간세포암 환자에서 Indocyanine Green 청소율과 기저 간의 염증과 섬유화 정도 간의 관계

Abstract

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≥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. (J Korean Surg Soc 2008;74:267-273)