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. 2014 Aug;69(1):61-7.
doi: 10.1016/j.cryobiol.2014.05.003. Epub 2014 May 22.

Cryoprotective therapy for hepatocellular carcinoma: study of 51 patients with a single lesion

Alnaggar Mohammed Abdulatef Ali  1 , Niu Lizhi  2 , Li Jialiang  2 , Yao Fei  3 , Wang Yuan  3 , Zeng Jianying  3 , Ye Jin  1 , Chen Jibing  4 , Mu Feng  2 , Xu Kecheng  2
Affiliations

Cryoprotective therapy for hepatocellular carcinoma: study of 51 patients with a single lesion

Alnaggar Mohammed Abdulatef Ali et al. Cryobiology. 2014 Aug.

Abstract

Percutaneous cryoablation is a potentially curative treatment for hepatocellular carcinoma (HCC). After liver cryosurgery, rapid elevations of transaminases and bilirubin are common, but are usually transient and normalize within a few days. This study retrospectively reviewed clinical data from 51 patients who underwent liver cryoablation in our hospital during the past 4.5 years. Sixty-six percutaneous cryoablations were performed in these patients and transaminase and bilirubin levels before and after the procedure were observed. Although most patients received liver-protective treatment before cryosurgery, transaminase levels were double (mean alanine transaminase (ALT) and aspartate transaminase (AST) were 71 U/L and 85 U/L, respectively) the normal ranges in our hospital. One day after cryosurgery, ALT and AST had increased 3.3-fold (peak mean was 241 U/L) and 5-fold (peak mean was 427 U/L), respectively, but were close to the preoperative level 5 days post-cryosurgery. No significant increase of serum bilirubin was observed. Serum transaminase and bilirubin levels were compared between hepatitis B positive and hepatitis B negative patients. Only in the hepatitis B positive group were total bilirubin (74 μmol/L/23 μmol/L=3.2) and direct bilirubin (45 μmol/L/12 μmol/L=3.8) more than 3 times the preoperative level 7-9 days after treatment. Overall, ALT and AST are valuable as indicators of liver function impairment following cryosurgery. In patients with hepatitis B virus, serum bilirubin was 3 times the preoperative level 7-9 days after cryosurgery. Liver-protective treatment may alleviate liver function impairment due to cryosurgery.

Keywords: Bilirubin; Hepatic functional reserve; Hepatocellular carcinoma; Liver-protective agent; Percutaneous cryoablation; Transaminase.

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