Correlation between postoperative prognosis in gastrointestinal cancer patients and blastformation rate of lymphocytes

Gastrointestinal cancer patients were followed up for up to 30 months postoperatively and their clinical status related to a parameter of nonspecific immunity, the blastformation rate of peripheral blood lymphocytes against phytohemagglutinin. By the fourth postoperative week, the blastformation rate had recovered from the effect of the operation. In patients who had undergone curative resection, the postoperative level rose to exceed the preoperative level, whereas whereas in those in whom resection had not been possible, the blastformation rate failed to show this rise by the fourth week, and continued at the decreased immediate postoperative level. Results for long-term follow-up (30 months postoperatively) showed that the blastformation rate continued at high levels (almost all over 40%) in cases of curative resection without recurrence, but remained low (under 40%) in those in which the tumor could not be removed. The 40% level of the blastformation rate test thus correlated well with the prognosis. The blastformation rate, therefore, proved a very good parameter for following the pre-and post-operative clinical course of gastrointestinal cancer patients.</p

Studies on relationship between serum properdin and cancer III. Influence of anticancer agents on the serum properdin level

1. When the various anticancer agents are injected intravenously to normal rabbits and intraperitoneally to normal mice, it seems that the serum properdin levels fall transitorily for some hours after administration with a small dose and then keep rising, but with a massive dose it continues to fall from the beginning. 2. The properdin level is decreased considerably by Thio-TEPA and Carzinophilin; moderately by Mitomycin C; and slightly by M. H. OX-substance hardly changes the level and 8-azaguanine rather has a tendency to raise the level. 3. The administration of most anticancer agents seems to suppress the properdin system. 4. The influence of these agents on human serum properdin is similar to that of rabbits. 5. The properdin levels keep at high titers in the group to which the agents act effectively on the cancer, but the levels fall down more rapidly and animals die earlier in the group to which the agents act ineffectively on the cancer as compared with the control group.</p

Studies on relationship between serum properdin and cancer I. A modified method for the assay of serum properdin

1. Properdin assay which is comparatively sensitive and reproducible has been described. The assay may be called a modified method of properdin assay by HUNTER·HILL and McNALL. 2. The properdin assay of serum is possible by using a very small amount of test serum (0.1 ml at the least). The necessary amount of zymosan is very little, the procedure of properdin assay is comparatively simple and it can safely be used clinically. 3. Serum properdin of guinea pig, rat, rabbit and mouse can easily be measured by means of Rp and Ra made from guinea-pig sera. 4. In the properdin assay of human serum, human Rp serum IS preferable to guinea-pig Rp serum. 5. Human Rp serum is always prepared easily from pooled sera of advanced cancer bearing patients. 6. Insulin has not such ability of making Rp and R3 as can replace zymosan. 7. Properdin assay is possible by means of goat's hemolytic system as well as sheep's hemolytic system.</p

Studies on relationship between serum properdin and cancer II. Studies on the serum properdin levels of tumor bearing animals and patients with malignant tumors

1. The properdin levels in sera from mice bearing Ehrlich ascitic carcinoma and from rabbits with Brown-Pearce carcinoma decrease inversely with the increase of the ascites or the tumors. In the incipient period of tumor transplantation, the level rather rises. When the tumor is proliferating or large, the level keeps falling or is low. On the contrary, when the tumor is regressing or disappears, the level elevates or reverts to that before transplantation. Strong A and R III mice with spontaneous mammary cancer have markedly low serum properdin levels as compared with those of healthy mice. 2. The properdin levels are less than 2 units per milliliter of the serum in 44.4 per cent of patients with gastric cancer, in 18.2 per cent of ones with non-malignant tumor and in 18.2 per cent of ones with gastric or duodenal ulcer. The abnormal low level has been found in 33.3 per cent of patients without recurrence, who had undergone extended radical gastrectomy combined with radical lymphadenectomy for gastric cancer. 3. Some correlation can be seen between the serum properdin levels and the degree of progress of gastric cancer. 4. The cancer patients with low total serum protein have lower serum properdin levels than those having nomal protein. 5. As for influence of surgical operation on the serum properdin levels, there is observed a tendency that a minor operation causes the levels to increase and a major operation causes the levels to fall. 6. It has been inferred that the properdin system could be one of the host natural resistance against cancer.</p

Pancreaticogastrostomy: Effect of Partial Gastrectomy on the Pancreatic Stump in Rabbits

