2.2. Postoperative Changes of Laboratory Data and Liver Regeneration
Serial changes of laboratory data before hepatectomy and on POD 1, 3, 5 and 7 are shown in
Figure 1.
Liver resection rate was significantly correlated with white blood cell counts on POD 1 (r = 0.65, p = 0.005), serum bilirubin levels on POD 3 (r = 0.51, p = 0.045), serum albumin levels on POD 3 (r = 0.57, p = 0.020), serum aspartate aminotransferase levels on POD 3 (r = 0.63, p = 0.007) and POD 5 (r = 0.81, p = 0.0006), and prothrombin time-international normalized ratio (INR) on POD 3 (r = 0.71, p = 0.002) and POD 5 (r = 0.78, p = 0.004) but was inversely correlated with serum C-reactive protein levels (r = −0.67, p = 0.005). Remnant liver volume per body weight on POD 0 was inversely correlated with white blood cell counts on POD 1 (r = −0.61, p = 0.011), serum aspartate aminotransferase levels on POD 3 (r = −0.78, p = 0.0002) and POD 5 (r = −0.78, p = 0.019), and prothrombin time-INR on POD 3 (r = −0.68, p = 0.003) and POD 5 (r = −0.78, p = 0.003) but was significantly correlated with serum C-reactive protein levels (r = 0.66, p = 0.006).
According to remnant liver volume per body weight on POD 0, 16 patients were divided into two groups. One group consisted of eight patients with remnant liver volume per body weight on POD 0 of 10 cm
3/kg or less, and another group consisted of the other eight patients with remnant liver volume per body weight on POD 0 >10 cm
3/kg. Serial changes of laboratory data in both the groups are shown in
Figure 2. White blood cell counts on POD 1, serum bilirubin levels on POD 3 and 5, serum albumin levels on POD 3, serum aspartate aminotransferase levels on POD 3 and 5, and prothrombin time-INR on POD 3 and 5 were significantly higher in the eight patients with remnant liver volume per body weight on POD 0 of 10 cm
3/kg or less. On the other hand, serum C-reactive protein levels on POD 1 were lower in this group.
Ratio of liver volume on POD 14 to liver volume on POD 0 was correlated with white blood cell counts on POD 1 (r = 0.63, p = 0.007), prothrombin time-INR on POD 3 (r = 0.62, p = 0.009) and POD 5 (r = 0.72, p = 0.010), and serum aspartate aminotransferase levels on POD 3 (r = 0.71, p = 0.002) and POD 5 (r = 0.67, p = 0.015). On the other hand, serum C-reactive protein levels on POD 1 were inversely correlated with ratio of liver volume on POD 14 to liver volume on POD 0 (r = −0.62, p = 0.012).
According to the ratio of liver volume on POD 14 to liver volume on POD 0, 16 patients were divided into two groups. Eight patients showing ratio of liver volume on POD 14 to liver volume on POD 0 of 150% or higher were classified into high liver regeneration group, and the others eight showing this ratio <150% were classified into low liver regeneration group. Serial changes of laboratory data in both the groups are shown in
Figure 3. Prothrombin time-INR on POD 3 and 5, serum bilirubin levels on POD 3 and 7, and serum aspartate aminotransferase levels on POD 3 and 5 were significantly higher in high liver regeneration group. On the other hand, platelet counts on POD 5 and serum
C-reactive protein levels on POD 1 were lower in the high liver regeneration group.
2.3. Postoperative Changes of Serum Growth Factor Levels and Liver Regeneration
Serial changes of serum growth factor levels are shown in
Figure 4. Postoperative changes in serum levels of HGF and leptin paralleled those in prothrombin time-INR and serum levels of bilirubin. The changes in serum levels of macrophage colony-stimulating factor (M-CSF) paralleled those in white blood cell counts. The changes in serum platelet-derived growth factor (PDGF)-BB levels paralleled those in platelet counts.
Liver resection rate was significantly correlated with serum M-CSF levels on POD 5 (r = 0.78, p = 0.037) and POD 7 (r = 0.81, p = 0.003) but not with serum HGF and leptin levels on POD 1. Remnant liver volume per body weight on POD 0 was inversely correlated with serum M-CSF levels on POD 5 (r = −0.76, p = 0.045) and POD 7 (r = −0.75, p = 0.010) and tended to be inversely correlated with serum HGF levels on POD 1 (r = −0.46, p = 0.076) and serum leptin levels on POD 1 (r = −0.47, p = 0.064).
According to remnant liver volume per body weight on POD 0, serial changes of serum growth factor levels are shown in
Figure 5. In eight patients with remnant liver volume per body weight on POD 0 of 10 cm
3/kg or less, serum M-CSF levels on POD 5 and POD 7 were significantly higher. On the other hand, serum TPO levels on POD 1 were lower in this group.
Ratio of liver volume on POD 14 to liver volume on POD 0 was significantly correlated with serum HGF levels on POD 1 (r = 0.54, p = 0.030), serum leptin levels on POD 1 (r = 0.54, p = 0.028), and serum M-CSF levels on POD 5 (r = 0.76, p = 0.047) and POD 7 (r = 0.80, p = 0.003). On the other hand, ratio of liver volume on POD 14 to liver volume on POD 0 was inversely correlated with serum PDGF-BB levels on POD 5 (r = −0.61, p = 0.011), and serum TPO levels on POD 1 (r = −0.60, p = 0.012).
Serial changes of serum growth factor levels in high liver regeneration group and low liver regeneration group are shown in
Figure 6. Serum leptin levels on POD 1 and serum M-CSF levels on POD 5 and POD 7 were significantly higher in high liver regeneration group. Serum HGF levels on POD 1 seemed to be higher in high liver regeneration group although the difference was not significant. On the other hand, serum PDGF-BB levels on POD 5 and serum TPO levels on POD 1 were lower in the high liver regeneration group.