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.