Influence of Surgical Stress of Esophageal Cancer on Cell Mediated Immunity -Comparisons with Surgical Stress of Gastric Cancer-

Yoshitaka Nakata, Kin-ichi Nabeya, Tateo Hanaoka, Chou-ou Kaku, Osamu Kimura, Hajime Kobayashi, Terushi Yamada, Tadashi Sekihara, Shojiro Koido, Minoru Matsuda

Second Department of Surgery, Kyorin University School of Medicine

The influence of surgical stress on cell mediated immunity was studied in 40 patients with esophageal cancer and in 34 patients with gastric cancer. (1) The postoperative fluctuations in monocyte count and OKIal⁺ cells demonstrated that the patients with esophageal cancer needed more than one month to be freed from the influence of surgical stress, whereas the patients with gastric cancer recovered from surgical stress within two weeks. (2) The assay of postoperative fluctuation rates in PHA blastogenetic reaction and NK cell activity at two weeks postoperatively showed a decline of lymphocyte functions, with a significant difference (p<0.01 and p<0.05 respectively) found between the patients with esophageal cancer and those with gastric cancer. The patients with gastric cancer were recovered to the preoperative level at one month postoperatively, while those with esophageal cancer were not. The lymphocyte function of esophageal cancer patients also tended to decline even at two month after surgery. It was considered that the nutritional status influenced the lymphocyte functions, because of esophageal cancer patients showed a decline of fluctuation rates in serum albumin level with a significant difference (p<0.01) compared with those of gastric cancer patients. (3) The postoperative fluctuations in OKT3⁺ cell rate and OKT4⁺/OKT8⁺ rate were small, and surgical stress did not have any influence on lymphocyte subsets. (4) The results suggest that the administration of biological response modifier (BRM) and sufficient postoperative nutritional management are essential in surgery for esophageal cancer performed by thoracotomy and laparotomy which involves gross stress.

Key words
surgical stress of esophageal cancer, cell mediate immunity of esophageal cancer

Reprint requests
Yoshitaka Nakata Second Department of Surgery, Kyorin University School of Medicine
6-20-2 Shinakawa, Mitaka City, Tokyo, 181 JAPAN

Accepted
January 13, 1993

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