Page 232 - ebook HCC

PROGRAMME
GENEV
EASL HCC SUMMITHCC SUMMIT
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230 PROGRAMME AND ABSTRACTSAND ABSTRACTS GENEVA, SWITZERLANDA, SWITZERLAND EASL 231
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FEBRUARY 13 - 16, 2014Y 13 - 16, 2014
FEBRUAR
Poster Board Number C22 Poster Board Number C23
INDEPENDENCE OF SERUM AUTOTAXIN LEVELS BILE DUCT INJURY AFTER TACE
FROM THE STATUS OF HEPATOCELLULAR
CARCINOMA Xiaoyu Wen , Qinglong Jin , Yue Qi , Junqi Niu 1
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1 Hepatology, The first hospital of Jilin University, Changchun, China
Mayuko Kondo , Hitoshi Ikeda , Takeaki Ishizawa , Kenichiro Enooku , Corresponding author’s e-mail: wenxiaoyu328@aliyun.com
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Yasunori Tokuhara , Ryunosuke Ohkawa , Baasanjav Uranbileg , Ryosuke Tateishi ,
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Haruhiko Yoshida , Yutaka Yatomi , Norihiro Kokudo , Kazuhiko Koike 1
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1 Department of Gastroenterology, Department of Clinical Laboratory Medicine, Introduction: TACE (transcatheter arterial chemoembolization) has been widely accepted
3 Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, as a safe and effective treatment of primary and secondary malignant hepatic tumors.
Graduate School of Medicine, The University of Tokyo, Tokyo, Japan Despite the excellent therapeutic effects of TACE, a spectrum of complications occurs
after TACE of hepatocellular carcinoma (HCC). Among these, complications related to
Corresponding author’s e-mail: mkondou-tky@umin.ac.jp bile duct injury have been reported including a biliary stricture; biloma; biliary peritoneum;
hemobilia and biliopleural fstulas. Here we report two cases of bile duct injury that develop
after TACE of HCC.
Introduction: Although autotaxin (ATX) has been speculated to play a role in cancer
invasion or metastasis as an autocrine motility factor, its clinical significance in Aims: To report two rare cases about bile duct injury after tace.
hepatocellular carcinoma (HCC) has not been fully understood yet.
Methodology: A 46-year old man developed intrahepatic biloma within 2 months of
Aims: To clarify the clinical significance of ATX in HCC pathophysiology. chemoembolization. A 53-year old man developed bile duct necrosis in 3 months after
Methodology: Serum levels and mRNA expression in HCC of ATX were evaluated in chemoembolization. They were admitted because of the epigastric discomfort and jaundice
consecutive 148 HCC patients treated with radiofrequency ablation (RFA) and 30 patients respectively. On CT, Intrahepatic biloma appeared as a round, solitary, or multiple cystic
with hepatic resection. area and the bile duct necrosis appeared as bile duct vanishing. Because of the clinical
symptoms, the patient with intrahepatic biloma was treated by percutaneous drainage and
Results: Although increased serum ATX levels were observed in almost all the patients the patient with bile duct necrosis was treated with gallbladder drainage. The latter patients
treated with RFA, they were not reduced after RFA. Furthermore, serum ATX levels were died of hepatic failure 2 months after discharge and another patient is in the follow up.
associated not with tumor burden but with the parameters predicting for liver fibrosis, i.e., Results: According to the reference, in patients with hepatocellular carcinoma, potential
CLINICAL POSTER ABSTRACTS patients, there was no significant correlation between serum ATX levels and ATX mRNA dilatation of intrahepatic bile duct However, other potential risk factors such as Child-Pugh CLINICAL POSTER ABSTRACTS
liver stiffness values, serum hyaluronic acid levels, serum type IV collagen 7S levels,
risk factors of bile duct injury due to TACE such as a tumor smaller than 5 cm and
and aspartate aminotransferase-to-platelet ratio index. Then, in surgically-treated
expression levels in HCC tissues. Notably, ATX mRNA expression levels in HCC tissues
classification and presence of portal vein tumor thrombus did not influence the incidence
were not higher than those in peri-tumorous tissues; increased ATX mRNA expression
after discharge and another patient is in the follow up.
was observed in tumorous tissues compared to peri-tumorous tissues in 8 of 30 patients.
Conclusions: For the two cases, we think the technical-related risk factors such as
Finally, serum ATX levels in surgically-treated HCC patients were rather correlated with
proximal injection of drugs and repeated injection with a frequency of less than 3 months
ATX mRNA expression levels in peri-tumorous tissues as well as with liver fibrosis stage.
significantly influenced the incidence of bile duct injury.
Conclusions: The increase in serum ATX levels in HCC patients may not be caused by
abundant ATX production in HCC tissues but by fibrosis in the background livers.