Effects of parenteral nutrition without and with growth hormone on growth hormone/insulin-like growth factor-1 axis after hepatectomy in hepatocellular carcinoma with liver cirrhosis.
BACKGROUND
Complex alterations in the growth hormone (GH)/insulin-like growth factor-1 (IGF-1) axis are thought to play an important role in the protein catabolism that complicates major surgical procedures. The aim of this study was to evaluate the potential roles of recombinant human growth hormone (rhGH) therapy after hepatectomy in hepatocellular carcinoma (HCC) with liver cirrhosis, and to investigate whether postoperative administration of rhGH increases the risk of tumor recurrences.


METHODS
Twenty-four patients with HCC in the setting of cirrhosis who underwent hepatectomy were randomly divided into 2 groups: parenteral nutrition (PN) group (n = 12) and rhGH + parenteral nutrition group (n = 12). Liver function, serum GH, IGF-1, and IGF binding protein-3 (IGFBP-3) were measured before operation, at postoperative days (POD) 1 and 6. IGF-1 and IGFBP-3 mRNA in liver tissue was measured by reverse transcriptase polymerase chain reaction. Liver Ki67 immunohistochemistry staining was studied. At the same time, 12 patients with cholelithiasis or liver hemangioma who underwent operation were segregated as a normal control.


RESULTS
On POD 6, compared with the PN group, serum prealbumin, GH, IGF-1, IGFBP-3, hepatic IGF-1 mRNA, IGFBP-3 mRNA, and liver Ki67 LI were higher in rhGH + PN group. The 6- and 12-month tumor-free survival rates, a median tumor-free survival time, were not different between the PN and rhGH + PN group.


CONCLUSIONS
rhGH + PN can ameliorate changes in the GH/IGF-1 axis after hepatectomy for HCC in the setting of cirrhosis.
Cao
Jie
J
Department of General Surgery, Affiliated Guangzhou First Municipal People's Hospital, Guangzhou Medical College, Guangzhou, China. ljq77@medmail.com.cn
Luo
Shi-Min
SM
Liang
Lijian
L
Lai
Jiaming
J
D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D018572:Disease-Free Survival; D005260:Female; D013006:Growth Hormone / Q000378:metabolism / Q000494:pharmacology*; D006498:Hepatectomy; D006801:Humans; D007150:Immunohistochemistry; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000378:metabolism; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D019394:Ki-67 Antigen / Q000378:metabolism; D008103:Liver Cirrhosis / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition / Q000379:methods*; D011184:Postoperative Period; D012333:RNA, Messenger / Q000378:metabolism; D020133:Reverse Transcriptase Polymerase Chain Reaction; D016896:Treatment Outcome
D018972:Insulin-Like Growth Factor Binding Protein 3; D019394:Ki-67 Antigen; D012333:RNA, Messenger; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone