BACKGROUND:Liver function is one of the most important parameters for the outcome of transarterial chemoembolization (TACE). The Liver Maximum Capacity (LiMAx) -Test is a bedside test that provides a real-time option for liver function testing. The objective of this pilot study is to investigate the suitability of the LiMAX test for estimating the TACE outcome. OBJECTIVE AND METHODS:20 patients with intermediate-stage hepatocellular carcinoma (HCC) received a LiMAx test 24 h pre and post TACE. In addition, laboratory values were collected to determine liver function and model for endstage liver disease (MELD) scores. The success of TACE was assessed 6 weeks post intervention by morphological imaging tests using modified response evaluation criteria in solid tumors (mRECIST). RESULTS:Patients with an objective response (OR = CR + PR) according to mRECIST post TACE have significantly higher values in the pre-interventional LiMAx test than patients with a non-OR (PD or SD) post TACE (rb(14) = 0.62, p = 0.01). Higher pre-interventional LiMAx values therefore indicate OR. Patients with a disease control (DC = CR + PR + SD) according to mRECIST post TACE have significantly higher values in the pre-interventional LiMAx test than patients with a non-DC (PD) post TACE (rb(14) = 0.65, p = 0.01). Higher pre-interventional LiMAx values therefore indicate DC. The bi-serial correlations of LiMAx values pre and post TACE with the outcome OR or DC are descriptively stronger than those of MELD with OR or DC. This suggests that the LiMAx test correlates better with the treatment response than the MELD score. CONCLUSIONS:For the first time, we were able to show in our study that patients who are scheduled for TACE could benefit from a LiMAx test to be able to estimate the benefit of TACE. The higher the pre-interventional LiMAx values, the higher the benefit of TACE. On the other hand, laboratory parameters summarized in the form of the MELD score, had significantly less descriptive correlation with the TACE outcome.

中文翻译：

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预测经动脉化疗栓塞 (TACE) - 介入前和介入后 13C-美沙西丁呼气试验的结果

背景：肝功能是影响经动脉化疗栓塞（TACE）结果的最重要参数之一。肝最大容量 (LiMAx) - 测试是一种床边测试，可为肝功能测试提供实时选项。这项试点研究的目的是调查 LiMAX 测试对估计 TACE 结果的适用性。目的和方法：20 名中期肝细胞癌 (HCC) 患者在 TACE 前后 24 小时接受 LiMAx 测试。此外，收集实验室值以确定肝功能和终末期肝病模型 (MELD) 评分。在干预后 6 周，使用改良的实体瘤反应评估标准 (mRECIST) 通过形态学成像测试评估 TACE 的成功率。结果：根据 mRECIST TACE 后客观反应 (OR = CR + PR) 的患者在干预前 LiMAx 测试中的值显着高于 TACE 后非 OR（PD 或 SD）患者（rb(14) = 0.62， p = 0.01）。因此，较高的介入前 LiMAx 值表明 OR。根据 mRECIST TACE 后疾病控制 (DC = CR + PR + SD) 的患者在介入前 LiMAx 测试中的值显着高于 TACE 后非 DC (PD) 患者 (rb(14) = 0.65, p = 0.01）。因此，较高的介入前 LiMAx 值表示 DC。TACE 前后 LiMAx 值与结果 OR 或 DC 的双序列相关性在描述性上强于 MELD 与 OR 或 DC 的相关性。这表明，与 MELD 评分相比，LiMAx 测试与治疗反应的相关性更好。结论：第一次，我们能够在我们的研究中表明，计划接受 TACE 的患者可以从 LiMAx 测试中受益，从而能够估计 TACE 的益处。介入前 LiMAx 值越高，TACE 的益处就越大。另一方面，以 MELD 评分形式总结的实验室参数与 TACE 结果的描述性相关性显着降低。