A Case of Granulocyte-Colony Stimulating Factor Producing Gastric Cancer

Tsutomu Sato, Roppei Yamada, Naoto Yamamoto, Takashi Ohshima, Chikara Kunisaki, Hirotoshi Sugita²⁾, Yasushi Rino¹⁾ and Toshio Imada

Yokohama City University, Medical Center, Gastroenterological Center
Department of Surgery, Yokohama City University Hospital¹⁾
Department of Surgery, Byoubugaura Hospital²⁾

Granulocyte-colony stimulating factor (G-CSF)-producing gastric cancers are rare, and only 34 cases, including our own, have been reported in Japan. We report a case of gastric cancer in a patient with a high level of serum G-CSF preoperatively that was immunohistologically diagnosed as a G-CSF-producing gastric cancer. A 67-year-old man admitted to our hospital for epigastric pain was found to have type 1 gastric cancer in the upper gastric body by gastrointestinal endoscopy, and biopsy revealed poorly differentiated adenocarcinoma. The preoperative laboratory data revealed leukocytosis (19,090/μl) and a high serum level G-CSF (91 pg/ml). Total gastrectomy plus splenectomy was performed in June 2005. Postoperatively, leukyocytosis was improved, with the leukocyte count decreasing to a nadir 6,760/μl, and the serum G-CSF level decreased to below 10 pg/ml. The patient is alive 5 months postoperatively and recurrence-free. Immunohistochemical testing of the resected gastric cancer with anti-G-CSF antibody revealed a positive reaction in the tumor cells, and a definite diagnosis of G-CSF producing gastric cancer was made.

Key words
granulocyte-colony stimiulating factor (G-CSF), gastric cancer, chemotherapy

Reprint requests
Tsutomu Sato Yokohama City University, Medical Center, Gastroenterological Center
4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024 JAPAN

Accepted
June 28, 2006

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