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J.Jpn. Surg. Soc.. 119(3): 278-285, 2018


Feature topic

PROJECTS BRIDGING BASIC AND CLINICAL RESEARCH FOR SAFE LIVER RESECTION IN THE TREATMENT OF HEPATIC CANCER

Department of Surgical Science & Oncology, Sapporo Medical University School of Medicine, Sapporo, Japan

Toru Mizuguchi, Yasutoshi Kimura, Ichiro Takemasa

We review our previous basic and clinical studies on performing safe liver resection for the treatment of hepatic cancer. Hyaluronate, hepatocyte growth factor (HGF), and Fibroscan can be used for the assessment of liver fibrosis. These molecules are putatively associated with hepatocarcinogenesis. Aldehyde dehydrogenase 1 (ALDH1) is a prognostic factor in hepatocellular carcinoma patients who have non-B, non-C hepatitis viral infections. A relationship between ALDH1 and cancer stem cells was indicated. Disorders of the urinary trypsin inhibitor and of the pituitary tumor transforming gene cause a cell-division failure in the M phase. Liver regeneration in both disorders is delayed as a clinical effect of the energy that activates the inflammatory molecules. Antithrombin Ⅲ is an anticoagulant protein associated with the deterioration of liver function and was shown to be negatively correlated with indocyanine green clearance rates. Optimal surgical research will lead to advances in surgical techniques and devices for safer liver resection in hepatic cancer patients, similar to the inferior vena cava reconstruction, hanging maneuver for liver transection, and extracorporeal Pringle methods developed so far.


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