Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
권호 표지

The Prognostic Value of the Preoperative Lymphocyte Count in Patients with Gastric Cancer

위암환자에서 수술 전 말초혈액 림프구 수와 예후

  • Kang, Shin-Yong (Department of Surgery, Kyungpook National University Hospital, Kyungpook National University College of Medicine) ;
  • Yu, Wan-Sik (Department of Surgery, Kyungpook National University Hospital, Kyungpook National University College of Medicine) ;
  • Chung, Ho-Young (Department of Surgery, Kyungpook National University Hospital, Kyungpook National University College of Medicine) ;
  • Park, Sung-Hun (Department of Surgery, Kyungpook National University Hospital, Kyungpook National University College of Medicine)
  • 강신용 (경북대학교 의과대학 경북대학교병원 외과학교실) ;
  • 유완식 (경북대학교 의과대학 경북대학교병원 외과학교실) ;
  • 정호영 (경북대학교 의과대학 경북대학교병원 외과학교실) ;
  • 박성훈 (경북대학교 의과대학 경북대학교병원 외과학교실)
  • Received : 2008.12.03
  • Accepted : 2009.03.16
  • Published : 2009.03.31
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Abstract

Purpose: The aim of this study was to evaluate the prognostic value of the peripheral blood lymphocyte count before surgery in those patients with gastric cancer. Materials and Methods: The study group was comprised of a series of 1,054 patients who underwent curative gastrectomy. The appropriate lymphocyte count cutoff value was determined. The prognostic factors were evaluated by univariate and multivariate analyses. Results: The lymphocyte count cutoff value was 1,500/ul. The patients were classified into two groups: Group A had a lymphocyte count $\geq$ 1,500/ul (n=765) and Group B had a lymphocyte count <1,500/ul (n=289). There were statistically significant differences between the groups according to their age (P<0.001), the tumor stage (P=0.038) and the tumor size (P<0.001). The 5- and 10-year survival rates of Group A were 80.1% and 76.6%, respectively and those of Group B were 72.4% and 63.5%, respectively (P=0.002). When multivariate analysis was performed by the Cox proportional hazards model, the lymphocyte count was not an independent prognostic factor. Conclusion: Although the prognosis of patients with a high lymphocyte count was better than that of the patients with a low lymphocyte count, our results did not support using the preoperative peripheral blood lymphocyte count as an independent prognostic factor for patients with gastric cancer.

목적: 위암환자에서 면역기능이 암 발생과 치료후의 예후와 관련이 있는 것으로 알려져 있어 본 연구에서는 위암 환자에서 수술 전 말초혈액내 림프구 수와 예후와의 관계를 알아보고자 하였다. 대상 및 방법: 1990년부터 1999년까지 10년 동안 위선암으로 근치적 수술을 받은 환자들 중에서 수술 전 백혈구 수와 림프구 수를 확인할 수 있었던 1,054명의 환자들을 대상으로 하였다. 결과: 대상환자 중 림프구 수가 1,500/ul 미만인 환자는 289명이었고 1,500/ul 이상인 환자는 765명이었다. 60세 이상의 환자에서(P<0.001), 종양의 크기가 5 cm 이상의 경우에 림프구 수가 통계학적으로 유의하게 낮았고(P<0.001), 병기에 따라서 림프구 수가 통계학적으로 유의한 차이를 보였다(P=0.038). 단변량 분석 결과 림프구 수가 1,500/ul 미만인군의 5년 및 10년 생존율은 각각 72.4%, 63.5%였고, 림프구수가 1,500/ul 이상인 군의 5년 및 10년 생존율은 각각 80.1%, 76.6%로 통계학적으로 유의한 차이가 있었다(P=0.002). 그러나 다변량 분석 결과 림프구 수에 따른 생존율은 통계학적으로 유의한 차이가 없었다. 결론: 근치적 위절제술을 받은 위암환자의 수술 전 말초혈액의 림프구 수의 측정은 쉽고 간편하게 할 수 있고 림프구 수에 따라서 예후에 유의한 차이가 있으나 독립적인 예후 인자로서의 가치는 없는 것으로 생각된다.

Keywords

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