Published online May 27, 2023. doi: 10.4240/wjgs.v15.i5.917
Peer-review started: October 9, 2022
First decision: December 12, 2022
Revised: December 22, 2022
Accepted: April 4, 2023
Article in press: April 4, 2023
Published online: May 27, 2023
The mechanism of regeneration of the future liver remnant (FLR) after associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a hot research topic in the field of hepatobiliary surgery, but the definitive mechanism of regeneration has not yet been fully elucidated.
Regulatory T cells (Tregs) are closely associated with tissue and organ regeneration in a number of studies, but no studies have been reported on their association with liver regeneration.
This study explored the correlation between CD4+CD25+ Tregs and FLR regeneration after ALPPS from the perspectives of FLR regeneration volume, FLR regeneration rate, kinetic growth rate (KGR), and liver fibrosis score.
Collection of clinical data and peripheral blood samples from hepatocellular carcinoma (HCC) patients treated with ALPPS. Flow cytometry was performed to detect changes in the proportion of CD4+CD25+ Tregs to CD4+ T cells in peripheral blood before and after ALPPS. To analyze the relationship between peripheral blood CD4+CD25+ Treg proportion and clinicopathological information and FLR.
The postoperative CD4+CD25+ Treg proportion in stage 1 ALPPS was negatively correlated with the amount of proliferation volume, proliferation rate, and KGR of the FLR after stage 1 ALPPS. Patients with a high Treg proportion had a lower postoperative KGR as well as a more severe degree of fibrosis. Also, Treg proportion was a good predictor of in postoperative proliferation volume, proliferation rate and KGR.
CD4+CD25+ Tregs in the peripheral blood of patients with HCC at stage 1 ALPPS were negatively correlated with indicators of FLR regeneration after stage 1 ALPPS and may influence the degree of fibrosis in patients’ livers. Treg percentage was highly accurate in predicting the FLR regeneration after stage 1 ALPPS.
Research on the mechanism of FLR regeneration after ALPPS is still being explored. In future studies, this report provides certain strong evidence to explore the regeneration mechanism, which will provide positive reference value to further improve the regeneration rate of FLR after ALPPS, reduce the waiting time of patients for ALPPS surgery and improve the survival rate of HCC patients.