Abstract: 【Abstract】 Objective〓To evaluate the effect of indocyanine green clearance test at 15 min (ICGR15) on assessing preoperative liver reserve function in patients with hepatocellular carcinoma(HCC). Methods〓Sixty-three diagnosed HCC patients who had undergone hepatectomy from June 2012 to July 2013 were enrolled in this study. According to the quantity of ICGR15, the patients were divide into different groups, and the recovery of postoperative liver function were compared during different groups. The clinic data were analyzed by logistic regression analyze. Results〓The incidence rate of liver dysfunction in the ICGR15≥10% group was significantly increased than that in the ICGR15<10% group(68.2% vs 19.5%, P<0.05). The quantity of ICGR15 in Child-pugh B group were significantly increased than that in Child-pugh A group(19.01%±11.14% vs 7.57%±8.34%, P<0.05), and ICGR15 was correlated with Child-pugh score (P<0.05, r=0.313). The specificity of ICGR15 to predict recovery of postoperative liver function was 82.5%,which increased significantly than that of OGTT(P<0.05), and 65.2% with sensibility, 68.2% with positive predictive value, 80.5% with negative predictive value of ICGR15, which were all no statistical significance when comparing with OGTT (P>0.05). ICGR15 was associated with postoperative liver function (P<0.05, r=0.434), while OGTT negatively correlated with postoperative liver function (P>0.05). Logistic regression analyze revealed that ICGR15, vessel cancer embolus, blood loss and other operative complication were independent risk factors for postoperative liver dysfunction. Conclusion〓In the present study, ICGR15 showed a high sensitivity and specificity in assessing preoperative liver reserve function in patients with hepatocellular carcinoma, and was exact to predict recovery of postoperative liver function.

Key words: HCC, Indocyanine green clearance, Liver reserve function, Liver dysfunction　

摘要： 【摘要】 目的 探讨吲哚菁绿清除试验(ICGR15)在肝癌术前评估肝储备功能的临床应用价值。方法〓回顾性分析2012年6月至2013年7月我院63例肝细胞癌手术病人临床资料,根据术前ICGR15分组,对比不同组别术后肝功能恢复情况,并对相关临床资料进行多因素非条件Logistic回归分析。结果〓ICGR15≥10%组术后肝功能代偿不全的发生率显著高于ICGR15<10%组(68.2% vs 19.5%,P<0.05)。Child-pugh评分中B级组ICGR15分值较A级组显著升高(19.01%±11.14% vs7.57%±8.34%,P<0.05);ICGR15分值与Child-pugh评分有较好的相关性(P<0.05,r=0.313)。ICGR15预测肝癌术后肝功能不全的特异度为82.5%,明显高于OGTT(P<0.05),而敏感度为65.2%,特异度为82.5%,阳性预测值为68.2%,阴性预测值为80.5%,但与OGTT比较均无统计学差异(P>0.05)。ICGR15与术后肝功能恢复情况有相关性(P<0.05,r=0.434),而OGTT与术后肝功能恢复情况无明显相关性(P>0.05)。Logistic回归分析示ICGR15、脉管癌栓、术中出血量以及术后其他相关并发症是发生术后肝功能代偿不全的独立危险因素。结论 ICGR15是肝癌术前评估肝脏储备功能较理想的临床指标,能较准确预测术后肝功能恢复情况。

关键词: 肝细胞癌, ICG, 肝储备功能, 肝功能不全