Abstract
One hundred seventy-seven gastric cancer patients who underwent total or proximal gastrectomy were examined for serum immunosuppressive acidic protein (IAP), which is an acute phase reactant protein and has immunosuppressive competence in serum. We evaluated whether IAP is a predictive marker for indication of splenectomy and postoperative immunotherapy using a nonspecific immunopotentiator, protein-bound polysaccharide P (PSK).
Multivariate analysis utilizing Cox's model was performed with seven variables including age, sex, pTNM stage, postoperative adjuvant therapy, preoperative serum levels of IAP and histopathological grading. In Cox's multivariate regression model, postoperative chemotherapy with or without PSK was the most significant prognostic factor in patients with abnormal levels of IAP, especially in those with splenectomy.
These results indicate that if patients with abnormal levels of IAP who had immunosuppressive status induced by the spleen underwent splenectomy, they showed good results with postoperative immunotherapy, and therefore, the preoperative IAP value is a possible indicator for splenectomy and the effectiveness of immunotherapy using PSK.
