Impact of splenectomy on circulating T-lymphocyte subsets in stage III gastric cancer.
BACKGROUND
The role of splenectomy remains unclear in patients with gastric cancer who undergo total gastrectomy. The aim of this study was to prospectively evaluate the impact of splenectomy on circulating T-lymphocyte subsets and survival in advanced gastric cancer.


METHODS
Analysis of lymphocyte subsets was performed in 40 patients with American Joint Committee on Cancer (AJCC) stage III gastric adenocarcinoma located on the upper one-third of the stomach, who underwent a curative total gastrectomy with or without splenectomy. Circulating T-lymphocyte subsets were measured on venous blood by using flow cytometry and monoclonal antibodies at preoperative day 1, and postoperative months 1, 3, 6, 12 and 18.


RESULTS
The proportion of lymphocytes and the values of CD3, CD8, CD16 and CD25 subsets were higher in the splenectomy group of patients at postoperative month 3. In the spleen preservation group at the same point of treatment, the proportion of granulocytes and the values of CD4 and CD4 : CD8 ratio were higher. Except for CD16 levels, all T-lymphocyte subsets showed no significant difference between splenectomy and spleen preservation groups after postoperative month 3. Increased CD16 levels in the splenectomy group were not associated with improvement in patients' 5-year survival rates.


CONCLUSIONS
These results suggest that the long-term impact of splenectomy does not play an important role in postoperative quantitative changes of circulating T-lymphocyte subsets of patients with stage III gastric cancer who have undergone total gastrectomy. Furthermore, splenectomy does not give a prognostic benefit, based on tumour recurrence and survival of patients with proximal one-third gastric cancer who undergo total gastrectomy.
Department of Surgery, College of Medicine, Korea University, Seoul, Korea. minyoung@korea.ac.kr
Min Young
MY
Cho
Matthew D
MD
Kroh
Yong Geul
YG
Joh
Sung Ock
SO
Suh
D000230:Adenocarcinoma / Q000097:blood* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D013156:Splenectomy; D013274:Stomach Neoplasms / Q000097:blood* / Q000473:pathology; D016176:T-Lymphocyte Subsets