POSTOPERATIVE CHANGES OF HOST IMMUNITY AND THE PROGNOSIS IN GASTRIC CANCER PATIENTS WITH LEAKAGE OF ANASTMOSIS

The influence of leakage on host immunity and prognosis were studied in 16 gastric cancer patients (stage II and III) complicated after distal gastrectomy and compared them with 30 patients without leakage. Postoperative changes of immunologic parameters (IL-2, IL-6 and T cell subsets) were observed and 5-year survival rates of each stage were investigated and compared with the no-leakage group. In the group with leakage, the average number of SIRS positive days (9.2 days) was prolonged significantly when compared with the control group (2.1 days). Furthermore serum level of IL-6 had a second elevation and IL-2 production was decreased postoperatively for a longer period, CD4+2H4-cell ratio (helper T) stayed at a low level for 3 months, CD11b+CD8 bright+cell ratio (suppressor T) increased for 1 month. Deterioration of 5-year survival rates was seen in the group with leakage and in both stages, but a ignificant difference was not seen. Based on these results, we think that prolonged SIRS after cancer surgery due to leakage suppressed host immunity and this fact caused cancer recurrence and poorer prognosis.