title: Alteration of non-protein respiratory quotient after hepatocellular carcinoma treatment can be related to des-γ-carboxy prothrombin before treatment.
abstract: BACKGROUND
  Transcatheter arterial chemoembolization (TACE) is an effective treatment for hepatocellular carcinoma (HCC) that would occasionally lead to energy malnutrition through therapeutic hypoxic stress. We aimed to clarify the correlation between the energy malnutrition after TACE and low tolerability for hypoxia of non-tumoral liver before TACE.
  
  
  RESULTS
  We performed a prospective cohort study involving 100 HCC patients who underwent TACE at Kobe University Hospital. Indirect calorimetry was performed before and 7 days after TACE, and non-protein respiratory quotient (npRQ) as an indicator of the energy malnutrition was measured. Blood biochemical examinations were also performed before TACE. As an indicator of hypoxic marker, des-γ-carboxy prothrombin (DCP) was measured before TACE. The correlation between npRQ ratio (7 days after/before TACE) and DCP (before TACE) was statistically examined. Spearman's correlation coefficient test showed that npRQ ratio (Day 7/Day 0) was significantly related to DCP (Day 0) (p=0.0481, r=-0.2033). On the other hand, npRQ ratio (Day 7/Day 0) was not related to alpha fetoprotein (Day 0) (p=0.6254, r=-0.0494).
  
  
  CONCLUSIONS
  The npRQ reduction after TACE was related to a high value of DCP before TACE. The energy malnutrition after TACE would originate from low tolerability for hypoxia of non-tumoral liver. The HCC patients with a high value of DCP before TACE would clinically have a high risk of the energy malnutrition after TACE.
authors: Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017 Japan.
authors: Masaya
authors: M
authors: Saito
authors: Yasushi
authors: Y
authors: Seo
authors: Yoshihiko
authors: Y
authors: Yano
authors: Akira
authors: A
authors: Miki
authors: Kenji
authors: K
authors: Momose
authors: Hirotaka
authors: H
authors: Hirano
authors: Masaru
authors: M
authors: Yoshida
authors: Takeshi
authors: T
authors: Azuma
keywords: Des-γ-carboxy prothrombin; Energy malnutrition; Hepatocellular carcinoma; Hypoxic stress; Indirect calorimetry; Non-protein respiratory quotient; Transcatheter arterial chemoembolization
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