To assess the influence of digestive juice on the pancreatic stump when pancreaticogastrostomy was performed after pancreatoduodenectomy, the pancreatic stump was anastomosed to the intact stomach (group I), the stomach after partial gastrectomy (group II), or the jejunum (group III) in rabbits, and the nature of the digestive juice at the anastomotic site as well as the histologic changes of the pancreatic tissue were investigated. The digestive juice was highly acidic in group I, slightly acidic in group II, and almost neutral in group III. Histological examination of the pancreatic stump revealed extensive coagulative necrosis and delayed replacement with granulation tissue in group I, while there was less prominent liquefactive necrosis and early replacement with granulation tissue in groups II and III. Intraperitoneal abscess formation around the anastomotic site and atrophic fibrosis of the pancreas (similar to the changes after pancreatic duct ligation) occurred in 27.8% and 46.2% of group I rabbits, respectively, but no such changes were detected in groups II and III (both P &#60; 0.05). These results indicate that the highly acidic gastric juice had a widespread corrosive effect on the anastomosed pancreatic tissue, and that partial gastrectomy may be necessary to prevent anastomotic leakage and pancreatic duct obstruction after pancreaticogastrostomy.</p

Reactivating effect of levamisole on cell-mediated immunity in gastrointestinal cancer patients

Cell-mediated immunity was studied in 23 cases of advanced gastrointestinal cancer. The patients received levamisole at 150 mg/day for three consecutive days each week for four weeks. In cases at the terminal stage of gastrointestinal cancer, the blastformation rate of peripheral blood lymphocytes against phytohemagglutinin (PHA) after the administration of levamisole showed a slight increase, but cases with blastformation rates over 40% increased markedly three or four weeks after the initial administration of levamisole. The peripheral blood lymphocyte count showed little change in these cases.</p

Preoperative blastformation rate in gastrointestinal cancer patients

The rate of blastformation of peripheral blood lymphocytes in response to stimulation by phytohemagglutinin (PHA) was assessed preoperatively in 393 patients with gastrointestinal cancer. The series consisted of 291 cases of gastric cancer and 102 cases of colon cancer, all patients being under 70 years of age. The blastformation rate was related to the stage of cancer ground at operation. Preoperative blastformation rates for both colon cancer and gastric cancer decreased as the cancer progressed. With Stage I gastric cancer 81.4% of those that underwent curative resection had preoperative blastformation rates greater than 40%. However, the number of those with blastformation rates over 40% decreased markedly in the curative cases of gastric cancer Stage II to stage IV. Eighty three percent of cases that underwent curative resection with colon cancer, including advanced cancer, had preoperative blastformation rates of over 40%. These results indicated that the correlation of the preoperative blastformation rate with success of curative resection better for colon cancer than for gastric cancer.</p

Immunotherapy of gastric cancer with levamisole

Ninety-nine gastric cancer patients initially received levamisole at a daily dose of 150 mg for three consecutive days before operation. This therapy was repeated fortnightly (3-day administration followed by 11-day withdrawal period) for more than one month as long as possible and the survival rate up to 18 months was compared with thas of control patients. The 18 month survival rate of advanced Stage IV patients was significantly higher in patients receiving levamisole than that of control patients. The effects of levamisole in cases of advanced cancer have been discussed in relation to the literature available.</p

Cancer immunotherapy with levamisole

Levamisole, an agent acting upon depressed cellular immunity, enhancing and normalizing it and consequently showing antitumor activity in the cancer-bearing body, was administered to patients with gastrointestinal cancer at a daily dose of 150 mg for three consecutive days every other week, starting as a rule, three days before operation. The patients were evaluated for survival. Of the 143 patients (66 with curative resection, 40 with noncurative resection and 37 without resection) who received levamisole therapy for one month or more, 57 survived postoperatively six months and of 44 treated 37 survived one year. In this study, 185 patients with gastrointestinal cancer were used for comparison purposes. The six-month survival rate was 100% (23/23) in the levamisole treated group and 95.3% (102/107) in the control group after curative resection (p greater than 0.5), 100% (23/23) and 90.5% (49/54) after noncurative resection (p less than 0.01), and 72.5% (8/11) and 33.3% (9/24), respectively, in non-resectable patients (p less than 0.01). The one-year survival rate was 100% (21/21) and 95.3% (102/107) after curative resection (p greater than 0.5), 77.8% (14/18) and 59.3% (32/54) after noncurative resection (0.05 less than p less than 0.1), and 40% (2/5) and 8.3% (2/24) in non-resectable patients (0.05 less than p than 0.1) in the levamisole group and in the control group, respectively. The difference in survival in survival rates between levamisole-treated and control groups was most prominent in the non-resectable patients followed by those undergoing noncurative resection and curative resection.</p