Regional Ischemic Preconditioning Has Clinical Value in Cirrhotic HCC Through MAPK Pathways

Area of Science:

• Hepatobiliary Surgery
• Oncology
• Molecular Biology

Background:

• Assessing the clinical utility of regional ischemic preconditioning (RIP).
• Investigating the role of mitogen-activated protein kinase (MAPK) pathways in RIP's protective effects.
• Focus on cirrhotic patients with hepatocellular carcinoma (HCC) undergoing hepatectomy.

Purpose of the Study:

• To evaluate the clinical value of RIP in cirrhotic HCC patients undergoing liver resection.
• To elucidate the involvement of MAPK signaling in the protective mechanisms of RIP.

Main Methods:

• Comparison of hemi-hepatic vascular inflow occlusion (HHV) with and without RIP.
• Analysis of clinical data, surgical outcomes, and intraoperative/postoperative parameters.
• Measurement of phosphorylated MAPK levels (ERK, p38, JNK) pre- and post-reperfusion.

Main Results:

• RIP group showed significantly reduced intraoperative blood loss and postoperative plasma transfusion.
• Higher prothrombin activity observed in the RIP group postoperatively.
• RIP modulated MAPK pathways: increased ERK phosphorylation, decreased p38 and JNK phosphorylation.

Conclusions:

• RIP demonstrates clinical value in cirrhotic HCC patients undergoing liver resection.
• RIP's protective effects are potentially mediated by alterations in MAPK pathway phosphorylation.