Careful follow-up and proper decision on hepatectomy upon assessment of PRS are important in elderly HCC patients.

To clarify the relationship between morphological measurements of hepatic volume by computed tomography (CT-vol) and functional volume (RI-vol) by technetium-99m galactosyl human serum albumin (99mTc-GSA) scintigraphy, and its clinical significance, we examined 16 patients with a background liver status of either normal liver function (n=4), chronic hepatitis or cirrhosis (n=7), or obstructive jaundice (n=5). In five patients who underwent preoperative portal vein embolization (PVE), volumetric measurement was performed 2 weeks after PVE. The mean values of CT-vol and RI-vol of the right lobe were 692+/-147 cm3 (66.1+/-10.7%) and 668+/-159 cm3 (67.8+/-13.2%), respectively, and those of the left lobe were 329+/-138 cm3 (33.9+/-10.6%) and 328+/- 170 cm3 (32.2+/-13.2%), respectively. There were no significant differences in the volume measurements between the two volumetric techniques. Correlations between CT-vol and RI-vol in the right and left lobes were positive and significant (r=0.912 and 0.903, respectively; both P's<0.001). The mean values of post-PVE CT-vol and RI-vol of the right lobe in five patients were significantly different (628+/-149 and 456+/-211 cm3, respectively; P=0.033). However, the mean values of post-PVE CT-vol and RI-vol of the left lobe were not different (496+/-124 and 483+/-129 cm3, respectively). We propose that volumetric measurement by 99mTc-GSA scintigraphy is useful for detecting changes in functional volume of individual lobes of the liver and is a more dynamic method compared with detection of morphological changes by CT scan.

DMBT1 (deleted in malignant brain tumors) is a candidate tumor suppressor gene that has been mapped to chromosome 10q25.3-q26.1, a region in which frequent loss of heterozygosity (LOH) has been observed in several human tumors. Since DMBT1 is highly expressed in the lung, we analyzed LOH at the DMBT1 locus and expression of this gene in lung cancer. Thirty-five (53%) of 66 primary lung cancers showed LOH, and diminished expression of DMBT1 was observed in 20 (91%) of 22 lung cancer cell lines: three (14%) of them showed loss of expression. We further determined the primary structure of DMBT1 and analyzed genetic alterations in this gene using 23 lung cancer cell lines. Two (9%) of them had homozygous deletion within the gene, and two cell lines had genetic aberrations: one was a rearrangement involving exons 5 and 6, and the other was a missense mutation at codon 52. These results suggest that inactivation of the DMBT1 gene plays an important role in human lung carcinogenesis.

Early enhancement in the arterial phase might be a useful indicator of lower malignant potential and better survival in ICC patients.