The Study Of Reserved Liver Funtion In Hepatic Carcinoma After Transcatheter Arterial Chemoembolization By ～(13)C-methacetin Breath Test

AIM:To investigate the characteristic of the 13C-methacetin breath test (13C-MBT) as a tool to monitor hepatic function of patients with hepatic carcinoma by comparing with Child-pugh classification and general liver function. To evaluate the reserved liver function and forecast hazard in liver carcinoma after transcatheter arterial chemoembolization(TACE) .METHODS:Three subjects were chosen: 39 patients with primary liver cancer,16 patients with hepatic metastasis and 14 healthy volunteers served as controls. According to Child-pugh classification,the primary liver cancer patients were divided into three groups: 22 in group A (5-8 scores), 12 in group B (9-11 scores), 5 in group C (12-15 scores) respectively. All subjects received 13C–MBT and routinal liver function test after an overnight fast. The three major parameters of 13CO2 maximum excretion rate before 40 min (MVmax40), 13CO2 cumulative excretion of 40 min(CUM40) and that of 120 min(CUM120) were recorded and three metabolism curves(DOB curve,MV curve,CD curve) were pictured. The quantity of ascites and portal cancerous thrombus was measured by ultrasonography B-mode or computed tomography. The scores of the Child-pugh classification were calculated according to corresponding formulae. 36 patients were chosen to receive TACE and re-examined by 13C-MBT after 1 wk and 4 wk,RESULTS:1. In controls,hepatic metastasis and primary liver cancer groups, both of the 13C DOB curve and MV curve showed the similar shape, the peak time occurred at about 20 min after administration, which getting lower progressively. There were significant differences between the primary liver cancer group and others groups. But it was not statistical effect between hepatic metastasis group and controls. The shape has obvious distinction in group A,B and C of primary liver cancer, group A was a single sharp peak curve, while group B, a relative flat peak curve, on a lower lever for a long time after the ascent phase, groupC , without a clear excretion peak, even negative. The oblique rate of CD curve was getting lower gradually with the increasing of the impair degree of the liver and the cumulative excretory quantity was declined.2. About the three parameters of 13C-MBT, there was no statistical effect between hepatic metastasis group and controls, but there were significant differences between the primary liver cancer group and the other two groups(p<0.05). While in primary liver cancer groups, there was...