Immunological Response to Surgical Stress in Cancer Patients

Yasuyuki Sugiyama, Shigetoyo Saji, Tomohiko Furuta, Shuji Azuma, Kiichi Miya, Mitsuhiko Kusakabe, Makoto Yamada

Second Department of Surgery, Gifu University School of Medicine

The efficacy of nonspecific immunotherapy for immunosuppression caused by surgical stress was studied. As the degree of surgical stress increased, both PHA-induced blastogenesis and natural killer (NK) activity of peripheral blood mononuclear cells (PBMC) of tumor bearing rats were reduced, followed by facilitation of lung metastasis. Administration of OK-432 prior to surgical stress, however, prevented the reduction of immunity of PBMC and the facilitation of lung metastasis. In gastric cancer patients, the values of PHA-induced blastogenesis and NK activity of PBMC 1∼2 weeks after gastrectomy were significantly lower than those measured before surgery. Pre- and postoperative immunotherapy prevented the reduction of immunity of PBMC, while postoperative immunotherapy did not. Furthermore, to evaluate the efficacy of nonspecific immunotherapy, a total of 275 gastric cancer patients were randomly divided into the following 3 groups; a pre- and postoperative immunotherapy group, a postoperative immunotherapy group and a group without any immunotherapy. The patients whose cancers were histologically classified as stage I because of both m and n₀ were excepted from the study. When the patients classified as having stage II cancer were statistically analyzed, the survival of the pre- and postoperative immunotherapy groups was significantly longer than that of the postoperative immunotherapy group. The results indicate that nonspecific immunotherapy which is started prior to surgery should be effective against the immunosuppression caused by surgical stress and should prolong survival.

Key words
surgical stress, cancer patients, nonspecific immunotherapy

Reprint requests
Yasuyuki Sugiyama Second Department of Surgery, Gifu University School of Medicine
40 Tsukasa-machi, Gifu, 500 JAPAN

Accepted
July 6, 1992

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