肠内营养干预对食管癌放疗患者免疫营养状态及放射性损伤的影响
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摘要
目的:研究肠内营养干预对食管癌放疗患者免疫营养状态及放射性损伤的影响。方法:选择四川大学华西医院2017年1月～10月期间进行放疗的食管癌患者作为研究对象,按照随机数表法分为接受肠内营养干预的实验组、常规干预的对照组。放疗前及放疗结束后,测定血清中营养指标、放射性损伤标志物的含量以及外周血中免疫细胞的含量。结果:与放疗前比较,实验组患者放疗后血清中ALB、PA、TRF、RBP的含量以及外周血中Th细胞、NK细胞、Breg细胞、Treg细胞的含量无显著性变化,血清中PDGF-BB、TGF-β1、CTGF、TNF-α、SAA的含量显著升高;对照组患者放疗后血清中ALB、PA、TRF、RBP的含量以及外周血中Th细胞、NK细胞的含量显著降低,而血清中PDGF-BB、TGF-β1、CTGF、TNF-α、SAA的含量以及外周血中Breg细胞、Treg细胞的含量显著升高;实验组患者放疗后血清中ALB、PA、TRF、RBP的含量以及外周血中Th细胞、NK细胞的含量高于对照组,血清中PDGFBB、TGF-β1、CTGF、TNF-α、SAA的含量以及外周血中Breg细胞、Treg细胞的含量低于对照组。结论:肠内营养干预用于食管癌放疗患者能够改善免疫营养状态、减轻放射性损伤。
Objective:To study the effects of enteral nutrition intervention on immune nutritional status and radiation damage in patients with esophageal cancer radiotherapy.Methods:Patients with esophageal cancer who underwent radiotherapy in West China Hospital,Sichuan University between January to October 2017 were chosen as the research subjects and divided into the experimental group who received enteral nutrition intervention and the control group who received routine intervention.The contents of nutrition indicators and radiation damage markers in serum as well as the contents of immune cells in peripheral blood were determined before radiotherapy and after radiotherapy ended.Results:Compared with those before radiotherapy,serum ALB,PA,TRF and RBP contents as well as peripheral blood Th cell,NK cell,Breg cell and Treg cell contents of experimental group did not change significantly while serum PDGF-BB,TGF-β1,CTGF,TNF-αand SAA contents were significantly higher after radiotherapy;serum ALB,PA,TRF and RBP contents as well as peripheral blood Th cell and NK cell contentsof control group were significantly lower while serum PDGF-BB,TGF-β1,CTGF,TNF-αand SAA contents as well as peripheral blood Breg cell and Treg cell contents were significantly higher after radiotherapy;serum ALB,PA,TRF and RBP contents as well as peripheral blood Th cell and NK cell contents of experimental group after radiotherapy were higher than those of control group while serum PDGF-BB,TGF-β1,CTGF,TNF-αand SAA contents as well as peripheral blood Breg cell and Treg cell contents were lower than those of control group.Conclusion:enteral nutrition intervention can improve immune nutritional status and reduce radiation damage in patients with esophageal cancer radiotherapy.
Objective:To study the effects of enteral nutrition intervention on immune nutritional status and radiation damage in patients with esophageal cancer radiotherapy.Methods:Patients with esophageal cancer who underwent radiotherapy in West China Hospital,Sichuan University between January to October 2017 were chosen as the research subjects and divided into the experimental group who received enteral nutrition intervention and the control group who received routine intervention.The contents of nutrition indicators and radiation damage markers in serum as well as the contents of immune cells in peripheral blood were determined before radiotherapy and after radiotherapy ended.Results:Compared with those before radiotherapy,serum ALB,PA,TRF and RBP contents as well as peripheral blood Th cell,NK cell,Breg cell and Treg cell contents of experimental group did not change significantly while serum PDGF-BB,TGF-β1,CTGF,TNF-αand SAA contents were significantly higher after radiotherapy;serum ALB,PA,TRF and RBP contents as well as peripheral blood Th cell and NK cell contentsof control group were significantly lower while serum PDGF-BB,TGF-β1,CTGF,TNF-αand SAA contents as well as peripheral blood Breg cell and Treg cell contents were significantly higher after radiotherapy;serum ALB,PA,TRF and RBP contents as well as peripheral blood Th cell and NK cell contents of experimental group after radiotherapy were higher than those of control group while serum PDGF-BB,TGF-β1,CTGF,TNF-αand SAA contents as well as peripheral blood Breg cell and Treg cell contents were lower than those of control group.Conclusion:enteral nutrition intervention can improve immune nutritional status and reduce radiation damage in patients with esophageal cancer radiotherapy.
