Risk Prediction Using Histological Activity Index Score for Patients Receiving Hepatic Resection

Shinrou Yoshidome, Gen Tanabe, Kensuke Nuruki, Shinichi Ueno, Masahiro Hamanoue, Kouichi Kurita, Takashi Aikou

First Department of Surgery, Kagoshima University, School of Medicine

In order to evaluate the operative risk before hepatic resection, the histological activity index (HAI) score of non-cancerous liver tissue obtained by needle biopsy was calculated in 58 patients with hepatocellular carcinoma receiving hepatic resection. No correlation was found between the HAI score and aspartate aminotransferase, alanine aminotransferase or total bilirubin before surgery, while significant correlations were observed between HAI score and intraoperative blood loss (r=0.53, p<0.01). The HAI scores of the patients with the postoperative complication were significantly higher than those without complication (p<0.05). Further, a stepwise logistic regression analysis showed that a category IV (fibrosis) of HAI was significantly associated with the occurrence of postoperative complications (odds ratio 2.74, p=0.011). Moreover, postoperative complications were experienced frequently in patients received lobectomy with the HAI score 6 or more and in patients received segmentectomy or less with that 10 or more. In conclusion, preoperative histological assessment of non-cancerous liver using the HAI score system is useful for risk prediction in patients receiving hepatic resection.

Key words
histological activity index score, hepatocellular carcinoma, risk prediction, hepatic resec tion, postoperative complication

Reprint requests
Shinrou Yoshidome First Department of Surgery, Kagoshima University, School of Medicine
8-35-1 Sakuragaoka, Kagoshima, 890 JAPAN

Accepted
December 6, 1995

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