ICG clearance test combined with prothrombin time and standard remnant liver volume predict the recovery of postoperative liver function in patients with hepatocellular carcinoma

Objective To explore the preoperative ICG clearance test combined with preoperative prothrombin time and standard remnant liver volume in predicting the recovery of postoperative liver function in patients with hepatocellular carcinoma.Methods Sixty-four patients with large hepatocellular carcinoma underwent hepatic resection from 2010 January to 2013 February at Affiliated Hospital of Guilin Medical College were included in our study.The patients were divided into two groups based on the level of liver function compensation after hepatectomy.The differences of preoperative examination biochemical and general situation were analyzed;Logistic regression analysis and ROC analysis on the relationship between preoperative ICGR15,prothrombin time,standard residual liver volume and postoperative moderate to severe liver function decompensation group was analyzed.Results Between mild hepatic decompensation group and moderate to severe hepatic decompensation group,ICGR15,prothrombin time,standard remnant liver volume were statistically significant( P 0.05).Logistic regression analysis got the regression equation:PLFPI = 0.186 × ICGR15 +0.849 × PT- 0.007 × SRLV- 9.617.Through ROC analysis the critical value of PLFPI predict postoperative severe liver function decompensation is- 33,with a sensitivity of 100% and a specificity of 87.10%.Sensitivity is more obvious than the preoperative ICG15,prothrombin time and SRLV high.Conclusion Preoperative ICGR15 combined with preoperative prothrombin time,standard remnant liver volume can predict hepatic functional recovery in patients with hepatocellular carcinoma after operation;PLFPI - 0.33as the boundarie of postoperative liver function prediction index that can prevent the patients with hepatocellular carcinoma after hepatic resection to occur severe hepatic decompensation is feasible.