The role of the proliferation markers Ki‑67, topoisomerase IIα and PCNA in assessing the risk of liver failure after major liver resections

The study aims to evaluate the role of Ki‑67, topoisomerase IIα, and proliferating cell nuclear antigen (PCNA) in the development of post‑resection liver failure, as well as to quantify their immunohistochemical expression in liver tissue following major hepatectomy. A prospective case‑control observational study was conducted, enrolling 54 patients who underwent major liver resection at the Minsk Scientific and Practical Center for Surgery, Transplantology, and Hematology between October 2019 and October 2023. Immunohistochemical analysis was performed on biopsy samples from the remnant liver tissue to assess the concentration of regeneration markers. The proliferative activity marker Ki‑67 was found to exhibit a strong direct correlation with the international normalized ratio (INR) and serum lactate levels, both well‑validated biomarkers of liver failure. This correlation suggests an indirect association between the immunohistochemical marker of proliferative activity (Ki‑67) and the development of post‑resection liver failure. However, assessment of concentrations of the proliferation markers topoisomerase IIα and PCNA concentrations did not reveal any statistically significant association with the development of post‑resection liver failure. The findings indicate that immunohistochemical assessment of Ki‑67 levels holds promise as a tool for both predicting and confirming the development of post‑resection liver failure.

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