A Study in Histopathological Findings of the Hepatic Parenchyma and Trimethadione Tolerance Test in Hepatectomized Patients with Hepatocellular Carcinoma

Akio Ishikawa, Katsuhisa Tsuji, Katashi Fukao, Akira Osada, Yuji Yamamoto, Masaaki Ohtsuka, Takeshi Todoroki, Yasuhiro Takase, Masayuki Nakano*, Einosuke Tanaka**

Department of Surgery, Institute of Clinical Medicine and Institute of Community Medicine**, University of Tsukuba
The Research Center for Pathologic Fungi and Microbial Toxicosis, Chiba University*

In fifty-six hepatectomized patients with hepatocellular carcinoma, histopathological examination of hepatic parenchyma were performed along with trimethadione (TMO) tolerance test which is an estimation based on serum dimethadione (DMO)/TMO ratio and liver function tests (albumin, ALB; bilirubin, BIL; prothrombin time, PT) and indocyanine green clearance test (retention at 15 min, ICGR15). The correlation ratios were r=-0.495 or r=0.473 between DMO/TMO ratio and ICGR15 or PT, respectively. The DMO/TMO ratios were 0.28 in liver cirrhosis (LC), 0.37 in early LC (EC), 0.51 in liver fibrosis (FB) and chronic hepatitis (CH) and 0.52 in normal (NO). The DMO/TMO ratio showed significant differences between LC and EC, EC and, FB, CH and NO. But it did not show significant differences between Nagayo's type A cirrhosis and Nagayo's type B cirrhosis. We concluded that the TMO tolerance test can estimate the difference of degree in the formation of septal fibrosis from portal tract to the area of central vein in EC and LC, and that of the total amount of hepatocytes in LC and FB, CH.

Key words
hepatectomy, hepatic functional reserve, trimethadione tolerance test histopathological findings of the hepatic parenchyma

Reprint requests
Akio Ishikawa Department of Surgery, Institute of Clinical Medicine, University of Tsukuba
1-1-1 Tennoudai, Tsukuba, 305 JAPAN

Accepted
April 14, 1993

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