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KMID : 0359119760080020029
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Korean Journal of Gastroenterology
1976 Volume.8 No. 2 p.29 ~ p.37
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Gastric Carcinoma and Immunotherapy
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허경발:Hur Kyung-Bal
저자없음:No authors listed
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Abstract
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The stomach carcinoma is one of the most frequently observed malignat tumor in Korean male patients. Result of surgery in early carcinoma is encouraging and it is reported to be about 45Yo of five year survival rate, but cases are few and rare. The majority of cases are that of either unresectable or metastatic regional lymphose involvement of carcinoma. Their prognosis is poor. In those who had regional lymphnoac metastasis two year and three year survival rates are reported to be each 37. 1Po and 17. 9% respectively. Develpoment of immunotherapy of the malignant disease made us greatly interested on the immunotherapy on the post resection stomach carcinoma. Studies on immunological competen y by way of D.N.C.B. skin test started from 1971 and few cases those ivho may understand t!ne new developmentof additional immunotherapy were selected for B.C.G. innoculation after the subtotal gastrectomy. Recently monitering of peripheral thymus depentent lymphocytes(T-cell) count were undertaken to correlate the clinical course of the patients with imnunotherapy. Total cases of study of the D.N.C.B.were 264. In healthy men of 53 only one man showed anergy, this anergic man is still healthy af ter three years observation. Table 1 further demonstrate the incidence D.N.C.B. anergy in each group of patients, it notes that t.he unresectable malignant patient showed anergy 77 out of 105 cases(73. 3%). From the D.N.C.B. studies it may be clear to state that patients immunological competency is severely deteriorated in the advanced tumor patients. The peripiieral T-cell cocnt a!so shoived that the advanced malignant patients had lower T-cell counts and it is progressive!y decreasing at the terminal stage. (Table 2). In few cases who has B.C.G. after the subtotal gastrectomy the T-cell count are increasing after the treatments. (Table 4) In 1971 five patients received B.C.G. therapy after the subtotal gastrectomy and three patien- ts are still living well. These 5 had all regional lymp!inode metastasis. The usual three year survival rate in similar patients is about 17 ta 20%. Number of B.C.G. cases are not many to compare a statistical significancy but it may suggest a good deal of implication. Chancc. Of two year survival after the B.C.G. therapy may be also far better than non-B.C.G,;group. (Table 5). The immunotherapy on malignant patients may be controversial, and yet we understand that the malignant tumor patients had impared immunity or immunological ability and that B.C.G. or immunotherapy may be effective on microscopic malignant lesion, in a selectud cases an immunotherapy after subtotal gastrectomy for gastric carcinoma may’ offer a beneficial ef- fects on clinical course of the disease.
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KEYWORD
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