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Clinical and Prognostic Significance of Urinary Trypsin Inhibitor in Patients with Hepatocellular Carcinoma After Hepatectomy

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

Abstract

Background

Urinary trypsin inhibitor (UTI), produced in the liver, has been considered to suppress inflammation. The production of UTI may decrease after a hepatectomy and thereby increase the incidence of postoperative inflammation. This study investigated whether the changes in the UTI level affected the postoperative course in patients undergoing a hepatectomy for hepatocellular carcinoma (HCC). The prognostic significance of UTI was also analyzed.

Methods

The perioperative plasma UTI was measured in 25 HCC patients who underwent hepatic resection, and the correlation between the kinetics of UTI and clinicopathological factors was investigated. The expression of UTI in the resected specimens was examined by immunohistochemistry in 65 patients. Expression of UTI in the cancer cells were then correlated to both the liver pathology and the clinical outcomes in the corresponding patients.

Results

The plasma UTI level greatly decreased on the first postoperative day. This decrease significantly correlated with the resected tumor volume (r s = −.530, P = .006), but it had no influence on inflammatory complications. Immunohistochemistry revealed UTI expression in both noncancerous and cancerous lesions. An overexpression of UTI in HCC tissue was found to be an independent prognostic factor for early recurrence (P = .006).

Conclusions

Although UTI plasma levels were noted to decrease after the removal of an HCC tumor, this decrease did not lead to an increase in inflammatory complications. However, overexpression of UTI in cancer was found to be a risk factor for tumor recurrence after resection, suggesting that UTI expression may be a useful prognostic marker.

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Acknowledgment

This work was partly supported by a grant-in-aid of the Japan Society for the Promotion of Science, Tokyo, Japan (18591497). We thank Dr. Katsuyuki Murata (Department of Environmental Health Sciences, Akita University School of Medicine) for statistical advice.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Akita University School of Medicine, Akita, Japan

    Isao Kikuchi MD, Hiroshi Uchinami MD, PhD, Makoto Kume MD, PhD & Yuzo Yamamoto MD, PhD

  2. Department of Pathology, Akita University School of Medicine, Akita, Japan

    Hiroshi Nanjo MD, PhD

  3. Department of Radiology, Akita University School of Medicine, Akita, Japan

    Manabu Hashimoto MD, PhD

  4. Department of Gastroenterological Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan

    Akio Nakajima MD, PhD & Yuzo Yamamoto MD, PhD

  5. Department of Pediatrics, Morgan Stanley Children’s Hospital of New York, Columbia University, College of Physicians and Surgeons, New York, NY, USA

    Ali Mencin MD

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  1. Isao Kikuchi MD
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  2. Hiroshi Uchinami MD, PhD
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  3. Hiroshi Nanjo MD, PhD
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  4. Manabu Hashimoto MD, PhD
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  5. Akio Nakajima MD, PhD
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  8. Yuzo Yamamoto MD, PhD
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Correspondence to Hiroshi Uchinami MD, PhD.

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Kikuchi, I., Uchinami, H., Nanjo, H. et al. Clinical and Prognostic Significance of Urinary Trypsin Inhibitor in Patients with Hepatocellular Carcinoma After Hepatectomy. Ann Surg Oncol 16, 2805–2817 (2009). https://doi.org/10.1245/s10434-009-0622-2

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  • DOI: https://doi.org/10.1245/s10434-009-0622-2

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