The Evaluation of Liver Function and Surgical Influence by ICGR15 after Chemotherapy for Colorectal Liver Metastases.
The Evaluation of Liver Function and Surgical Influence by ICGR15 after Chemotherapy for Colorectal Liver Metastases.
复制标题
DOI：
10.7150/jca.13759
复制
发表时间：
2016
影响因子：
3.9
通讯作者：
Natsugoe S
中科院分区：
文献类型：
--
作者：
Hiwatashi K;Ueno S;Sakoda M;Iino S;Minami K;Mori S;Kita Y;Baba K;Kurahara H;Mataki Y;Maemura K;Shinchi H;Natsugoe S
背景：大约60%的结直肠癌患者在确诊后的某个时间点发生肝转移。本研究的目的是调查术前ICGR 15的评估是否是化疗后肝损伤的有用临床指标，并调查多种化疗对肝功能的影响。结果;年龄≥65岁（P = 0.047）、接受过≥3个周期（P = 0.022）和≥6个周期（P = 0.001）全身化疗的患者的平均ICGR 15值较高。术后并发症患者的ICGR 15值往往较高（P = 0.085）。接受≥6个周期全身化疗的患者的AST（P = 0.003）、ALT（P = 0.015）和碱性磷酸酶（ALP）水平较高（P = 0.041）。化疗≥3个周期的患者AST（P = 0.015）和ALP（P = 0.015）水平较高。结论;由于病理诊断通常仅在手术后才能建立，因此术前评估（如识别窦损伤）很困难。基于这项研究，较高的ICGR 15值可能提供手术并发症的指征，并且是频繁化疗周期后肝功能障碍的预测因子。肝切除术应尽可能谨慎地进行，术前化疗的周期数应尽可能少。
Background; Approximately 60% of patients with colorectal cancer develop liver metastasis at some point after diagnosis. The aim of this study is to investigate whether the evaluation of ICGR15 preoperatively is a useful clinical indicator of hepatic injury following chemotherapy and to investigate the influence of multiple chemotherapies on liver function. Results; Mean ICGR15 values were higher in patients ≥65 years (P = 0.047) and in patients with ≥3 cycles (P = 0.022) and ≥6 cycles (P = 0.001) of systemic chemotherapy. ICGR15 values tended to be higher in patients with postoperative complications (P = 0.085). Patients receiving systemic chemotherapy for ≥6 cycles had higher levels of AST (P = 0.003), ALT (P = 0.015), and alkaline phosphatase (ALP) (P = 0.041). Patients receiving systemic chemotherapy for ≥3 cycles had higher levels of AST (P = 0.015) and ALP (P = 0.015). Conclusions; Because the pathological diagnosis is usually established only after operation, preoperative evaluation such as the identification of sinusoidal injury is difficult. Based on this study, higher ICGR15 values may provide an indication of surgical complications and be a predictor of liver dysfunction following frequent cycles of chemotherapy. Hepatectomy should be performed with the utmost care in such patients, and the number of cycles of preoperative chemotherapy should probably be as low as possible.