Research progress on effect of the splenectomy in patients with portal hypertension on theoccurrence and recurrence of hepatocellular carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

HONG Ruofeng ,  LI Yiming , LU Hongwei , JI Hong

Department of General Surgery, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004, P. R. China;

Corresponding?author：

LI Yiming, Email: liyiming2003@sina.com

Keywords：

portal hypertension; splenectomy; hepatocellular carcinoma; review

DOI：

10.7507/1007-9424.201706052

Video：

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Objective To summarize the effect of the splenectomy in patients with portal hypertension on the occurrence and recurrence of hepatocellular carcinoma. Methods The related literatures about the splenectomy in patients with hepatocirrhosis combined with portal hypertension or patients with hepatocellular carcinoma combined with portal hypertension in recent years were reviewed. Results At present, most academics considered that, for patients with hepatocirrhosis combined with portal hypertension, splenectomy could reduce the occurrence of hepatocellular carcinoma. For patients with hepatocellular carcinoma combined with portal hypertension, splenectomy+hepatectomy didn’t increase the perioperative mortality, and it could reduce the recurrence rate of hepatocellular carcinoma. Conclusion Splenectomy for patients with portal hypertension is safe, and it can inhibit the occurrence and progress of hepatocellular carcinoma, however, the specific mechanism remain needs further study.

Citation： HONG Ruofeng, LI Yiming, LU Hongwei, JI Hong. Research progress on effect of the splenectomy in patients with portal hypertension on theoccurrence and recurrence of hepatocellular carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2018, 25(1): 104-107. doi: 10.7507/1007-9424.201706052 Copy

