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.	肖开银, 彭民浩. 原发性肝癌流行病学研究进展. 中国普外基础与临床杂志, 2000, 7(4): 272-274.
2.	刘文艺, 吴鸿. 原发性肝癌合并门脉高压症外科治疗体会. 中国现代医学杂志, 2011, 21(19): 2293-2295.
3.	邱培才, 陈积圣. 脾切除对诱发性肝癌大鼠免疫功能的影响. 中国普外基础与临床杂志, 2000, 7(4): 224-225.
4.	Prehn RT. The paradoxical effects of splenectomy on tumor growth. Theor Biol Med Model, 2006, 3: 23.
5.	易坚, 邹志森. 脾脏与肿瘤免疫. 实用癌症杂志, 1999, 14(3): 80-81.
6.	陈维佩, 韩殿冰. 肝硬化门静脉高压症时脾功能与脾的病理生理. 中华肝胆外科杂志, 2006, 12(9): 578-579.
7.	安映红, 袁守军. tuftsin 及其衍生物 T 肽的抗癌作用研究进展. 中国药理学通报, 2016, 32(6): 747-750.
8.	汪谦, 李湘竑, 陈俊任, 等. 肝癌合并有脾亢的外科治疗. 消化外科, 2004, 3(5): 319-321.
9.	余灵祥, 李志伟, 郭晓东, 等. 脾切除术对肝炎后肝硬化患者肝癌发生的影响. 现代生物医学进展, 2013, 13(10): 1959-1961.
10.	耿爱文. 脾切除术对肝炎后肝硬化发生肝癌的影响. 深圳中西医结合杂志, 2016, 26(22): 123-124.
11.	董晓平, 杨帆, 周倜, 等. 脾切除术对肝癌发生的影响. 现代生物医学进展, 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.	吴云华, 艾中立, 刘志苏, 等. 脾切除对肝硬变大鼠移植型肝癌的影响. 湖北医科大学学报, 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, 张清秀, 黄平. 肝细胞肝癌合并门静脉高压症的诊疗进展. 现代医药卫生, 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.	李仓, 张启瑜, 孙克龙, 等. 肝癌切除联合选择性减断流术在原发性肝癌合并中重度门静脉高压症中的应用. 肝胆胰外科杂志, 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.	蔡建强, 胡敬群, 毕新宇, 等. 肝脾联合切除术治疗肝癌合并肝硬化脾功能亢进的远期疗效. 中华医学杂志, 2004, 84(1): 10-12.
26.	曹志新, 陈孝平, 吴在德. 肝癌合并肝硬化患者脾脏 Th1/Th2 细胞因子免疫状态的研究. 中华实验外科杂志, 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.	马东伟. 原发性肝癌合并门脉高压症的外科治疗. 中国现代医生, 2010, 48(33): 142-143.
34.	孙国明. 肝脾联合切除治疗肝癌伴肝硬化脾功能亢进的安全性和疗效. 中国现代普通外科进展, 2016, 19(02): 145-146+149.
35.	郭建光. 肝脾联合切除治疗肝癌合并门脉高压的疗效观察. 临床医药文献电子杂志, 2016, 3(7): 1219-1220.
36.	宋向东, 刘争, 赵华, 等. 肝脾联合切除治疗肝癌伴肝硬化脾功能亢进临床研究. 中国卫生标准管理, 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.	姚关兵, 周军, 陈念平, 等. 原发性肝癌合并门静脉高压、脾亢的外科治疗. 医学综述, 2009, 15(10): 1514-1517.
39.	李聪, 蔡建强. 肝脾联合切除治疗肝癌合并肝硬化脾功能亢进的现状. 中国肿瘤外科杂志, 2011, 3(2): 106-108.
40.	林志强, 俞武生, 卢春丽, 等. 不同治疗方法对肝癌合并脾功能亢进的疗效分析. 中国当代医药, 2012, 19(21): 46-48.

