研究等業績 - その他 - 有田 淳一
-
Sato T.
BioScience Trends ( BioScience Trends ) 11 ( 3 ) 333 - 339 2017年
<p>Preoperative evaluation of liver functional reserve is important in hepatobiliary surgery. Although the indocyanine green retention rate at 15 minutes (ICG-R15) is the gold standard for this purpose, a new method without technical complexity would be preferable. We assessed the usefulness of the previously established index of convexity (IOC). In total, 159 consecutive patients who underwent both technetium-99m-galactosyl human serum albumin (<sup>99m</sup>Tc-GSA) scintigraphy and the ICG-R15 were included. Correlation coefficients between indices from <sup>99m</sup>Tc-GSA scintigraphy and blood examinations including ICG-R15 were evaluated, and a conversion formula from the IOC to the ICG-R15 was established. The IOC was calculated as [L(15) × 2 − L(3) − L(27)] / [L(27) − L(3)], where L(t) indicates the radiation counts within the whole liver at t minutes after <sup>99m</sup>Tc-GSA injection. The IOC showed a significantly stronger correlation with the ICG-R15 (<i>r</i> = −0.532, <i>p</i> < 0.001) than the index of blood clearance (HH15) and the receptor index (LHL15). A formula for estimating ICG-R15 from IOC was "ICG-R15 = −31.0 × IOC + 30.1". In conclusion, the IOC is a better index for evaluating preoperative liver functional reserve than the conventional indices. A formula for estimating ICG-R15 from the IOC will be useful.</p>
-
Kawaguchi Y.
BioScience Trends ( BioScience Trends ) 11 ( 5 ) 574 - 580 2017年
<p>Effective adjuvant therapies have not been established for hepatocellular carcinoma (HCC). The study aimed to determine prognostic influence of statin against HCC recurrence after initial resection. From 2003 to 2013, 734 patients underwent initial HCC resection. Exposure to statins was defined as the use at the recommended daily dosage for > 90 days after surgery. Outcomes were compared between patients who did and did not receive statins. Of 734 patients, 31 (4.2%) received statins for dyslipidemia (statin group) and 703 (95.8%) did not (non-statin group). The proportions of hepatitis B (6.5% <i>vs</i>. 22.8%, <i>P</i> = 0.032), C (19.4% <i>vs</i>. 45.0%, <i>P</i> = 0.005), and a fibrosis score of F3-4 (16.1 % <i>vs</i>. 39.8%, <i>P</i> = 0.008) were significantly lower in the statin than non-statin group. The recurrence-free survival rate was significantly higher in the statin than non-statin group (<i>P</i> < 0.001), without significant difference of the overall survival rate (<i>P</i> = 0.142). A multivariable Cox proportional hazards model revealed that the use of statins (hazard ratio, 0.34; <i>P</i> = 0.005) was associated with a significantly lower risk of HCC recurrence. After one-to-two propensity score matching, the RFS rate was also significantly higher in the statin group (<i>n</i> = 31) than in the non-statin group (<i>n</i> = 62) (<i>P</i> = 0.008). In conclusion: The statins use reduced the risk of HCC recurrence after initial resection. Statins may have protective influences on HCC recurrence in patients who undergo initial liver resection.</p>