42%±3.91%,P<0.01) and in group B(16.28±6.07%, P<0.01). Blood glucose lever of 120 min after glucose loading test in group C (9.91 mmol/L±3.09mmol/L)was significantly higher than that in group A(5.42mmol/L±0.83mmol/L, (P<0 01) and group B(6.68±1.61, P<0.01). The accuracy (81.0%,86.2%), positive (90.6%, 93.5%) and negative prediction value (72.5%, 74.4%) of OGTT and ICGR 15 were respectively significent greater than those of Pugh's scoring (P<0.01).Conclusions ICGR15 and OGTT are worthwhile indicators to assess hepatic function reserve for patients with PHC. Combination of both ICGR15 and OGTT has higher predictive value on hepatic function reserve.