Immune status of the spleen and surgical treatment in patients with advanced gastric cancer]

The immune status of spleen and the effect of surgical treatment in advanced gastric cancer (AGC) patients were evaluated by means of testing NK cell activity, T-lymphocyte subsets and circulating immune complex (CIC). The results showed (1) the significant impairment of NK cell activity and T-lymphocyte subsets, were decreased in CD3+, CD4+ cells and increased in CD6+ cells resulting in CD4+/CD8+ cell ratio decrease in peripheral blood lymphocytes (PBL), splenic venous blood lymphocytes (SVL) and spleen cells (SC) of AGC, as compared with PBL of normal population; (2) NK cell activity or CD4+/CD8+ cell ratio of SVL and SC were significantly lower than those of PBL in AGC patients, mainly caused by marked decrease of CD4+ cells in SC; (3) NK cell activity, CD4+ cells and CD4+/CD8+ cell ratio were significantly elevated in most of AGC cases receiving either radical gastrectomy (R2+) or extensive radical gastrectomy (R3). A striking declination in CD8+ cells were found only after R3 operation; (4) after a short period (10-14 days) or a long period (2-4 years) of radical gastrectomy, NK cell activity and T-lymphocyte subsets showed no significant differences between R2+ and R3 operation. As a rule, AGC would weaken immune function of patients, and along with the development of the tumor, the immunosuppression in the spleen would be generated gradually. For these reasons, a complete tumor resection would be necessary to improve the immunocompetence, and the combined splenectomy might be advisable if indicated.