1.	肖開銀, 彭民浩. 原發性肝癌流行病學研究進展. 中國普外基礎與臨床雜志, 2000, 7(4): 272-274.
2.	劉文藝, 吳鴻. 原發性肝癌合并門脈高壓癥外科治療體會. 中國現代醫學雜志, 2011, 21(19): 2293-2295.
3.	邱培才, 陳積圣. 脾切除對誘發性肝癌大鼠免疫功能的影響. 中國普外基礎與臨床雜志, 2000, 7(4): 224-225.
4.	Prehn RT. The paradoxical effects of splenectomy on tumor growth. Theor Biol Med Model, 2006, 3: 23.
5.	易堅, 鄒志森. 脾臟與腫瘤免疫. 實用癌癥雜志, 1999, 14(3): 80-81.
6.	陳維佩, 韓殿冰. 肝硬化門靜脈高壓癥時脾功能與脾的病理生理. 中華肝膽外科雜志, 2006, 12(9): 578-579.
7.	安映紅, 袁守軍. tuftsin 及其衍生物 T 肽的抗癌作用研究進展. 中國藥理學通報, 2016, 32(6): 747-750.
8.	汪謙, 李湘竑, 陳俊任, 等. 肝癌合并有脾亢的外科治療. 消化外科, 2004, 3(5): 319-321.
9.	余靈祥, 李志偉, 郭曉東, 等. 脾切除術對肝炎后肝硬化患者肝癌發生的影響. 現代生物醫學進展, 2013, 13(10): 1959-1961.
10.	耿愛文. 脾切除術對肝炎后肝硬化發生肝癌的影響. 深圳中西醫結合雜志, 2016, 26(22): 123-124.
11.	董曉平, 楊帆, 周倜, 等. 脾切除術對肝癌發生的影響. 現代生物醫學進展, 2011, 11(4): 715-718.
12.	Lv X, Yang F, Guo X, et al. Hypersplenism is correlated with increased risk of hepatocellular carcinoma in patients with post-hepatitis cirrhosis. Tumour Biol, 2016, 37(7): 8889-8900.
13.	Kondo R, Kage M, Ogata T, et al. Therapeutic efficacy of splenectomy is attenuated by necroinflammation of the liver in patients with liver cirrhosis. J Hepatobiliary Pancreat Sci, 2015, 22(3): 217-224.
14.	吳云華, 艾中立, 劉志蘇, 等. 脾切除對肝硬變大鼠移植型肝癌的影響. 湖北醫科大學學報, 1998, 19(4): 44-46.
15.	Bruix J, Sherman M, Llovet JM, et al. Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL conference. European Association for the Study of the Liver. J Hepatol, 2001, 35(3): 421-430.
16.	Capussotti L, Ferrero A, Viganò L, et al. Liver resection for HCC with cirrhosis: surgical perspectives out of EASL/AASLD guidelines. Eur J Surg Oncol, 2009, 35(1): 11-15.
17.	李始亮, 張清秀, 黃平. 肝細胞肝癌合并門靜脈高壓癥的診療進展. 現代醫藥衛生, 2016, 32(8): 1203-1205.
18.	Li C, Zhao H, Zhao J, et al. Prognosis of patients with hepatocellular carcinoma and hypersplenism after surgery: a single-center experience from the People’s Republic of China. Onco Targets Ther, 2014, 7: 957-964.
19.	李倉, 張啟瑜, 孫克龍, 等. 肝癌切除聯合選擇性減斷流術在原發性肝癌合并中重度門靜脈高壓癥中的應用. 肝膽胰外科雜志, 2015, 27(1): 5-8.
20.	Kim SH, Kim DY, Lim JH, et al. Role of splenectomy in patients with hepatocellular carcinoma and hypersplenism. ANZ J Surg, 2013, 83(11): 865-870.
21.	Duan YF, Li XD, Sun DL, et al. A preliminary study on surgery for hepatocellular carcinoma patients with portal hypertension. Am J Surg, 2015, 210(1): 129-133.
22.	Chen XP, Wu ZD, Huang ZY, et al. Use of hepatectomy and splenectomy to treat hepatocellular carcinoma with cirrhotic hypersplenism. Br J Surg, 2005, 92(3): 334-339.
23.	Zhang XY, Li C, Wen TF, et al. Synchronous splenectomy and hepatectomy for patients with hepatocellular carcinoma and hypersplenism: A case-control study. World J Gastroenterol, 2015, 21(8): 2358-2366.
24.	Wang C, Li C, Wen TF, et al. Safety of synchronous hepatectomy and splenectomy for patients with hepatocellular carcinoma and hypersplenism. Hepatogastroenterology, 2012, 59(114): 526-528.
25.	蔡建強, 胡敬群, 畢新宇, 等. 肝脾聯合切除術治療肝癌合并肝硬化脾功能亢進的遠期療效. 中華醫學雜志, 2004, 84(1): 10-12.
26.	曹志新, 陳孝平, 吳在德. 肝癌合并肝硬化患者脾臟 Th1/Th2 細胞因子免疫狀態的研究. 中華實驗外科雜志, 2001, 18(6): 518-519.
27.	Li B, Zhang S, Huang N, et al. Dynamics of the spleen and its significance in a murine H22 orthotopic hepatoma model. Exp Biol Med (Maywood), 2016, 241(8): 863-872.
28.	Barnie PA, Zhang P, Lv H, et al. Myeloid-derived suppressor cells and myeloid regulatory cells in cancer and autoimmune disorders. Exp Ther Med, 2017, 13(2): 378-388.
29.	Zoso A, Mazza EM, Bicciato S, et al. Human fibrocytic myeloid-derived suppressor cells express IDO and promote tolerance via Treg-cell expansion. Eur J Immunol, 2014, 44(11): 3307-3319.
30.	Hu CE, Gan J, Zhang RD, et al. Up-regulated myeloid-derived suppressor cell contributes to hepatocellular carcinoma development by impairing dendritic cell function. Scand J Gastroenterol, 2011, 46(2): 156-164.
31.	Long X, Wang J, Zhao JP, et al. Splenectomy suppresses growth and metastasis of hepatocellular carcinoma through decreasing myeloid-derived suppressor cells in vivo. J Huazhong Univ Sci Technolog Med Sci, 2016, 36(5): 667-676.
32.	Yang P, Li QJ, Feng Y, et al. TGF-β-miR-34a-CCL22 signaling-induced Treg cell recruitment promotes venous metastases of HBV-positive hepatocellular carcinoma. Cancer Cell, 2012, 22(3): 291-303.
33.	馬東偉. 原發性肝癌合并門脈高壓癥的外科治療. 中國現代醫生, 2010, 48(33): 142-143.
34.	孫國明. 肝脾聯合切除治療肝癌伴肝硬化脾功能亢進的安全性和療效. 中國現代普通外科進展, 2016, 19(02): 145-146+149.
35.	郭建光. 肝脾聯合切除治療肝癌合并門脈高壓的療效觀察. 臨床醫藥文獻電子雜志, 2016, 3(7): 1219-1220.
36.	宋向東, 劉爭, 趙華, 等. 肝脾聯合切除治療肝癌伴肝硬化脾功能亢進臨床研究. 中國衛生標準管理, 2016, 7(15): 40-41.
37.	Li W, Shen SQ, Wu SM, et al. Simultaneous hepatectomy and splenectomy versus hepatectomy alone for hepatocellular carcinoma complicated by hypersplenism: a meta-analysis. Onco Targets Ther, 2015, 8: 2129-2137.
38.	姚關兵, 周軍, 陳念平, 等. 原發性肝癌合并門靜脈高壓、脾亢的外科治療. 醫學綜述, 2009, 15(10): 1514-1517.
39.	李聰, 蔡建強. 肝脾聯合切除治療肝癌合并肝硬化脾功能亢進的現狀. 中國腫瘤外科雜志, 2011, 3(2): 106-108.
40.	林志強, 俞武生, 盧春麗, 等. 不同治療方法對肝癌合并脾功能亢進的療效分析. 中國當代醫藥, 2012, 19(21): 46-48.

