Shchepotin I B, Valetsky V L, Chorny V A, Shabahang M, Nauta R J, Buras R R, Evans S R
Department of Surgery, Georgetown University Medical Center, Washington DC 20007, USA.
Eur J Cancer. 1997 Aug;33(9):1413-8. doi: 10.1016/s0959-8049(97)00128-7.
Medical consequences of many nuclear accidents on humans are well studied, but the results pertaining to gastric cancer patients who were exposed to radiation as a result of the Chernobyl nuclear accident have not been analysed. In this study, the outcome of the surgical treatment of 68 gastric cancer patients who were exposed to radiation as a result of the Chernobyl nuclear accident was compared with that of 117 consecutive gastric cancer patients from uncontaminated areas of the Ukraine. Patients in the study group was significantly younger than that of the control group. Comparative analysis showed the same frequency of regional metastases (65.7% versus 71.1%, P > 0.05), but a smaller number of distant metastases (23.8% versus 38.1%, P < 0.05) in the study group. 41.2% of patients in the study group underwent total gastrectomy compared to 19.6% of patients in the control group (P = 0.002). Postoperative complications developed in 13.2% of patients in the study group, while postoperative mortality in the study group was 7.3% compared to 1.7% in the control group. A significant decrease in CD16 cells was noted in patients from the study group following the operative procedure. Young age, invasive tumours with smaller number of distant metastases, frequent necessity for total gastrectomy and combined operations with adjacent organs, a higher level of postoperative morbidity and mortality and low levels of natural killer cells (CD16+) with a tendency to decrease after surgery are characteristic of patients with carcinoma of the stomach affected by the Chernobyl accident.
许多核事故对人类造成的医学后果已得到充分研究，但切尔诺贝利核事故导致受辐射的胃癌患者的相关结果尚未得到分析。在本研究中，将68名因切尔诺贝利核事故而受辐射的胃癌患者的手术治疗结果与来自乌克兰未受污染地区的117名连续胃癌患者的结果进行了比较。研究组患者明显比对照组患者年轻。对比分析显示区域转移频率相同（65.7%对71.1%，P>0.05），但研究组远处转移的数量较少（23.8%对38.1%，P<0.05）。研究组41.2%的患者接受了全胃切除术，而对照组为19.6%（P = 0.002）。研究组13.2%的患者出现术后并发症，研究组的术后死亡率为7.3%，而对照组为1.7%。术后研究组患者的CD16细胞显著减少。年龄较轻、远处转移数量较少的浸润性肿瘤、全胃切除术和与相邻器官联合手术的频繁必要性、较高的术后发病率和死亡率以及自然杀伤细胞（CD16+）水平较低且术后有下降趋势是受切尔诺贝利事故影响的胃癌患者的特征。