1. 肖开银, 彭民浩. 原发性肝癌流行病学研究进展. 中国普外基础与临床杂志, 2000, 7(4): 272-274.
2. 刘文艺, 吴鸿. 原发性肝癌合并门脉高压症外科治疗体会. 中国现代医学杂志, 2011, 21(19): 2293-2295.
3. 邱培才, 陈积圣. 脾切除对诱发性肝癌大鼠免疫功能的影响. 中国普外基础与临床杂志, 2000, 7(4): 224-225.
4. Prehn RT. The paradoxical effects of splenectomy on tumor growth. Theor Biol Med Model, 2006, 3: 23.
5. 易坚, 邹志森. 脾脏与肿瘤免疫. 实用癌症杂志, 1999, 14(3): 80-81.
6. 陈维佩, 韩殿冰. 肝硬化门静脉高压症时脾功能与脾的病理生理. 中华肝胆外科杂志, 2006, 12(9): 578-579.
7. 安映红, 袁守军. tuftsin 及其衍生物 T 肽的抗癌作用研究进展. 中国药理学通报, 2016, 32(6): 747-750.
8. 汪谦, 李湘竑, 陈俊任, 等. 肝癌合并有脾亢的外科治疗. 消化外科, 2004, 3(5): 319-321.
9. 余灵祥, 李志伟, 郭晓东, 等. 脾切除术对肝炎后肝硬化患者肝癌发生的影响. 现代生物医学进展, 2013, 13(10): 1959-1961.
10. 耿爱文. 脾切除术对肝炎后肝硬化发生肝癌的影响. 深圳中西医结合杂志, 2016, 26(22): 123-124.
11. 董晓平, 杨帆, 周倜, 等. 脾切除术对肝癌发生的影响. 现代生物医学进展, 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. 吴云华, 艾中立, 刘志苏, 等. 脾切除对肝硬变大鼠移植型肝癌的影响. 湖北医科大学学报, 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, 张清秀, 黄平. 肝细胞肝癌合并门静脉高压症的诊疗进展. 现代医药卫生, 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. 李仓, 张启瑜, 孙克龙, 等. 肝癌切除联合选择性减断流术在原发性肝癌合并中重度门静脉高压症中的应用. 肝胆胰外科杂志, 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. 蔡建强, 胡敬群, 毕新宇, 等. 肝脾联合切除术治疗肝癌合并肝硬化脾功能亢进的远期疗效. 中华医学杂志, 2004, 84(1): 10-12.
26. 曹志新, 陈孝平, 吴在德. 肝癌合并肝硬化患者脾脏 Th1/Th2 细胞因子免疫状态的研究. 中华实验外科杂志, 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. 马东伟. 原发性肝癌合并门脉高压症的外科治疗. 中国现代医生, 2010, 48(33): 142-143.
34. 孙国明. 肝脾联合切除治疗肝癌伴肝硬化脾功能亢进的安全性和疗效. 中国现代普通外科进展, 2016, 19(02): 145-146+149.
35. 郭建光. 肝脾联合切除治疗肝癌合并门脉高压的疗效观察. 临床医药文献电子杂志, 2016, 3(7): 1219-1220.
36. 宋向东, 刘争, 赵华, 等. 肝脾联合切除治疗肝癌伴肝硬化脾功能亢进临床研究. 中国卫生标准管理, 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. 姚关兵, 周军, 陈念平, 等. 原发性肝癌合并门静脉高压、脾亢的外科治疗. 医学综述, 2009, 15(10): 1514-1517.
39. 李聪, 蔡建强. 肝脾联合切除治疗肝癌合并肝硬化脾功能亢进的现状. 中国肿瘤外科杂志, 2011, 3(2): 106-108.
40. 林志强, 俞武生, 卢春丽, 等. 不同治疗方法对肝癌合并脾功能亢进的疗效分析. 中国当代医药, 2012, 19(21): 46-48.

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

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