A. Nakao et al., FALSE-POSITIVE ENDOTOXEMIA DERIVES FROM GAUZE GLUCAN AFTER HEPATECTOMY FOR HEPATOCELLULAR-CARCINOMA WITH CIRRHOSIS, Hepato-gastroenterology, 44(17), 1997, pp. 1413-1418
Background/Aims: The purpose of this study was to evaluate the occurre
nce of false-positive endotoxemia after hepatectomy for hepatocellular
carcinoma in patients with cirrhosis. The chromogenic conventional li
mulus test (Toxicolor test) revealed transiently increased blood endot
oxin, levels after hepatic resection for hepatocellular carcinoma in p
atients with liver cirrhosis. However, clinical signs of endotoxemia w
ere not observed in all of the cases. Methodology: Pre- and postoperat
ive changes of blood endotoxin levels and beta-glucan were measured in
20 patients with liver cirrhosis who underwent hepatic resection for
hepatocellular carcinoma, using the Toxicolor test, the Endospecy test
(which specifically reacts with endotoxin) and the Gluspecy test (whi
ch specifically reacts with beta-glucan). The changes in endotoxin lev
els and beta-glucan in ascitic fluid during surgery were also studied.
Results: The Toxicolor test revealed transiently increased blood endo
toxin levels, but Endospecy test results were not elevated. The change
s in the Gluspecy test were almost the same as in. the Toxicolor test.
During surgery, beta-glucan levels in the ascitic fluid increased rem
arkably due to their release from the surgical gauze. Digestion studie
s using 1-3-beta-D-glucanase on specimens which showed high Toxicolor
and Gluspecy test values resulted in a lack of response for both tests
. Conclusion: The cause of false-positive endotoxemia was determined t
o be caused by beta-glucan, which was released from the surgical gauze
.