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肝硬化患者脾切除联合肝细胞癌切除术后免疫功能的变化

Changes of immune function in patients with liver cirrhosis after splenectomy combined with resection of hepatocellular carcinoma.

作者信息

Cao Zhi-Xin, Chen Xiao-Ping, Wu Zai-De

机构信息

Hepatic Surgery Center, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.

出版信息

Hepatobiliary Pancreat Dis Int. 2003 Nov;2(4):562-5.

Abstract

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.

摘要

目的

研究肝硬化合并肝细胞癌(HCC)患者脾切除联合肝癌切除术后免疫功能的变化。

方法

将16例肝硬化合并HCC患者分为两组:脾切除联合肝切除组(脾切除组,n = 7)和单纯肝切除组(非脾切除组,n = 9)。检测并比较两组患者术前及术后2个月外周静脉血7 ml中T淋巴细胞亚群如CD4、CD8、CD4/CD8以及Th淋巴细胞细胞因子如干扰素γ(IFN-γ)、IL-2、IL-10的水平。

结果

两组患者术前CD4、CD8、CD4/CD8、IL-2、IFN-γ、IL-10水平差异无统计学意义。术后2个月,脾切除组CD4水平(38.2%±3.7%)、CD4/CD8比值(1.7±0.3)、IFN-γ水平(104.4±14.9 pg/ml)、IL-2水平(98.6±18.6 pg/ml)升高,CD8水平(23.7±3.7 pg/ml)、IL-10水平(55.5±11.2 pg/ml)降低。非脾切除组CD4水平(32.5%±4.0%)、CD4/CD8比值(1.1±0.1)、IFN-γ水平(70.5±12.6 pg/ml)、IL-2水平(80.9±13.5 pg/ml)均低于脾切除组,而CD8水平(29.4%±4.0%)、IL-10水平(89.4±10.0 pg/ml)显著高于脾切除组(P<0.05)。

结论

肝硬化合并HCC患者行脾切除联合肝切除术不会降低反而促进T淋巴细胞亚群及Th1/Th2细胞因子从失衡状态恢复,改善患者抗肿瘤免疫功能。

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