| Hepatocellular carcinoma(HCC) is one of the most common malignant tumor, accounting for primary liver tumor for nearly 90 percent, annual new cases of HCC about 35 million people, about 320,000 people died of the disease , The morbidity and mortality rates as high as second only to stomach cancer and esophagus cancer in common in China. As the etiology of HCC in-depth study, people found that the incidence of HCC is a multi-phase, multi-factor cumulative effects, hepatitis virus (HBV, HCV)were recognized as one of the main cause, study showed that the posthepatitic cirrhosis was the major risk factor. The main clinical manifestations of posthepatitic cirrhosis were hypohepatia and portal hypertension, porta-azygous disconention is a main procedure in a variety of surgical treatment of portal hypertension, for the treatment of various clinical efficacy and long-term relationship with the HCC has been a lot reports.Hypersplenotrophy, hypersplenism as the main complications in portal hypertension if the splenectomy necessary in the course of treatment, there have always been controversial. At present the relations between the HCC and spleen are mostly concentrated in the spleen on the progress and treatment of HCC's role in the process, but had not been reported the role of spleen in hepatocarcinogenesis . The topic was to investigate the impact of splenectomy wtth porta-azygous disconnection on hepatocarcinogenesis in the patients of posthepatitiscirrhosis, provide a theoretical basis for the treatment of posthepatitic cirrhosis with portal hypertension and the study of hepatocarcinogenesis.This topic through case-control study designed to determine the group conditions, according to diagnostic criteria and exclusion criteria,from January 2005 to June 2007 six handred twenty five posthepatitis cirrhosis with portal hypertension and hypersplenism patients in our hospital were include in this study. Among them 464 cases without hepatocellular carcinoma(HCC) (group1) ,161 cases with HCC(group2). General information,clinical and laboratory examination datas, imaging examination results and history of splenectomy with porta-azygous disconention were collected. Univariate and multivariate logistic regression analysis of the impact of splenectomy with porta-azygous disconnecton on hepatocarcinogenesis were performed by SAS9.0Statistical results showed that between group 1 and 2 there was statistically significant difference in age(P<0.05),but no statistically significant difference in gender, ascites, hepatic encephalopathy, live function(child-pugh)class,total bilirubin and platelet count(P>0.05). Single-variable and multivariate analysis revealed that the patients with abnomal of alkaline phosphatase(ALP)increased 1.838 times risk of hepatocarcinogenesis(odds ratio ,OR:1.838; confidence interval of 95%: 1.197～2.824),abnomal ofγ-glutamyltransferase(GGT) increased 7.950 times risk of hepatocarcinogenesis (OR:7.950,95%CI: 5.098～2.397).Compareing patients with and without history of splenectomy with porta-azygous disconection ,this procedure significant reduced the risk of hepatocarcinogenesis(OR:0.436,95%CI: 0.219～0.871)At present, the impact of patho-spleen on hepatocarcinogenesis of posthepatitic cirrhosis with portal hypertension has not been reported, the study found, splenectomy with porta-azygous disconention procedure could significantly reduce the risk of hepatocarcinogenesis in patients of posthepatitic cirrhosis with portal hypertension, hypersplenotrophy and hypersplenism, The abnomal of ALP and GGT increasee risk of hepatic carcinoma in these patients .Patho-spleen may have a promotion role of hepatocarcinogenesis in patients of posthepatitic cirrhosis with portal hypertension ,splenectomy may reduce the risk of hepatocarcinogenesis, to the conclusion that further studies for splenectomy with porta-azygous disconention may provide a theoretical basis in the treatment of posthepatitic cirrhosis with portal hypertension...
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