脾脏在肝癌合并肝硬化中的临床价值
Role of the spleen in patients with liver cancer and cirrhosis
Received date: 2022-09-06
Online published: 2023-10-24
Chang Jessica, 陈旭晓, 陈拥军 . 脾脏在肝癌合并肝硬化中的临床价值[J]. 外科理论与实践, 2023 , 28(04) : 394 -398 . DOI: 10.16139/j.1007-9610.2023.04.018
The spleen is the largest lymphoid organ that can affect the immunological microenvironment in the liver via the portal system. Patients with liver cancer, often develop hypersplenism and splenomegaly from underlying cirrhosis and portal hypertension. The malfunction of the spleen not only induces hepatic fibrogenesis, but also changes the immune responses in the liver, so that liver cirrhosis accelerates while liver regeneration subdues. As a result, the hepatic microenvironment and the rest of the immune system reach a “tumor progressing” or “tumor tolerant” state. Splenectomy has been shown to improve immune responses, liver function and general condition in patients with liver cancer. Hence, splenectomy may possibly improve the tolerance in live cancer patients for other anticancer treatments. However, the long-term benefits and effects on the overall survival of concomitant hepatectomy and splenectomy for liver cancer patients with portal hypertension and hypersplenism still remain controversial.
Key words： Liver cancer; Spleen; Portal hypertension; Cirrhosis
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