口服营养支持对鼻咽癌放疗患者营养状态、免疫功能及放射性损伤的影响
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摘要
目的:研究口服营养支持对鼻咽癌放疗患者营养状态、免疫功能及放射性损伤的影响。方法:选择2017年1月~11月期间在华西医院接受放疗的鼻咽癌患者,随机分为进行口服营养支持的营养支持组、进行常规干预的常规对照组。放疗前及放疗结束后1周时,测定血清中营养指标、放射损伤指标的含量及外周血中免疫细胞的含量。结果:与放疗前比较,营养支持组患者放疗结束后1周时血清中ALB、PA、TWEAK、Leptin、Ghrelin的含量以及外周血中CD3~+CD4~+、CD3~+CD8~+、CD3~-CD19~+、CD3~-CD56~+免疫细胞的含量无显著变化(P>0.05),血清中TGF-β1、IL-6、IL-17、MMP9的含量显著升高(P<0.05);而常规对照组放疗结束后1周时血清中ALB、PA的含量以及外周血中CD3~+CD4~+、CD3~+CD8~+、CD3~-CD19~+、CD3~-CD56~+免疫细胞的含量显著降低,TWEAK、Leptin、Ghrelin、TGF-β1、IL-6、IL-17、MMP9的含量显著升高(P<0.05)。结论:口服营养支持用于鼻咽癌放疗患者能够避免营养状态及免疫功能的损伤并减轻放射性损伤。
Objective:To study the effects of oral nutrition support on nutritional status,immune function and radiation damage in patients with nasopharyngeal carcinoma radiotherapy.Methods:Patients with nasopharyngeal carcinoma who received radiotherapy in West China Hospital between January and November 2017were selected and randomly divided into the nutrition support group who received oral nutrition support and the normal control group who received routine intervention.The levels of nutrition indicators and radiation damage indicators in serum as well as the contents of immune cells in peripheral blood were determined before radiotherapy and 1week after end of radiotherapy.Results:Compared with those before radiotherapy,serum ALB,PA,TWEAK,Leptin and Ghrelin levels as well as peripheral blood CD3~+CD4~+,CD3~+CD8~+,CD3~-CD19~+and CD3~-CD56~+immune cell contents of nutrition support group didn't change significantly(P>0.05)whereas serum TGF-β1,IL-6,IL-17and MMP9levels increased significantly 1week after end of radiotherapy(P<0.05);serum ALB and PA levels as well as peripheral blood CD3~+CD4~+,CD3~+CD8~+,CD3~-CD19~+and CD3~-CD56~+immune cell contents of normal control group decreased significantly whereas TWEAK,Leptin,Ghrelin,TGF-β1,IL-6,IL-17and MMP9levels increased significantly 1week after end of radiotherapy(P<0.05).Conclusion:Oral nutrition support can avoid the damage of nutritional status and immune function and reduce the radiation damage in patients with nasopharyngeal carcinoma radiotherapy.
Objective:To study the effects of oral nutrition support on nutritional status,immune function and radiation damage in patients with nasopharyngeal carcinoma radiotherapy.Methods:Patients with nasopharyngeal carcinoma who received radiotherapy in West China Hospital between January and November 2017were selected and randomly divided into the nutrition support group who received oral nutrition support and the normal control group who received routine intervention.The levels of nutrition indicators and radiation damage indicators in serum as well as the contents of immune cells in peripheral blood were determined before radiotherapy and 1week after end of radiotherapy.Results:Compared with those before radiotherapy,serum ALB,PA,TWEAK,Leptin and Ghrelin levels as well as peripheral blood CD3~+CD4~+,CD3~+CD8~+,CD3~-CD19~+and CD3~-CD56~+immune cell contents of nutrition support group didn't change significantly(P>0.05)whereas serum TGF-β1,IL-6,IL-17and MMP9levels increased significantly 1week after end of radiotherapy(P<0.05);serum ALB and PA levels as well as peripheral blood CD3~+CD4~+,CD3~+CD8~+,CD3~-CD19~+and CD3~-CD56~+immune cell contents of normal control group decreased significantly whereas TWEAK,Leptin,Ghrelin,TGF-β1,IL-6,IL-17and MMP9levels increased significantly 1week after end of radiotherapy(P<0.05).Conclusion:Oral nutrition support can avoid the damage of nutritional status and immune function and reduce the radiation damage in patients with nasopharyngeal carcinoma radiotherapy.
引文
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14 Sun D,Zhao M,Yin J,et al.Vestibular function disorders and potential mechanisms in irradiation nasopharyngeal carcinomapatients[J].Acta Otolaryngol,2016,136(8):759-763.
