Primary liver tumors

Impact of splenectomy partial splenic embolization on immune function in patients with hepatocellular carcinoma and hypersplenism

AIM: To investigate the impact of splenectomy and partial splenic embolization (PSE) on immune function in patients with hepatocellular carcinoma and hypersplenism.

METHODS: A prospective study was performed. Sixty-nine patient clinically diagnosed as liver cancer with hypersplenism were randomly divided into two groups: PSE group (n = 37) and splenectomy group (n = 32). The PSE group underwent PSE and transcatheter arterial chemoembolization (TACE), while the splenectomy group underwent splenectomy and TACE. Before and after treatment, blood routine examination was performed, and immunologic parameters were determined in both groups. The complications associated with treatment were also observed.

RESULTS: In the PSE group, significant differences were noted in WBC and PLT (both P < 0.05) but not in RBC (P > 0.05) between before and after treatment. Similar results were also obtained in the splenectomy group. No significant differences were found in preoperative CD4⁺ lymphocyte percentage and CD4⁺/CD8⁺ ratio between the PSE group and the splenectomy group. However, significant differences were noted in CD4⁺ lymphocyte percentage and CD4⁺/CD8⁺ ratio 7 and 28 days after treatment (CD4⁺: t = 16.063 and 9.409, both P < 0.05; CD4⁺/CD8⁺: t = 2.060 and 2.228, both P < 0.05). Significant differences were noted between preoperative and postoperative CD4⁺ lymphocyte percentage and CD4⁺/CD8⁺ ratio in the PSE group (all P < 0.05) but not in the splenectomy group (all P > 0.05). There is no significant difference in the incidence of complications (such as fever, abdominal pain, ascites, and pleural effusion) between the two groups (P > 0.05).

CONCLUSION: PSE has several advantages over splenectomy in the treatment of hepatocellular carcinoma with hypersplenism, including simpleness, fewer complications, and being able to improve cellular immune function.