Flow cytometric analysis of asialoglycoprotein receptor expression predicts hepatic functional reserve after hepatectomy.

OBJECTIVE To validate a cheaper and more accessible flow cytometry-based method of assessing Asialoglycoprotein Receptor (ASGPR) expression for hepatic functional reserve. STUDY DESIGN A retrospective analysis. PLACE AND DURATION OF STUDY Beijing Ditan Hospital, Capital Medical University, Beijing, from January 2011 to October 2013. METHODOLOGY Patients with Hepatocellular Carcinoma (HCC) undergoing major hepatectomy at Beijing Ditan Hospital, during the study period were retrospectively studied. The fraction of hepatocytes expressing ASGPR in liver tissues was assessed by flow cytometry. Patients were grouped according to the presence or absence of postoperative hepatic dysfunction. The correlation between ASGPR expression and pre-operative liver function parameters with the outcomes of hepatectomy were analyzed. RESULTS Fewer hepatocytes from patients with postoperative hepatic dysfunction expressed ASGPR [63.3 (57.3 - 68.2)] than from patients without postoperative hepatic dysfunction [72.4 (70.6 - 76.3), p < 0.001]. Multiple logistic regression demonstrated ASGPR levels to be independently correlated with postoperative hepatic dysfunction (Odds ratio 3.34, 95% CI: 2.61-6.02, p < 0.001), and the Receiver Operating Characteristic (ROC) curve for prediction of postoperative liver dysfunction at ≤ 68.95% ASGPR+ hepatocytes achieved a sensitivity of 100% and specificity of 90.6%. The ROC curve for prediction of postoperative liver failure related death at ≤ 58.53% ASGPR+ hepatocytes achieved a sensitivity of 100% and specificity of 99%. CONCLUSION Flow cytometric assessment of ASGPR expression may be a useful predictor of liver dysfunction following major hepatectomy for HCC in Chinese patients.