Evaluation of Hepatic Functional Reservation by Gamma-Globulin_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

1. Department of A nesthesiology , West China Hos pi tal , S ichuan Uni versi t y , Cheng du 610041 , China;;
2. Department of General S urgery , West China Hos pi tal , S ichuan Uni versi t y , Cheng du 610041 , China;

Corresponding author：

Keywords：

Gamma-globulin ,Liver function ,Hepatic functional reservation

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【 Abstract 】 Objective To explore the effect of gamma-globulin in evaluating hepatic functional reservation in patients with liver tumor. Methods Serum protein electrophoresis (SPE) was performed on 30 patients with liver tumor to get gamma-globulin and preoperative Child-Pugh classification. Then the relations between gamma-globulin and preoperative and postoperative Child-Pugh classification were studied. While with gamma-globulin as evaluating standard, the validity compared with Child-Pugh classification were studied. Results The gamma-globulin was lower in classification A patients 〔（ 21.053 3 ± 6.001 4)% 〕 than that in classification B 〔 (28.800 0 ± 8.672 5)% 〕 before operation. While the gamma-globulin 〔 (21.022 0 ± 5.354 6)% 〕 of classification A patients after operation was also lower than that of classification B/C 〔 (29.556 0 ± 7.698 5)% 〕 . These differences were significant (P ＜ 0.05). With gamma-globulin gt;30% as evaluating standard ， the sensitivity and specificity were 80.00% and 96.00%, respectively. Conclusion Gamma-globulin can reflect hepatic functional reservation in patients with liver tumor. Combining gamma-globulin and Child-Pugh classification can evaluate hepatic functional reservation more objectively.

Citation： L IA N G Peng ,YI N J ie,WA N G X uan,Z EN GYong. Evaluation of Hepatic Functional Reservation by Gamma-Globulin. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2008, 15(4): 274-277. doi: Copy

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1. 16 　 Mullin EJ, Metcalfe MS, Maddern GJ. How much liver resection is too much? [Ｊ] . Am J Surg, 2005; 190(1) ∶ 87.
2. 　朱化刚. 术前肝脏储备功能的判断与安全肝切除量 [Ｊ]. 肝胆外科杂志, 2005; 13（6）∶406.
3. 　Caban A, Wiaderkiewicz R, Kamiński M, et al. Arterial ketone index in assessing liver function and its detoxicative capability after ischemia-reperfusion injury [Ｊ]. Acta Biochim Pol, 2000; 47(4)∶1137.
4. 　Nagashima I, Takada T, Okinaga K, et al. A scoring system for the assessment of the risk of mortality after partial hepatectomy in patients with chronic liver dysfunction [Ｊ]. J Hepatobiliary Pancreat Surg, 2005; 12(1)∶44.
5. 　Poon RT, Fan ST. Assessment of hepatic reserve for indication of hepatic resection: how I do it [Ｊ]. J Hepatobiliary Pancreat Surg, 2005; 12(1)∶31.
6. 　严律南, 陈晓理, 李志辉, 等. 肝癌肝切除术围手术期处理的临床研究(附2 143 例报告) [Ｊ]. 中国普外基础与临床杂志, 2005; 12(2)∶162.
7. 　Li GH, Zhu SL, Li JQ, et al. Evaluation of partial hepatectomy for primary liver carcinoma [Ｊ]. J Surg Oncol, 1989; 41(1)∶5.
8. 　Wakabayashi H, Ishimura K, Izuishi K, et al. Evaluation of liver function for hepatic resection for hepatocellular carcinoma in the liver with damaged parenchyma [Ｊ]. J Surg Res, 2004; 116(2)∶248.
9. 　李琴, 王宝恩, 贾继东, 等. 肝功能分级的演变及特点：从Child到MELD [Ｊ]. 中华肝脏病杂志， 2004; 12（5）∶319.
10. 　雷团结, 黎一鸣, 陈域，等. D-山梨醇肝清除率评估肝储备功能的临床研究 [Ｊ]. 中国实用外科杂志, 2005; 25（2）∶103.
11. 　彭宝岗, 黄洁夫, 吕明德, 等. 肝功能试验综合预测肝癌病人的肝储备功能 [Ｊ]. 中山医科大学学报, 1995; 16(2)∶44.
12. 　吕明德, 黄洁夫, 彭宝岗, 等. 多因素分析两步判别法预测肝功能储备力 [Ｊ]. 中华外科杂志, 1994; 32(12)∶745.
13. 　Maruyama S, Hirayama C, Horie Y, et al. Serum immunoglobulins in patients with chronic hepatitis C: a surrogate marker of disease severity and treatment outcome [Ｊ]. Hepatogastroenterology, 2007; 54(74)∶493.
14. 　Fernandez FJ, Rivas G, Salgado J, et al. Comparative evaluation of serum protein analysis by capillary zone electrophoresis and agarose gel electrophoresis [Ｊ]. Am Clin Lab, 2002; 21(4)∶26.
15. 　王庸晋. 现代临床检验学 [M]. 第2版. 北京：人民军医出版社， 2000∶272.
16. 　O’Connell TX, Horita TJ, Kasravi B. Understanding and interpreting serum protein electrophoresis [Ｊ]. Am Fam Physician, 2005; 71(1)∶105.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Evaluation of Hepatic Functional Reservation by Gamma-Globulin

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