Studies on Regional Hepatic Blood Flow and Substrate Metabolism in Patients with Hepatocellular Carcinoma
Resource
臺灣醫學會雜誌 v.85 n.12 pp.1151-1161
Journal
臺灣醫學會雜誌,v.85
Journal Issue
n.12
Pages
1151-1161
Date Issued
1986
Date
1986
Author(s)
LIAW, KOUNG-YI
TSANG, YUK-MING
SU, CHENG-TAU
CHANG, JIN-NIEN
LIU, CHIEN-LIANG
WEI, TA-CHENG
LIN, JEN-KUN
Abstract
To characterize the role of hepatocellular carcinoma ( HCC) and liver cirrhosis (Non-HCC) in the regional bloodflow and substrate metabolism, selective catheterization of right and left hepatic vein was performed in 8 hhuge HCC subjects (Group)1) and 4 smaller subjects (Group 2), both strictly limited to one lobe of the liver. The subject, whose HCC was screened by Echogram and or computerized tomogram, was chosen for the regional study. Blood flow was determined by standard clearance technique (Indocyanine Green) and Doppler Echogram in normal controls. Simultaneous arterial and two hepatic venous blood samples were obtained for glucose, lactate, pyruvate, acute-phase protein and amino acid determination. There was a remarkable loss of body weight noted in Group 1. Estimated hepatic blood flow ( EHBF) and hepatic substrate A-V difference of Group 1 and Group 2 were compared: EHBF was slightly reduced in Group 2 whereas it was markedly increased in its lobular blood flow in the HCC side of Group 1 ( 1480+655 vs 685+96 ml/min/1.73M2 in the smaller HCC side of Group 2). For hepatic arterial- venous difference, there were great difference in glucose level in the HCC side of Group 1. This increased glucose uptake was met by the increased uptake of free fatty acid, alanine and increased release of lactate. In the Non-HCC side of Group 1 and both right and left lobes of Group 2, the levels of uptake or release of glucose, lactate, pyruvate and alanine were similar. These data suggest that HCC alone resulted in marked increases in glucose, free- fatty acid and alanine uptake from -0.4 mmol/L, -0.04 mEq/L and +0.07 mmol/L on Non-HCC side to + 1.48 mmol/L, +0.08 mEq/ L and +0.1 mmol/L on HCC side. Contrarilly, the production of lactate increased on HCc side which resulted in the arterial -venous difference decreasing from 0.27 mmol/L in Non-HCC side to 0.06 mmol/L in HCC side. The estimated amount of glucose uptake was 15g/hour after 6 hour-fasting in Group 1 while the amount of glucose released was 14g/hour in Group 2. The increased rates of consumption of certain substrates on HCC side might be one of the pathogeneses of cachexia in HCC patients.
Type
journal article