ICGR15和OGTT预测肝癌患者肝脏储备功能的价值

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58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ICGR15(24.17%±6.59%)较A组(11.42%±3.91%)、B组(16.28%±6.07%)显著升高(P均<0.01)；C组OGTT120min血糖值(9.91mmol/L±3.09mmol/L)明显高于A组(5.42mmol/L±0.83mmol/L)、B组(6.68mmol/L±1.61mmol/L)(P均<0.01)；ICGR15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<0.01)。结论ICGR15和OGTT可作为预测PHC肝脏储备功能的指标，二者联合应用有助于提高预测的准确性。

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

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±3.09 mmol/L)was significantly higher than that in group A(5.42 mmol/L±0.83 mmol/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.