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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 10/2009

01-10-2009 | Hepatobiliary Tumors

Clinical and Prognostic Significance of Urinary Trypsin Inhibitor in Patients with Hepatocellular Carcinoma After Hepatectomy

Authors: Isao Kikuchi, MD, Hiroshi Uchinami, MD, PhD, Hiroshi Nanjo, MD, PhD, Manabu Hashimoto, MD, PhD, Akio Nakajima, MD, PhD, Makoto Kume, MD, PhD, Ali Mencin, MD, Yuzo Yamamoto, MD, PhD

Published in: Annals of Surgical Oncology | Issue 10/2009

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Abstract

Background

Urinary trypsin inhibitor (UTI), produced in the liver, has been considered to suppress inflammation. The production of UTI may decrease after a hepatectomy and thereby increase the incidence of postoperative inflammation. This study investigated whether the changes in the UTI level affected the postoperative course in patients undergoing a hepatectomy for hepatocellular carcinoma (HCC). The prognostic significance of UTI was also analyzed.

Methods

The perioperative plasma UTI was measured in 25 HCC patients who underwent hepatic resection, and the correlation between the kinetics of UTI and clinicopathological factors was investigated. The expression of UTI in the resected specimens was examined by immunohistochemistry in 65 patients. Expression of UTI in the cancer cells were then correlated to both the liver pathology and the clinical outcomes in the corresponding patients.

Results

The plasma UTI level greatly decreased on the first postoperative day. This decrease significantly correlated with the resected tumor volume (r s = −.530, P = .006), but it had no influence on inflammatory complications. Immunohistochemistry revealed UTI expression in both noncancerous and cancerous lesions. An overexpression of UTI in HCC tissue was found to be an independent prognostic factor for early recurrence (P = .006).

Conclusions

Although UTI plasma levels were noted to decrease after the removal of an HCC tumor, this decrease did not lead to an increase in inflammatory complications. However, overexpression of UTI in cancer was found to be a risk factor for tumor recurrence after resection, suggesting that UTI expression may be a useful prognostic marker.
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Metadata
Title
Clinical and Prognostic Significance of Urinary Trypsin Inhibitor in Patients with Hepatocellular Carcinoma After Hepatectomy
Authors
Isao Kikuchi, MD
Hiroshi Uchinami, MD, PhD
Hiroshi Nanjo, MD, PhD
Manabu Hashimoto, MD, PhD
Akio Nakajima, MD, PhD
Makoto Kume, MD, PhD
Ali Mencin, MD
Yuzo Yamamoto, MD, PhD
Publication date
01-10-2009
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 10/2009
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-009-0622-2

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