To explore the value of plasma thrombospondin-l (TSP-1) and transforming growth factor-β (TGF-β) in predicting posthepatectomy liver failure (PHLF).

Clinical data of 50 patients undergoing hepatectomy in the First Affiliated Hospital of Xinjiang Medical University from October 2017 to March 2018 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 29 patients were male and 21 female,aged (41±14) years on average. According to whether the number of the resected segments was≥3, all patients were divided into the extensive hepatectomy (extensive group, n=37) and limited hepatectomy groups (limited group, n=13). The dynamic changes of plasma levels of TSP-1 and TGF-β during the perioperative period were observed in two groups. PHLF was evaluated by the "50-50 criteria". The value of TSP-1 and TGF-β levels in predicting PHLF was analyzed by the receiver operating characteristic (ROC) curve. The TSP-1 and TGF-β levels were compared between two groups by t test or Mann-Whitney rank sum test. The rate comparison was carried out by Chi-square test or Fisher's exact test.

The total incidence of PHLF was 20% (10/50), 27% (10/37) in the extensive group, significantly higher than 0 in the limited group (P<0.05). In the extensive group, the plasma levels of TSP-1 at postoperative 1, 2, 5 and 7 d were 3 417(974, 7 090), 3 425(819, 4 961), 3 347(815, 4 957) and 3 526(1 213, 8 715) μg/L, significantly higher compared with 891(388, 1 695), 1 094(572, 1 476), 1 097(736, 1 611) and 1 061(479, 1 642) μg/L in the limited group (Z=2.621, 2.245, 2.190, 3.354; P<0.05). The plasma levels of TGF-β at postoperative 2 and 7 d were 2.57(1.52, 4.08) and 3.56(1.46, 4.60) μg/L in the extensive group, significantly higher than 1.52(1.20, 2.20) and 1.50(1.13, 1.65) μg/L in the limited group (Z=2.444, 2.691; P<0.05). The area under ROC curve of plasma TSP-1 level at postoperative 1 d in the diagnosis of PHLF was 0.88, with sensitivity 1.00 and specificity 0.75.

The plasma levels of TSP-1 and TGF-β are significantly increased in patients undergoing extensive hepatectomy. The extent of hepatectomy is correlated with the incidence of PHLF. The plasma TSP-1 level at postoperative 1 d can be utilized as an effective reference index for predicting PHLF.