Optimal embolization method for preoperative portal vein embolization and search for biomarkers for predicting liver hypertrophy

2023 Fiscal Year Final Research Report

• Project/Area Number: 19K17199
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 52040:Radiological sciences-related
• Research Institution: Shimane University (2020-2023); Hyogo Medical University (2019)
• Principal Investigator: Maruyama Mitsunari 島根大学, 学術研究院医学・看護学系, 助教 (80770122)
• Project Period (FY): 2019-04-01 – 2024-03-31
• Keywords: 門脈塞栓術 / 肝肥大 / 無水エタノール / n-butyl-2-cyanoacrylate

Outline of Final Research Achievements

Portal vein embolization is a procedure that increases the remnant liver volume by embolizing the portal vein in the area scheduled for resection in advance. A rat portal vein embolization model was created, and the liver hypertrophy rate in the non-embolized area and the liver atrophy rate in the embolized area were calculated. Compared with the absolute ethanol group, the n-butyl-2-cyanoacrylate: NBCA group showed more liver hypertrophy in the non-embolized area and liver atrophy in the embolized area. Furthermore, when comparing the vascular endothelial damage between the ethanol group and the NBCA group, the ethanol group had stronger vascular endothelial damage of 500 μm or less, but it was suggested that this did not contribute to necrosis. We searched for a microRNA biomarker that could early predict the remnant liver hypertrophy rate from the obtained non-embolized area tissue samples, but we were unable to find any.

Free Research Field

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Academic Significance and Societal Importance of the Research Achievements

門脈塞栓術は切除予定区域の門脈をあらかじめ塞栓することで、残存肝容量を増大させる手技である。安全に大量肝切除術を行うためには、残存予定肝を十分肥大させておく必要がある。系統的レビューでは、無水エタノールとn-butyl-cyanoacrylate (NBCA)がより残存肝肥大を誘発することが示されいる。しかし、現時点では、門脈塞栓術における無水エタノールとNBCAの優劣は明らかになっていない。ラット門脈塞栓モデルを用いた本研究では、NBCA郡のほうが、無水エタノール群より非塞栓領域の肝肥大と塞栓領域の肝萎縮を認めた。よって、門脈塞栓術に適した塞栓物質はNBCAであることが示唆された。