ABSTRACT
The present study aimed to observe the effects of perioperative oral supplementation with fish oil (FO) on liver regeneration in mice and examine the potential mechanism. A total of 120 male ICR mice were randomly divided into 5 groups: Sham, Control, fish oil (FO), Compound C [the AMPactivated protein kinase (AMPK) inhibitor dorsomorphin], and Compound C + FO. Changes in liver function, alterations in hepatocyte proliferation and in the expression of polarization markers, and activation of AMPK signaling were examined following partial hepatectomy (PH). The results demonstrated that restoration of serum alanine aminotransferase (ALT) and total bilirubin (TBIL) levels were significantly faster in FOtreated mice compared with Control mice, and this effect was suppressed by treatment with Compound C. FOtreated mice exhibited increased numbers of Ki67 positive hepatocytes and their postoperative livertobody weight ratio was significantly increased compared with the Control mice, which was also suppressed by cotreatment with the AMPK inhibitor. Furthermore, protein expression of Occludin, Claudin3, tight junction protein 1 and bile salt export pump was gradually increased in FOtreated mice compared with Control, whereas Compound C treatment reversed this effect. Therefore, the present study revealed that perioperative oral supplementation with FO may promote liver regeneration and improved liver function in mice following PH through AMPK activation.
Subject(s)
AMP-Activated Protein Kinases/genetics , Fish Oils/pharmacology , Hepatectomy/rehabilitation , Liver Regeneration/drug effects , Liver/drug effects , AMP-Activated Protein Kinases/antagonists & inhibitors , AMP-Activated Protein Kinases/metabolism , ATP Binding Cassette Transporter, Subfamily B, Member 11/genetics , ATP Binding Cassette Transporter, Subfamily B, Member 11/metabolism , Administration, Oral , Alanine Transaminase/blood , Alanine Transaminase/genetics , Animals , Bilirubin/blood , Cell Proliferation/drug effects , Claudin-3/genetics , Claudin-3/metabolism , Fish Oils/antagonists & inhibitors , Gene Expression Regulation , Hepatectomy/methods , Hepatocytes/cytology , Hepatocytes/drug effects , Hepatocytes/metabolism , Ki-67 Antigen/genetics , Ki-67 Antigen/metabolism , Liver/metabolism , Liver/surgery , Liver Function Tests , Liver Regeneration/genetics , Male , Mice , Mice, Inbred ICR , Occludin/genetics , Occludin/metabolism , Protein Kinase Inhibitors/pharmacology , Pyrazoles/pharmacology , Pyrimidines/pharmacology , Signal Transduction , Zonula Occludens-1 Protein/genetics , Zonula Occludens-1 Protein/metabolismABSTRACT
To compare the short-term outcomes between hepatocellular carcinoma (HCC) patients with and those without preoperative nutrition on the basis of postoperative enteral nutrition.HCC patients with postoperative enteral nutrition who underwent liver resection between February 2010 and December 2014 in Nanjing Drum Tower Hospital were considered for the study: 43 patients with and 36 patients without preoperative nutrition. Primary endpoint was the incidence of overall complications. Secondary endpoints were infectious and major complications.In the preoperative enteral nutrition group, shorter length of postoperative hospital stay (10.5â±â2.7 versus 13.7â±â6.3 days, Pâ=â0.007), less exogenous albumin infusion (10.2â±â22.4 versus 47.8â±â97.7âg, Pâ=â0.030), earlier first exhaust time (2.7â±â0.8 versus 3.0â±â0.9 days, Pâ=â0.043), and first defection time (3.5â±â0.9 versus 4.4â±â1.4 days, Pâ=â0.001) were observed. No significant differences were observed in the incidence of overall complications (32.6% versus 52.8%, Pâ=â0.070), infectious complications (7.0% versus 8.3%, Pâ=â1), and major complications (14.0% versus 11.1%, Pâ=â0.969) between the preoperative enteral nutrition and control group.Preoperative enteral nutrition could improve short-term outcomes of HCC patients via accelerating the recovery of gastrointestinal function and shortening the length of postoperative hospital stay.
Subject(s)
Carcinoma, Hepatocellular/surgery , Enteral Nutrition , Hepatectomy , Liver Neoplasms/surgery , Preoperative Care/methods , Adult , Aged , Female , Humans , Length of Stay/statistics & numerical data , Male , Middle Aged , Postoperative Care , Postoperative Complications/epidemiology , Postoperative Complications/prevention & control , Retrospective Studies , Treatment OutcomeABSTRACT
OBJECTIVE: Accurate staging information is necessary to determine the prognosis of patients with hepatocellular carcinoma (HCC) and to guide subsequent patient management. This study aims to investigate the prognostic performance of the Hong Kong Liver Cancer (HKLC) classification in a Chinese cohort of HCC patients. METHODS: A total of 668 HCC patients between 2003 and 2012 were included. Performances of the HKLC and the Barcelona Clinic Liver Cancer (BCLC) system were compared using Akaike information criterion (AIC), concordance-index (c-index), and area under the receiver operating characteristic curve (AUC). Independent prognostic factors of survival were identified using univariate and multivariate analyses. RESULTS: Independent predictors of survival were Child-Pugh grade (P=0.009), lactate dehydrogenase (P<0.001) and albumin (P=0.001) levels, tumor location (P=0.032), tumor number (P<0.001), tumor size (P<0.001), and vascular invasion (P<0.001). Discriminatory ability was shown to be better for HKLC (AUC at 1, 3, and 5 years were 0.740, 0.695, and 0.615, respectively) than BCLC (AUC at 1, 3, and 5 years were 0.622, 0.569, and 0.548, respectively). On the basis of AIC and c-index, HKLC had a higher predictive power for survival (AIC=4709.480, c-index=0.805) than BCLC (AIC=4852.708, c-index=0.717). CONCLUSION: In our selected patient population, whose main etiology was hepatitis B, the HKLC system was more suitable for predicting prognosis in a Chinese cohort of HCC patients than the BCLC classification.
