Changes of immune function in patients with liver cirrhosis after splenectomy combined with resection of hepatocellular carcinoma.
OBJECTIVE
To study the changes of immune function in liver cirrhosis patients after splenectomy combined with resection of hepatocellular carcinoma (HCC).


METHODS
Sixteen patients with HCC associated with liver cirrhosis were divided into two groups: splenectomy combined with hepatectomy (splenectomy group n=7) and hepatectomy (non-splenectomy group, n=9). T lymphocyte subsets such as CD4, CD8, CD4/CD8 and Th lymphocyte cytokines such as interferon gamma (IFN-gamma), IL-2, IL-10 in 7 ml peripheral venous blood before operation and 2 months after operation were examined and compared between the two groups.


RESULTS
There was no significant difference in pre-operative CD4, CD8, CD4/CD8, IL-2, IFN-gamma, IL-10 levels in the two groups. 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), IL-2 (98.6+/-18.6 pg/ml) were increased and those of CD8 (23.7+/-3.7 pg/ml), IL-10 (55.5+/-11.2 pg/ml) levels were decreased in the splenectomy group. The levels of CD4 (32.5%+/-4.0%), CD4/CD8 (1.1+/-0.1), IFN-gamma (70.5+/-12.6 pg/ml), IL-2 (80.9+/-13.5 pg/ml) in the non-splenectomy group were much lower than those in the splenectomy group, but the levels of CD8 (29.4%+/-4.0%), IL-10 (89.4+/-10.0 pg/ml) in the non-splenectomy group were significantly higher than those in the splenectomy group (P<0.05).


CONCLUSIONS
Splenectomy combined with hepatectomy for HCC patients associated with liver cirrhosis does not decrease but promote the recovery of T lymphocyte subsets and Th1/Th2 cytokines from imbalance and improve anti-tumor immune function of the patients.
Cao
Zhi-Xin
ZX
Hepatic Surgery Center, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China. czxtj@hotmail.com
Chen
Xiao-Ping
XP
Wu
Zai-De
ZD
D016516:CD4-CD8 Ratio; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000276:immunology / Q000601:surgery*; D003131:Combined Modality Therapy; D015897:Comorbidity; D016207:Cytokines / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007109:Immunity / Q000502:physiology*; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000276:immunology* / Q000601:surgery; D008113:Liver Neoplasms / Q000453:epidemiology / Q000276:immunology / Q000601:surgery*; D008297:Male; D011336:Probability; D011446:Prospective Studies; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D013156:Splenectomy / Q000009:adverse effects / Q000379:methods*
D016207:Cytokines