15 Kiang JG,Smith JT,Anderson MN,et al.Hemorrhage enhances cytokine,complement component 3,and caspase-3,and regulates microRNAs associated with intestinal damage after whole-body gamma-irradiation in combined injury[J].PLoS One,2017,12(9):e0184393.
16 Ma J,Xuan SH,Li Y,et al.Role of the TGFβ/PDCD4/AP-1signaling pathway in nasopharyngeal carcinoma and its relationship to prognosis[J].Cell Physiol Biochem,2017,43(4):1392-1401.
17 Liao W,Hei TK,Cheng SK.Radiation-induced dermatitis is mediated by IL17-expressingγδT cells[J].Radiat Res,2017,187(4):454-464.
2 Hong JS,Hua YJ,Su L,et al.Modified-nutrition index is a significant prognostic factor for the overall survival of the nasopharyngeal carcinoma patients who undergo intensity-modulated radiotherapy[J].Nutr Cancer,2017,69(7):1011-1018.
3 OuYang PY,Zhang LN,Tang J,et al.Evaluation of body mass index and survival of nasopharyngeal carcinoma by propensity-matched analysis:An observational case-control study[J].Medicine(Baltimore),2016,95(2):E2380.
4 Qiu WZ,Ke LR,Xia WX,et al.A retrospective study of 606cases of nasopharyngeal carcinoma with or without oropharyngeal candidiasis during radiotherapy[J].PLoS One,2017,12(8):e0182963.
5 Ozdemir S,Akin M,Coban Y,et al.Acute toxicity in nasopharyngeal carcinoma patients treated with IMRT/VMAT[J].Asian Pac J Cancer Prev,2015,16(5):1897-1900.
6 Jin T,Li KX,Li PJ,et al.An evaluation of nutrition intervention during radiation therapy in patients with locoregionally advanced nasopharyngeal carcinoma[J].Oncotarget,2017,8(48):83723-83733.
7 Terra X,Gmez D,García-Lorenzo J,et al.External validation of sTWEAK as a prognostic noninvasive biomarker for head and neck squamous cell carcinoma[J].Head Neck,2016,38(Suppl1):1358-1363.
8 Licursi V,Cestelli Guidi M,Del Vecchio G,et al.Leptin induction following irradiation is a conserved feature in mammalian epithelial cells and tissues[J].Int J Radiat Biol,2017,93(9):947-957.
9 Gholami M,Ahmadi SAY,Abaszadeh A,et al.Protective effects of melatonin and ghrelin on spermatogenesis:A narrative review of the literature[J].Int J Reprod Biomed,2017,15(5):265-272.
10 Ooft ML,van Ipenburg JA,Braunius WW,et al.Prognostic role of tumor infiltrating lymphocytes in EBV positive and EBV negative nasopharyngeal carcinoma[J].Oral Oncol,2017,71:16-25.
11 Tao CJ,Chen YY,Jiang F,et al.A prognostic model combining CD4/CD8ratio and N stage predicts the risk of distant metastasis for patients with nasopharyngeal carcinoma treated by intensity modulated radiotherapy[J].Oncotarget,2016,7(29):46653-46661.
12 Xu T,Huang Z,Su B,et al.Prognostic significance of circulating CD19+B lymphocytes in EBV-associated nasopharyngeal carcinoma[J].Med Oncol,2014,31(10):198.
13 Xu Y,Zhou R,Huang C,et al.Analysis of the expression of surface receptors on NK cells and NKG2Don immunocytes in peripheral blood of patients with nasopharyngeal carcinoma[J].Asian Pac J Cancer Prev,2018,19(3):661-665.
14 Sun D,Zhao M,Yin J,et al.Vestibular function disorders and potential mechanisms in irradiation nasopharyngeal carcinomapatients[J].Acta Otolaryngol,2016,136(8):759-763.
15 Kiang JG,Smith JT,Anderson MN,et al.Hemorrhage enhances cytokine,complement component 3,and caspase-3,and regulates microRNAs associated with intestinal damage after whole-body gamma-irradiation in combined injury[J].PLoS One,2017,12(9):e0184393.
16 Ma J,Xuan SH,Li Y,et al.Role of the TGFβ/PDCD4/AP-1signaling pathway in nasopharyngeal carcinoma and its relationship to prognosis[J].Cell Physiol Biochem,2017,43(4):1392-1401.
17 Liao W,Hei TK,Cheng SK.Radiation-induced dermatitis is mediated by IL17-expressingγδT cells[J].Radiat Res,2017,187(4):454-464.