Zhi-Xin Cao1, Xiao-Ping Chen, Zai-De Wu. 1. Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China.
Abstract
AIM: To study the effects of splenectomy in patients with cirrhosis undergoing hepatic resection for hepatocellular carcinoma. 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 gamma (IFN-gamma), 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-gamma, 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-gamma (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+/-1.6 X 10(9) and 310+/-32 X 10(9), respectively, which were significantly higher than those in non-splenectomy group (3.7+/-1.4 X 10(9) and 104+/-41 X 10(9)) respectively on the 14th post-operative day. T-Bil concentration in the splenectomy group (24+/-7 micromol/L) was significantly lower than that in the non-splenectomy group (37+/-13 micromol/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.
AIM: To study the effects of splenectomy in patients with cirrhosis undergoing hepatic resection for hepatocellular carcinoma. 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 gamma (IFN-gamma), 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-gamma, 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-gamma (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+/-1.6 X 10(9) and 310+/-32 X 10(9), respectively, which were significantly higher than those in non-splenectomy group (3.7+/-1.4 X 10(9) and 104+/-41 X 10(9)) respectively on the 14th post-operative day. T-Bil concentration in the splenectomy group (24+/-7 micromol/L) was significantly lower than that in the non-splenectomy group (37+/-13 micromol/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.