title: Hypersplenism is correlated with increased risk of hepatocellular carcinoma in patients with post-hepatitis cirrhosis.
abstract: Several risk factors exist for hepatocellular carcinoma in patients with post-hepatitis cirrhosis (PHC), including hypersplenism. Splenectomy is a common but controversial procedure in the management of hypersplenism, but its impact on hepatocellular carcinoma (HCC) remains uncertain. We conducted a hospital-based study of PHC patients to identify potential risk factors, including a history of splenectomy, which has been associated with progression from PHC to HCC. From 2002 to 2012, 2678 patients developed hypersplenism secondary to PHC. Of these patients, 828 developed HCC and 1850 did not. Potential risk factors of HCC were determined by univariate and multivariate analyses to exclude confounding variables. Odds ratios (ORs) and 95 % confidence intervals (95 % CIs) were determined for each factor. Many factors, such as liver function, platelet (PLT) counts, Child-Pugh class, and history of hepatitis, were associated with progression to HCC. PHC patients with hypersplenism who displayed elevated levels of alanine transaminase (ALT), aspartate transaminase (AST), γ-glutamyltransferase (GGT), ALK, phosphatase, and prolonged prothrombin time (PT) had a significantly increased risk of HCC. However, the patients who had splenectomy showed better liver function test results and less progression to HCC. In patients with PHC and hypersplenism, abnormal levels of ALT, AST, ALP, and GGT and prolonged PT are risk factors of HCC. Splenectomy, as the intervention method of hypersplenism, is performed less frequently in patients who developed HCC than in patients who did not develop HCC. Therefore, splenectomy may act as an independent factor that is significantly associated with HCC development.
authors.affiliation: Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, People's Republic of China.
authors.forename: Xing
authors.initials: X
authors.lastname: Lv
authors.affiliation: Department of C Area of General Surgery, The First Affiliated Hospital of Inner Mongolia Medical College, Inner Mongolia, 010000, People's Republic of China.
authors.forename: Fan
authors.initials: F
authors.lastname: Yang
authors.affiliation: Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, People's Republic of China.
authors.forename: Xin
authors.initials: X
authors.lastname: Guo
authors.affiliation: Department of General Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710038, People's Republic of China.
authors.forename: Tao
authors.initials: T
authors.lastname: Yang
authors.affiliation: Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, People's Republic of China.
authors.forename: Ti
authors.initials: T
authors.lastname: Zhou
authors.affiliation: Department of Cerebral Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710038, People's Republic of China.
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Dong
authors.affiliation: Department of Epidemiology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, People's Republic of China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Long
authors.affiliation: Department of Epidemiology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, People's Republic of China.
authors.forename: Dan
authors.initials: D
authors.lastname: Xiao
authors.affiliation: Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, People's Republic of China. yongchen62@yahoo.com.
authors.forename: Yong
authors.initials: Y
authors.lastname: Chen
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000235:genetics*; D016022:Case-Control Studies; D005260:Female; D006505:Hepatitis / Q000097:blood / Q000150:complications*; D006801:Humans; D006971:Hypersplenism / Q000097:blood / Q000150:complications*; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications*; D008113:Liver Neoplasms / Q000097:blood / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010976:Platelet Count / Q000379:methods; D012307:Risk Factors; D013156:Splenectomy / Q000379:methods; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase
keywords: Hepatocellular carcinoma; Hypersplenism; Liver function; Splenectomy