Effects of parenteral nutrition with and without GH on the GH/IGF-1 axis after hepatectomy in hepatocellular carcinoma with liver cirrhosis |
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Authors: | Cao Jie Luo Shimin Liang Lijian Lai Jiaming and Chen Shanming |
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Institution: | (1) Department of General Surgery, Affiliated Guangzhou First Municipal People’s Hospital, Guangzhou Medical College, Guangzhou, 510180, China;(2) Department of Hepatobiliary Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510130, China;(3) Department of Scientific Research and Education, Affiliated Guangzhou First Municipal People’s Hospital, Guangzhou Medical College, Guangzhou, 510180, China |
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Abstract: | Postoperative hepatic insulin-like growth factor-1 (IGF-1) production may be severely disturbed in patients with liver cirrhosis.
Complex alterations in the GH/IGF-1 axis are thought to play an important role in the protein catabolism that complicates
major surgical procedures. The aim of this study was to explore the effects of parenteral nutrition (PN) with and without
growth hormone (GH) on the GH/IGF-1 axis after hepatectomy for hepatocellular carcinoma (HCC) with cirrhosis and evaluate
the potential roles of recombinant human GH (rhGH) therapy. Twenty-four patients with HCC with cirrhosis who underwent hepatectomy
were randomly divided into two groups: a PN group (n = 12) and an rhGH + PN group (n = 12). Liver function, serum GH, IGF-1 and IGFBP-3 were measured before the operation and at post-operative days (POD) 1
and 6. Insulin-like growth factor-1 and IGFBP-3 mRNA in the liver tissue was detected by RT-PCR. The liver Ki67 immunohistochemistry
staining was studied. At the same time, 12 patients with cholelithiasis or liver hemangioma who underwent operation served
as normal control group. On POD 6, serum prealbumin, GH, IGF-1, IGFBP-3, hepatic IGF-1 mRNA, IGFBP-3 mRNA and liver Ki67 LI
were higher in the rhGH + PN group than in the PN group. There was no significant difference in the 6-and 12-month tumor-free
survival rate and the median tumor-free survival time between the PN group and the rhGH + PN group (P>0.05). These data indicate that rhGH + PN could ameliorate the changes in the GH/IGF-1 axis after hepatectomy for HCC in
the setting of cirrhosis. |
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Keywords: | carcinoma hepatocellular parenteral nutrition growth hormone insulin-like growth factor I insulin-like growth factor binding protein 3 |
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