Portal and systemic serum growth factor and acute-phase response after laparotomy or partial hepatectomy in patients with colorectal liver metastases: a prognostic role for C-reactive protein and hepatocyte growth factor.
BACKGROUND
Growth factors play a role in wound healing and tumour growth. The aim of this study was to compare the effect of partial hepatectomy (PH) and laparotomy on serum levels of growth factors and acute-phase proteins in patients with colorectal liver metastases and to correlate these levels with prognosis after PH.


METHODS
Epidermal growth factor (EGF), hepatocyte growth factor (HGF), insulin like growth factor-I (IGF-I), insulin, interleukin-6 (IL-6), C-reactive protein (CRP) and serum amyloid-A (SAA) were determined in portal and systemic serum in 24 PH patients and 9 laparotomy patients.


RESULTS
No differences were found in the clinicopathological characteristics of PH and laparotomy patients with the exception of the number of metastases, blood loss and operation time. The response of SAA, CRP and IGF-I was lower in PH patients than in laparotomy patients (P < 0.02). PH was associated with a higher IL-6 (P = 0.02) and HGF (P = 0.055) response than laparotomy. A higher HGF and CRP response was associated with a poorer prognosis. Total IGF-I was negatively correlated with the resected liver volume (r = -0.48, P < 0.05).


CONCLUSIONS
PH is associated with a lower acute-phase and total IGF-I response and a higher HGF and IL-6 response compared with laparotomy. HGF and CRP responses had an influence on the prognosis.
de Jong
K P
KP
Department of Surgery, Division of Hepato-Pancreato-Biliary Surgery & Liver Transplantation, University Hospital and Medical Faculty of the University of Groningen, 9700 RB Groningen, The Netherlands. k.p.de.jong@chir.azg.nl
Hoedemakers
R M J
RM
Fidler
V
V
Bijzet
J
J
Limburg
P C
PC
Peeters
P M J G
PM
de Vries
E G E
EG
Slooff
M J H
MJ
D000209:Acute-Phase Proteins / Q000032:analysis*; D002097:C-Reactive Protein / Q000032:analysis*; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006133:Growth Substances / Q000097:blood; D006498:Hepatectomy; D017228:Hepatocyte Growth Factor / Q000097:blood*; D006801:Humans; D007328:Insulin / Q000097:blood; D007813:Laparotomy; D008113:Liver Neoplasms / Q000097:blood / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D011379:Prognosis
D000209:Acute-Phase Proteins; D006133:Growth Substances; D007328:Insulin; D017228:Hepatocyte Growth Factor; D002097:C-Reactive Protein