1. 肖開銀, 彭民浩. 原發性肝癌流行病學研究進展. 中國普外基礎與臨床雜志, 2000, 7(4): 272-274.
2. 劉文藝, 吳鴻. 原發性肝癌合并門脈高壓癥外科治療體會. 中國現代醫學雜志, 2011, 21(19): 2293-2295.
3. 邱培才, 陳積圣. 脾切除對誘發性肝癌大鼠免疫功能的影響. 中國普外基礎與臨床雜志, 2000, 7(4): 224-225.
4. Prehn RT. The paradoxical effects of splenectomy on tumor growth. Theor Biol Med Model, 2006, 3: 23.
5. 易堅, 鄒志森. 脾臟與腫瘤免疫. 實用癌癥雜志, 1999, 14(3): 80-81.
6. 陳維佩, 韓殿冰. 肝硬化門靜脈高壓癥時脾功能與脾的病理生理. 中華肝膽外科雜志, 2006, 12(9): 578-579.
7. 安映紅, 袁守軍. tuftsin 及其衍生物 T 肽的抗癌作用研究進展. 中國藥理學通報, 2016, 32(6): 747-750.
8. 汪謙, 李湘竑, 陳俊任, 等. 肝癌合并有脾亢的外科治療. 消化外科, 2004, 3(5): 319-321.
9. 余靈祥, 李志偉, 郭曉東, 等. 脾切除術對肝炎后肝硬化患者肝癌發生的影響. 現代生物醫學進展, 2013, 13(10): 1959-1961.
10. 耿愛文. 脾切除術對肝炎后肝硬化發生肝癌的影響. 深圳中西醫結合雜志, 2016, 26(22): 123-124.
11. 董曉平, 楊帆, 周倜, 等. 脾切除術對肝癌發生的影響. 現代生物醫學進展, 2011, 11(4): 715-718.
12. Lv X, Yang F, Guo X, et al. Hypersplenism is correlated with increased risk of hepatocellular carcinoma in patients with post-hepatitis cirrhosis. Tumour Biol, 2016, 37(7): 8889-8900.
13. Kondo R, Kage M, Ogata T, et al. Therapeutic efficacy of splenectomy is attenuated by necroinflammation of the liver in patients with liver cirrhosis. J Hepatobiliary Pancreat Sci, 2015, 22(3): 217-224.
14. 吳云華, 艾中立, 劉志蘇, 等. 脾切除對肝硬變大鼠移植型肝癌的影響. 湖北醫科大學學報, 1998, 19(4): 44-46.
15. Bruix J, Sherman M, Llovet JM, et al. Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL conference. European Association for the Study of the Liver. J Hepatol, 2001, 35(3): 421-430.
16. Capussotti L, Ferrero A, Viganò L, et al. Liver resection for HCC with cirrhosis: surgical perspectives out of EASL/AASLD guidelines. Eur J Surg Oncol, 2009, 35(1): 11-15.
17. 李始亮, 張清秀, 黃平. 肝細胞肝癌合并門靜脈高壓癥的診療進展. 現代醫藥衛生, 2016, 32(8): 1203-1205.
18. Li C, Zhao H, Zhao J, et al. Prognosis of patients with hepatocellular carcinoma and hypersplenism after surgery: a single-center experience from the People’s Republic of China. Onco Targets Ther, 2014, 7: 957-964.
19. 李倉, 張啟瑜, 孫克龍, 等. 肝癌切除聯合選擇性減斷流術在原發性肝癌合并中重度門靜脈高壓癥中的應用. 肝膽胰外科雜志, 2015, 27(1): 5-8.
20. Kim SH, Kim DY, Lim JH, et al. Role of splenectomy in patients with hepatocellular carcinoma and hypersplenism. ANZ J Surg, 2013, 83(11): 865-870.
21. Duan YF, Li XD, Sun DL, et al. A preliminary study on surgery for hepatocellular carcinoma patients with portal hypertension. Am J Surg, 2015, 210(1): 129-133.
22. Chen XP, Wu ZD, Huang ZY, et al. Use of hepatectomy and splenectomy to treat hepatocellular carcinoma with cirrhotic hypersplenism. Br J Surg, 2005, 92(3): 334-339.
23. Zhang XY, Li C, Wen TF, et al. Synchronous splenectomy and hepatectomy for patients with hepatocellular carcinoma and hypersplenism: A case-control study. World J Gastroenterol, 2015, 21(8): 2358-2366.
