Effect of Adjuvant Immunochemotherapy on Immunologic Function of Gastric Cancer Patients

ABSTRACT

BACKGROUND: We have postoperatively performed adjuvant immunochemotherapy (Picibanil plus oral -fluorouracil) for advanced gastric cancer patients. We aimed to study the effect of immunochemotherapy on the immunologic function after gastric resection for advanced gastric cancer patients. METHODS: Twenty gastric cancer patients were randomly selected at the outpatient department from May 1994 to September 1994. All patients had undergone a total gastrectomy with a D2 lymph node dissection (at least) and had also undergone adjuvant immunochemotherapy for two years. No patients had any evidence of a local recurrence or a distant metastasis at the time of the study. The immunologic parameters were the total lymphocyte count and the percentages of T3 cells (CD3), T4 cells (CD4) and T8 cells (CD8), which were determined using monoclonal antibodies and flow cytometry. A delayed skin hypersensitivity reaction was induced with dinitrochlorobenzene (DNCB). These parameters before operation were compared with those after immunochemotherapy. RESULTS: The average total lymphocyte count before the operation showed no significant difference from that after immunochemotherapy (2,138+127.9/ml vs. 2,235.7+140.0/ml, respectively). The average proportions of T3, T4, and T8 cells among the lymphocytes also showed no significant difference (59.0+2.2%, 36.9+1.5%, and 25.8+1.5%, preoperatively, vs. 61.3+3.2%, 39.7+2.7%, and 23.4+1.8%, after immunochemotherapy, respectively). The distribution of the delayed skin hypersensitivity reactions of the patients was not significantly different from that of the normal control group. CONCLUSIONS: The postoperative immunological function was not suppressed by immunochemotherapy. This suggests that a long-term immunotherapy combined with chemotherapy might play a role in supporting immunologic functions after a gastric resection.