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Liver Collagen Contents Are Closely Associated with the Severity of Cirrhosis and Posthepatectomy Liver Failure in Patients with Hepatocellular Carcinoma and Child–Pugh Grade A Liver Function

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Hepatocellular carcinoma (HCC) is usually accompanied by different severities of cirrhosis, which is a risk factor for posthepatectomy liver failure (PHLF). Collagen proportional area (CPA) measurements can quantitatively determine the collagen contents of liver tissue. This study explored the impact of CPA on PHLF, and further investigated the correlation between CPA and a non-invasive method, namely cirrhotic severity scoring (CSS), previously proposed by our team.

Methods

A total of 224 HCC patients with Child–Pugh grade A liver function undergoing hepatectomy between 2017 and 2019 were retrospectively studied. Quantitative digital image analysis of resected liver tissues was used for the CPA measurement. Risk factors for PHLF were subjected to univariate and multivariate analyses, and the correlation between CPA and CSS was analyzed.

Results

Overall, 28 (12.5%) patients experienced PHLF. Patients with PHLF had higher CPA values than those without PHLF (p < 0.001). Multivariate analysis showed CPA and extent of hepatectomy to be independent risk factors for PHLF. CPA values were divided into four stages based on their quartiles (C1: < 6.6%; C2: 6.6–10.7%; C3: 10.7–18.0%; C4: ≥ 18.0%). The incidence of PHLF increased with increasing CPA stages (p < 0.001). Furthermore, CSS was significantly correlated with CPA (r = 0.720; p < 0.001). The incidence of PHLF also increased with increasing severity of cirrhosis evaluated by CSS (p < 0.001).

Conclusions

In HCC patients with Child–Pugh grade A liver function, cirrhosis could be staged by liver collagen contents, which significantly influenced PHLF. Furthermore, CSS was useful in the preoperative evaluation of cirrhotic severity.

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Acknowledgment

The authors thank Dr. Yaobing Chen and Dr. Cong Liu, Department of Pathology, Tongji Hospital, Huazhong University of Science and Technology, China, for their assistance in the pathological study.

Funding

This work was supported by funding from the National Science and Technology Major Project of China (No. 2017ZX10203207-002) to Prof. Zhiyong Huang, and funding from the National Natural Science Foundation of China (No. 81902839) to Dr. Erlei Zhang.

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Authors and Affiliations

  1. Department of Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

    Jin Gu MD, Erlei Zhang MD, Binyong Liang MD, Zunyi Zhang MD, Xiaoping Chen MD & Zhiyong Huang MD

  2. Department of Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

    Min Xiong MD

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  1. Jin Gu MD
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Correspondence to Min Xiong MD.

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Jin Gu, Erlei Zhang, Binyong Liang, Zunyi Zhang, Xiaoping Chen, Min Xiong, and Zhiyong Huang declare they have no conflicts of interest.

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Gu, J., Zhang, E., Liang, B. et al. Liver Collagen Contents Are Closely Associated with the Severity of Cirrhosis and Posthepatectomy Liver Failure in Patients with Hepatocellular Carcinoma and Child–Pugh Grade A Liver Function. Ann Surg Oncol 28, 4227–4235 (2021). https://doi.org/10.1245/s10434-020-09557-5

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