[The glucose tolerance test and insulin secretion test as risk factors in liver cancer surgery]

To investigate the predictive value of oral glucose tolerance test (O-GTT) and insulin secretion test (IST) on the risk of hepatectomy in liver cancer patients, we through double-blind method, compared the results of these two tests, clinical course of the patients, and the pathological findings. It was found that: 1) The positive prediction value, negative prediction value, and accuracy of O-GTT were 79.2%, 94.4%, and 85.7%, the corresponding figures of IST were 55.6%, 100%, and 61.9%, respectively. 2) Pattern of the curve of O-GTT believed to depend on roughly normal hepatic energy metabolism and islet secretion capacity suggested better tolerance for hepatectomy. 3) A part of the patients with advanced HCC had a depressed islet secretion capacity. 4) The delta IST/delta O-GTT showed an accurate negative prediction for hepatectomy when the ratio was less than 50 x 10(-9). 5) Apart from O-GTT and delta IST/delta O-GTT, the severity of the hepatitis and cirrhosis should be taken into account in the decision of carrying out hepatectomy.