Kim Joohyun, Kim Chang-Ju, Ko Il-Gyu, Joo Sun Hyung, Ahn Hyung Joon
Department of Surgery, Kyung Hee University School of Medicine, Seoul, Korea.
J Korean Surg Soc. 2012 Apr;82(4):238-45. doi: 10.4174/jkss.2012.82.4.238. Epub 2012 Mar 27.
Small-for-size syndrome (SFSS) is a major problem in liver surgery, and splenectomy has been used to prevent SFSS. However, it is unknown whether splenectomy has the same effect on liver regeneration in both standard and marginal hepatectomy. The aim of this study is to see a difference in effect of splenectomy on liver regeneration according to the amount of liver resection.
Thirty male Sprague-Dawley rats (220 to 260 g) were divided into the following five groups: control (n = 6), 70% hepatectomy (n = 6), 70% hepatectomy with splenectomy (n = 6), 90% hepatectomy (n = 6), and 90% hepatectomy with splenectomy (n = 6). The animals were euthanized 24 hours after surgery and liver specimens were obtained. To assess liver regeneration, we performed immunohistochemistry of liver tissue using 5-bromo-2-deoxyuridine (BrdU) labeling and Western blot analysis of hepatic growth factor (HGF) and transforming growth factor-β (TGF-β) in the liver tissue.
The splenectomized subgroup had a higher BrdU-positive cell count in the 90% hepatectomy group, but not in the 70% hepatectomy group (P < 0.001). Splenectomy significantly decreased TGF-β expression (P = 0.005) and increased the HGF to TGF-β ratio (P = 0.002) in the 90% hepatectomy group, but not in the 70% hepatectomy group.
The positive effect of splenectomy on liver regeneration was greater in the group with the larger liver resection. This phenomenon may be related to the relative balance between HGF and TGF-β in the liver.
小体积肝综合征(SFSS)是肝脏手术中的一个主要问题,脾切除术已被用于预防SFSS。然而,脾切除术在标准肝切除术和边缘性肝切除术中对肝再生的影响是否相同尚不清楚。本研究的目的是观察根据肝切除量不同,脾切除术对肝再生的影响差异。
将30只雄性Sprague-Dawley大鼠(220至260克)分为以下五组:对照组(n = 6)、70%肝切除术组(n = 6)、70%肝切除术加脾切除术组(n = 6)、90%肝切除术组(n = 6)和90%肝切除术加脾切除术组(n = 6)。术后24小时对动物实施安乐死并获取肝脏标本。为评估肝再生情况,我们对肝组织进行5-溴-2-脱氧尿苷(BrdU)标记的免疫组织化学检测,并对肝组织中的肝生长因子(HGF)和转化生长因子-β(TGF-β)进行蛋白质印迹分析。
在90%肝切除术组中,脾切除亚组的BrdU阳性细胞计数较高,但在70%肝切除术组中并非如此(P < 0.001)。在90%肝切除术组中,脾切除术显著降低了TGF-β表达(P = 0.005)并提高了HGF与TGF-β的比值(P = 0.002),但在70%肝切除术组中并非如此。
脾切除术对肝再生的积极作用在肝切除量较大的组中更为显著。这种现象可能与肝脏中HGF和TGF-β之间的相对平衡有关。