Influence On Immune Function Of Quantitative Microwave Ablation For Secondary Splenomagely And Hypersplenism

Objective Microwave ablation therapy for secondary splenomagely and hypersplenism has proved to be effective through previous animal experiment and clinical study. This study is to investigate the influence on immune function of quantitative microwave ablation for secondary splenomagely and hypersplenism. Material and methods 10 patients with secondary splenomagely and hypersplenism were performed by microwave ablation of the spleen , during laparoscopy or percutaneously with ultrasound guidance. The changes of splenic capsule, hemorrhage of puncture site were observed during the microwave ablation therapy. Before and 1,3,7 days after operation, changes of T lymphocyte subsets, B lymphocyte, natural killer cell and serum tuftsin were detected. Ten patients with cirrhosis, portal hypertension, secondary splenomagely and hypersplenism who underwent splenectomy were selected as control group. As to the control group , we also detect the same index at the same time. Evaluate the short-term influence on spleen immune function of microwave ablation therapy for splenomagely and splenectomy for splenomagely. Patients who underwent microwave ablation therapy for secondary splenomagely and hypersplenism were called back 1 month and 3 months after operation, detect their T lymphocyte subsets, B lymphocyte, natural killer cell in periphery blood to evaluate the long-term effects of microwave ablation therapy for splenomagely and influence on spleen function. Divide the patients into two group according to their albation volume, detect the relationship between ablation volume and change of immune function.T lymphocyte subsets, B lymphocyte and natural killer cell were detected by flow cytometry. Tuftsin was detected by reverse-phase high-performance liquid chromatography. (RP-HPLC)Results (1) The T- lymphocyte subsets CD3, CD4+ and CD4+/CD8+ of the patients who underwent splenectomy decreased sharply 1 day after operation. And return to pre-operation level 7 days after operation.There was no significant change of B lymphocyte before and after operation. NK cell activities decreased significantly 7days after operation. Serum tuftsin level decreased significantly 1 day after operation and continue to decrease 7 days after operation.This suggest that splenectomy damage immune function in the short-term. (2) There was no significant change of T-lymphocyte subsets CD3 , CD4+ , CD8+ , CD4+/CD8+ ,NK cell level in peripherial blood and serum tuftsin level of patients 7 days after microwave ablation, B lymphocyte increased significantly than pre-operation lday after operation and continue to increase 3 days, 7days after operation. This suggest that microwave ablation for spleen does not damage immune function and can partly improve it.(3) Patients who performed ablation therapy for secondary splenomagely and hypersplenism were called back 1 month , 3 months after operation,detect their immune index. Level of CD3, CD4+ increased significantly 1 month after operation, but decreased slightly 3 months after operation.There were no significant change of CD8+,CD4+/CD8+ and NK cell level 1 and 3 months after operation compared with pre-operation level.B lymphocyte continue to increase significantly 3 months after operation.(4)According to the spleen ablation volume , patients whose ablation volume <20%, level of CD3, CD4+ increased 1 month after ablation, and decreased slightly 3 months after ablation, and level of CD4+ lower than pre-operation level. CD8+ level was higher than pre-operation 1 and 3 months after operation. CD4+/CD8+ ratio is a little decreased and lower than pre-operation level 1 month and 3 months after operation.B lymphocyte continue to increase in the 3 months after operation. NK cell level was about the same level with ppre-operation 1 month after operation but decreased 3 months after operation. While patients whose ablation volume between 20%-40%, CD3, CD4+, ratio CD4+/CD8+ ,B lymphocyte and NK cell level increase 1 month after operationand continue to increase 3 months after operation. CD8+ level lower than pre-operation level 1 month after operation and continue to decrease 3 months later. This suggests that spleen ablation volume may influence spleen immune function. CD4+T lymphocyte level of ablation volume between 20-40% is significantly higher that those of <20% at 3 months after therapy, other index at other time does not have obvious difference.Conclusion (1) Immune function of the patients who underwent splenectomy is damaged in the short-term after splenectomy. (2) Microwave ablation therapy for splenomagely and splenectomy preserve part of the anatomic structure of spleen and maintain its physiological function especially the immune function, and in the long-term it can partly increase the spleen immune function. From immune point of view, we can say that it is safe and effective. (3) There was relationship between spleen ablation volume and immune function level of patients after therapy. We can say from our observation that spleen ablation volume >20% is benefit to enhance immune function and maintain its level.