Effects of splenectomy in patients with cirrhosis undergoing hepatic resection for hepatocellular carcinoma

摘要

AIM: To study the effects of splenectomy in patients with cirrhosis undergoing hepatic resection for hepatocellular circinoma. METHODS: Twenty-six patients with HCC associated with cirrhosis were divided into hepatectomy with splenectomy group (splenectomy group, n=11) and hepatectomy without splenectomy group (non-splenectomy group, n=15). T lymphocyte subsets such as CD4, CD8, CD4/CD8, helper T (Th) lymphocyte cytokines such as interferon γ(IFN-γ), interleukin 2(IL-2), interleukin 10(IL-10) and white blood cell (WBC), platelet (PLT), total bilirubin (T-Bil) were measured and used as parameters to evaluate the effects of splenectomy. RESULTS: There was no significant difference in CD4, CD8, CD4/CD8, IL2, IFN-γ, IL10, WBC, PLT, T-Bil levels between two groups before surgery. Two months after operation, the levels of CD4 (41.2%+-4.2 % vs 34.7%+-3.8%), CD4/ CD8 (1.7+-0.2 vs 1.0+-0.2), IFN-γ (102.3+-15.9 pg/ml vs 86.5+-14.8 pg/ml), IL-2(97.2+-15.6 pg/ml vs 77.6+-14.5 pg/ml) were increased and those of CD8 (25.6+-3.9 vs 32.8%+-4.1%), IL-10 (56.9+-10.4 pg/ml vs 72.6+-15.3 pg/ml) were decreased in splenectomy groups as compared with those in non-splenectomy group (P<0.05). WBC and PLT counts in the splenectomy group were 8.9+-1.6x10~9 and 310+-32x10~9, respectively, which were significantly higher than those in non-splenectomy group (3.7+-1.4x10~9 and 104+-41x10~9) respectively on the 14th post-operative day. T-Bil concentration in the splenectomy group (24+-7 μmol/L) was significantly lower than that in the non-splenectomy group (37+-13 μmol/L) on the 7th post-operative day (P<0.05). CONCLUSION: Splenectomy combined with hepatectomy for HCC associated with cirrhosis is helpful for the recovery of T-lymphocyte subsets and the maintenance of Th1/Th2 cytokine balance.