Changes of immune function in liver cirrhosis patients after splenectomy combined with resection of hepatocellular carcinoma / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To study the changes of immune function in liver cirrhosis patients after splenectomy combined with resection of hepatocellular carcinoma (HCC).</p><p><b>METHODS</b>Sixteen patients with HCC associated with liver cirrhosis were divided into two groups splenectomy combined with hepatectomy (n = 7) and hepatectomy (n = 9). T-lymphocyte subsets such as CD4, CD8, CD4/CD8 and Th-lymphocyte cytokines such as IFN-gamma, IL2, IL10 in 7 ml peripheral venous blood before operation and two months after operation were examined and compared between the two groups.</p><p><b>RESULTS</b>There was no significant difference in pre-operative CD4, CD4/CD8, IL2, IFN-gamma, IL10 levels in the two group. Two months after operation, the levels of CD4 (38.2% +/- 3.7%), CD4/CD8 (1.7 +/- 0.3), IFN-gamma [(104.4 +/- 14.9) pg/ml], IL2 [(98.6 +/- 18.6) pg/ml] were increased and those of CD8 (23.7 +/- 13.7) pg/ml and IL10 [(55.5 +/- 11.2) pn/ml] were decreased in the two groups, but the changes in the group of splenectomy combined with hepatectomy were more obvious than those in the hepatectomy group. The levels of CD4 (32.5% +/- 4.0%), CD4/CD8 (1.1 +/- 0.1), IFN-gamma [(70.5 +/- 12.6) pg/ml], IL2 [(80.9 +/- 13.5) pg/ml] in the group of splenectomy combined with hepatectomy, were much higher than those in the hepatectomy group; those of CD8 (29.4% +/- 4.0%), IL10 [(89.4 +/- 10.0) pg/ml] level were significantly lower than those in the hepatectomy (P < 0.05).</p><p><b>CONCLUSION</b>Splenectomy combined with hepatectomy for HCC associated with liver cirrhosis donor decrease but promote the recover T-lymphocyte subsets and Th1/Th2 cytokines from imbalance and improve the patient's antitumor immune function.</p>