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08 September 2019 : Animal Research  

The Predictive Role of Tenascin-C and Cellular Communication Network Factor 3 (CCN3) in Post Hepatectomy Liver Failure in a Rat Model and 50 Patients Following Partial Hepatectomy

Hao Li1ABCDEF*, Xinlan Ge2BE, Ke Pan2B, Minghao Sui1BC, Huayong Cai1BC, Chao Cui1BC, Chonghui Li2ACDEFG, Shichun Lu1ADEFG

DOI: 10.12659/MSM.917331

Med Sci Monit 2019; 25:6755-6766

Abstract

BACKGROUND: Matricellular proteins of the extracellular matrix (ECM) include tenascin-C (TNC) and cellular communication network factor 3 (CCN3). This study aimed to investigate the role of TNC and CCN3 as prognostic factors for post hepatectomy liver failure (PHLF) in a rat model of partial hepatectomy and 50 patients following partial hepatectomy.

MATERIAL AND METHODS: Sprague-Dawley rats underwent 85% (n=53) or 90% hepatectomy (n=53) in the partial hepatectomy (PHx) model. TNC and CCN3 mRNA expression in residual liver tissue was evaluated using quantitative reverse transcription-polymerase chain reaction (qRT-PCR), and enzyme-linked immunoassay (ELISA) determined the serum levels of TNC and CCN3. In 50 patients who underwent partial hepatectomy, TNC and CCN3 serum levels were measured on postoperative day 1 and day 3.

RESULTS: In the rat partial hepatectomy model, mRNA and serum levels of TNC and CCN3 were significantly increased within the first 24 h, and were higher in the 90% PHx group compared with the 85% PHx group. Fifty patients who underwent partial hepatectomy, included patients with PHLF (n=12) and patients without PHLF (n=38). Multivariate analysis confirmed that serum levels on postoperative day 3 TNChigh+CCN3high was a significant predictor of PHLF, which was associated with more than twice the risk of severe morbidity when compared with the low-risk patients (80% vs. 30%) and a significantly longer hospital stay (17 days vs. 8 days).

CONCLUSIONS: Further studies are needed to evaluate the potential role of the matricellular proteins, TNC and CCN3 as early clinical predictors for PHLF.

Keywords: Hepatectomy, Liver failure, Nephroblastoma Overexpressed Protein, Tenascin, Aged, Area Under Curve, bilirubin, Length of Stay, Logistic Models, Middle Aged, Morbidity, Multivariate Analysis, RNA, Messenger, ROC Curve, Risk Factors, Survival Analysis

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750