Studies on the Changes in Lymphocytes Subsets of Peripheral Blood, Splenic Venous Blood and Spleen and on the Effects of Preoperative OK-432 Administration in Patients with Resectable Gastric Cancer

Akinori Takagane, Masanori Terashima

Department of Surgery I, Iwate Medical University, School of Medicine

To evaluate the systemic immunosuppression caused by surgical stress and the influence of splenic immunological response on systemic immunity, we studied changes in the lymphocyte subsets of peripheral venous blood and splenic venous blood before and after gastrectomy in 48 gastric cancer patients using two color flow cytometry. In preoperative peripheral venous blood, the population of suppressor T cells increased in patients with stage IV disease. The increase in suppressor T cells was also observed in splenic venous blood in patients with lymph node metastasis. We further studied the effects of preoperative OK-432 administration in order to determine the possibility of preventing surgical immunosuppression. A total of 45 patients with resectable gastric cancer were entered in this study and randomized to two treatment arms: pre- and postoperative OK-432 administration (group A), and postoperative OK-432 administration (Group B). Lymphocyte subsets of peripheral venous blood before and after gastrectomy, splenic venous blood and splenic lymphocytes were measured by two color flow cytometry. Increases in the population of NK cells were observed in inter- and post-operative peripheral venous blood in group A. Furthermore, NK cell populations in splenic venous blood and splenic lymphocytes were significantly higher in group A than in group B. However, there were no differences in disease free survival between the two groups.

Key words
preoperative immunotherapy for gastric cancer, OK-432, lymphocyte subsets of peripheral venous blood, splenic venous blood and spleen

Reprint requests
Akinori Takagane Department of Surgery I, Iwate Medical University, School of Medicine
19-1 Uchimaru, Morioka, 020 JAPAN

Accepted
June 8, 1994

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