24. Wang C, Li C, Wen TF, et al. Safety of synchronous hepatectomy and splenectomy for patients with hepatocellular carcinoma and hypersplenism. Hepatogastroenterology, 2012, 59(114): 526-528.
25. 蔡建強, 胡敬群, 畢新宇, 等. 肝脾聯合切除術治療肝癌合并肝硬化脾功能亢進的遠期療效. 中華醫學雜志, 2004, 84(1): 10-12.
26. 曹志新, 陳孝平, 吳在德. 肝癌合并肝硬化患者脾臟 Th1/Th2 細胞因子免疫狀態的研究. 中華實驗外科雜志, 2001, 18(6): 518-519.
27. Li B, Zhang S, Huang N, et al. Dynamics of the spleen and its significance in a murine H22 orthotopic hepatoma model. Exp Biol Med (Maywood), 2016, 241(8): 863-872.
28. Barnie PA, Zhang P, Lv H, et al. Myeloid-derived suppressor cells and myeloid regulatory cells in cancer and autoimmune disorders. Exp Ther Med, 2017, 13(2): 378-388.
29. Zoso A, Mazza EM, Bicciato S, et al. Human fibrocytic myeloid-derived suppressor cells express IDO and promote tolerance via Treg-cell expansion. Eur J Immunol, 2014, 44(11): 3307-3319.
30. Hu CE, Gan J, Zhang RD, et al. Up-regulated myeloid-derived suppressor cell contributes to hepatocellular carcinoma development by impairing dendritic cell function. Scand J Gastroenterol, 2011, 46(2): 156-164.
31. Long X, Wang J, Zhao JP, et al. Splenectomy suppresses growth and metastasis of hepatocellular carcinoma through decreasing myeloid-derived suppressor cells in vivo. J Huazhong Univ Sci Technolog Med Sci, 2016, 36(5): 667-676.
32. Yang P, Li QJ, Feng Y, et al. TGF-β-miR-34a-CCL22 signaling-induced Treg cell recruitment promotes venous metastases of HBV-positive hepatocellular carcinoma. Cancer Cell, 2012, 22(3): 291-303.
33. 馬東偉. 原發性肝癌合并門脈高壓癥的外科治療. 中國現代醫生, 2010, 48(33): 142-143.
34. 孫國明. 肝脾聯合切除治療肝癌伴肝硬化脾功能亢進的安全性和療效. 中國現代普通外科進展, 2016, 19(02): 145-146+149.
35. 郭建光. 肝脾聯合切除治療肝癌合并門脈高壓的療效觀察. 臨床醫藥文獻電子雜志, 2016, 3(7): 1219-1220.
36. 宋向東, 劉爭, 趙華, 等. 肝脾聯合切除治療肝癌伴肝硬化脾功能亢進臨床研究. 中國衛生標準管理, 2016, 7(15): 40-41.
37. Li W, Shen SQ, Wu SM, et al. Simultaneous hepatectomy and splenectomy versus hepatectomy alone for hepatocellular carcinoma complicated by hypersplenism: a meta-analysis. Onco Targets Ther, 2015, 8: 2129-2137.
38. 姚關兵, 周軍, 陳念平, 等. 原發性肝癌合并門靜脈高壓、脾亢的外科治療. 醫學綜述, 2009, 15(10): 1514-1517.
39. 李聰, 蔡建強. 肝脾聯合切除治療肝癌合并肝硬化脾功能亢進的現狀. 中國腫瘤外科雜志, 2011, 3(2): 106-108.
40. 林志強, 俞武生, 盧春麗, 等. 不同治療方法對肝癌合并脾功能亢進的療效分析. 中國當代醫藥, 2012, 19(21): 46-48.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Research progress on effect of the splenectomy in patients with portal hypertension on theoccurrence and recurrence of hepatocellular carcinoma

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