日本消化器外科学会雑誌第24巻第12号

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2 Malignant liver diseases hedatocellular carcinoma cholangiocellular carcinoma rnetastatic liver turnor Combined liver diseases liver cinhosis active hedalilis Ope.time (min)

3 FiS. I Changes of lymphocyte counts in hepatectomized patients for malignant liver Lymphocyte (,/ mm3 ) + All ceses (n=25) + Group A (n-15; + Group B (n:10) 3 days I 3 wcks after after 4 weks after Fig. 2 Changes of helper T/suppressor T (Th/Ts) patients for malignant liver ratio in hepatectomized 2 ecks after All c.s s (n=25) + Grop A (n=15) + croup B (n=10) +

4 Fig. 3 Changes of NK activity in hepatectomized patients for malignant NK activity (96 ) LAK activity (%) 3 w*ks 4 weks.tter!fter Fig. 4 Changes of LAK activity in hepatectomized patients for malignant liver 2 weks rfte. 4 w@ks atter

5 Fig. 5 Changes of ADCC activity in hepatectomized patients for malignant liver Fig.6 Changes of IgG level in hepatectomized + All eses (n-25) +Grop A (n=15) +Grqp B (n-lo) weks aft r 3 patients for malignant liver 3 dlys.ftqr

6 Fig.7 Changes of IgA level in hepatectomized patients for malignant liver nrmors. + All es (nr25) + Grcup l1n-15) + c.dp B (n=10) 3 days I week tft6r after I wssk!fter + Att cas6s (n-25) + Group A (n=15) + Group B (n=10) 4 w@ks after

7 Fig. 9 Changes of C. level in hepatectomized patients for malignant liver +All cases (n:25) +Group A (n:151 +Group B (n:10) * p<0.05 vs. Group B Fig. eop op. 3 days I week 2 weeks 3 weeks 4 weeks after alter 10 Changes of C. level in hepatectomized patients for malignant liver Group B : Cases with no other liver diseases. after 2 wcks 4 weks!fter after

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10 Changes of Immunological Function after Hepatectomy in Patients with Malignant Liver Tumors Michiyoshi Hisanaga, Yoshiyuki Nakajima, Hiromichi Kanehiro, Yoshinori Murao, Toshiyuki Fukuoka, Junichiro Taki, Yukio Aomatsu, Masato Horikawa, Kiyoshi Kido' Atsushi Yoshimura, Masayoshi Ueno and Hiroshige Nakano First Department of Surgery, Nara Medical University Changes in immunological function were investigated after hepatectomy in 25 patients with malignant liver tumors by various parameters until 4th postoperative week. The patients were divided into two groups consisting of 15 patients associated with liver cirrhosis or active hepatitis (n=15, group A) and 10 patients with no other liver diseases (n:10, group B). The lymphocyte counts and Th/Ts ratio dropped to their minimum levels on the 3rd and 7th postoperative days, respectively. Both NK and LAK activities decreased significantly in the 2nd postoperative week (p<0.05), and showed virtual recovery in the 4th weeks. In group A, this decrease was particularly marked and recovery was delayed. No obvious changes were found in ADCC activity during the course of study. IgG' IgA

11 and IgM levels were rducd on the 3rd postoperative day and recovered by the end of the first week, with group A showing significantly higher values throughout the monitoring period (p<0.05). Both Ca and C4 were significantly elevated at I week (p(0.05), and then normalized at 2 weeks. In conclusion, in patients undergoing hepatectomy, the suppression of immunological function persists until the 2nd postoperative week. This suppression was more pronounced and recovery was delayed longer in patients associated with combined liver disease. Reprint requests: Michiyoshi Hisanrga First Department of Suryery, Nara Medical University 840 Shijocho, Kashihara, 694 JAPAN

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