The Effects of Splenectomy to Hepatocarcinogenesis in Different Gender Patients with Posthepatitis Cirrhosis by PS Methods
|School||Fourth Military Medical University|
|Keywords||PS method Splenectomy Gender Sex hormones Hepatitis Cirrhosis HCC|
The purpose combined retrospective and prospective study, in a review on the basis of factors affect the liver cancer, splenectomy hepatitis and cirrhosis in patients with HCC, and the difference in the performance of different gender and speculated that the cause of this difference reasons. Collected Xijing Hospital, Fourth Military Medical University from January 2002 to December 2009, was diagnosed with viral hepatitis, cirrhosis and hypersplenism with or without liver cancer cases 2848 cases, statistics these patients generally clinical data, laboratory data, imaging and pathology results, medical history, surgical history. A case-control study, based on whether the object of study combined hepatocellular carcinoma grouped group 1 (combined liver cancer), group 2 (Unconsolidated HCC group), according to sex, age indicator 1:1. Use the the SPSS17.0 software on the two sets of data do univariate analysis and multivariate Logistic regression analysis. If there is history of splenectomy grouping criteria, there is a significant difference in the impact of HCC propensity score method (PS Act) balanced factors, and press 1:2 pairing, eventually divided into group 1 (removal of the spleen group), group 2 (not the removal of the spleen group). SPSS17.0 statistical software paired T-test and chi-square tests and analysis of the two sets of data rows. Statistics data splenectomy surgery in patients with a history of male liver cancer group divided by sex and the presence or absence of liver cancer, male non-HCC group, female HCC group and four groups of female non-HCC group similar criteria to each group did not undergo splenectomy surgery patients 1:1. SPSS17.0 statistical software paired T-test analysis. Collect hepatitis, cirrhosis with hypersplenism underwent splenectomy (with or without the Minch devascularization) \SPSS17.0 statistical software line paired T-test analysis. Results of the first part of the experimental results show that the liver cancer group and unconsolidated HCC group was significantly higher compared to ALT, AST, ALP, GGT, and was statistically significant (P lt; 0.05), PLT, WBC difference was not statistically significance. Significant single factor influencing factors re Multivariate Logistic regression analysis showed that, ALT, ALP, GGT abnormal elevation increases the risk of liver cancer and splenectomy significantly reduce the risk of the occurrence of liver cancer, only the splenectomy hepatitis cirrhosis 55.9% (OR = 0.559, 95% CI = 0.401,0.778). The second part of the experiment using the PS method to remove the interference of other risk factors for liver cancer, also confirmed splenectomy can reduce the risk of liver cancer, the incidence of hepatocellular carcinoma in two groups were 12.26% and 33.33%, OR = 0.388, the difference statistically significant (P lt; 0.01). The third part of the experimental results show that the protective effect of splenectomy HCC there are gender differences, male role, while the female role was not obvious. The fourth part of the experimental results show that after splenectomy, male, female hormone than resection significantly change, especially progesterone and testosterone, suggesting that this may cause spleen resection of men and women after hepatitis patients with cirrhosis of liver cancer occur. However, no such reports. Conclusion splenectomy (with or without door odd devascularization) not only for hepatitis cirrhosis patients with hypersplenism effective treatment, can also improve liver function, alleviate liver cirrhosis and liver cirrhosis patients, on the other hand, can be reduced liver cancer risk, especially in male patients is more obvious. Speculated that progesterone and testosterone hormones may play an important role.