引文
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16 Zhao H,Zhao L,Zhou Z,et al.The roles of connective tissue growth factor in the development of anastomotic esophageal strictures[J].Arch Med Sci,2015,11(4):770-778.
17 Bowen JM,White I,Smith L,et al.Pre-therapy mRNA expression of TNF is associated with regimen-related gastrointestinal toxicity in patients with esophageal cancer:apilot study[J].Support Care Cancer,2015,23(11):3165-3172.
2 Zhou X,Qiu GQ,Bao WA,et al.The prognostic role of nutrition risk score(NRS)in patients with metastatic or recurrent esophagealsquamous cell carcinoma(ESCC)[J].Oncotarget,2017,8(44):77465-77473.
3 Mak M,Bell K,Ng W,et al.Nutritional status,management and clinical outcomes in patients with esophageal and gastro-oesophageal cancers:A descriptive study[J].Nutr Diet,2017,74(3):229-235.
4 Ma L,Luo GY,Ren YF,et al.Concurrent chemoradiotherapy combined with enteral nutrition support:a radical treatment strategy for esophageal squamous cell carcinoma patients with malignant fistulae[J].Chin J Cancer,2017,36(1):8.
5 Nakatani M,Migita K,Matsumoto S,et al.Prognostic significance of the prognostic nutritional index in esophageal cancer patients undergoing neoadjuvant chemotherapy[J].Dis Esophagus,2017,30(8):1-7.
6 Bo Y,Wang K,Liu Y,et al.The geriatric nutritional risk index predicts survival in elderly esophageal squamous cell carcinoma patients with radiotherapy[J].PLoS One,2016,11(5):e0155903.
7 Cox S,Powell C,Carter B,et al.Role of nutritional status and intervention in oesophageal cancer treated with definitive chemoradiotherapy:outcomes from SCOPE1[J].Br J Cancer,2016,115(2):172-177.
8 Starr B,Davis S,Ayala-Peacock D,et al.Reassessment of the role of enteral tube feedings for patients with esophageal cancer[J].Am Surg,2014,80(8):752-758.
9 Zhang Z,Li H,Yan C,et al.A comparative study on the efficacy of fast-track surgery in the treatment of esophageal cancerpatients combined with metabolic syndrome[J].Oncol Lett.2017Oct;14(4):4812-4816.
10 Zheng X,Song X,Shao Y,et al.Prognostic role of tumor-infiltrating lymphocytes in esophagus cancer:a meta-analysis[J].Cell Physiol Biochem,2018,45(2):720-732.
11 Noble F,Mellows T,McCormick Matthews LH,et al.Tumour infiltrating lymphocytes correlate with improved survival in patients with oesophageal adenocarcinoma[J].Cancer Immunol Immunother,2016,65(6):651-662.
12 Liu Y,Mu Y,Zhang A,et al.Cytokine-induced killer cells/dendritic cells and cytokine-induced killer cells immunotherapy for the treatment of esophageal cancer in China:a meta-analysis[J].Onco Targets Ther,2017,29(10):1897-1908.
13 Kurose K,Ohue Y,Wada H,et al.Phase ia study of FoxP3+CD4treg depletion by infusion of a humanized anti-CCR4antibody,KW-0761,in cancer patients[J].Clin Cancer Res,2015,21(19):4327-4336.
14 Schwartz M,Zhang Y,Rosenblatt JD.B cell regulation of the anti-tumor response and role in carcinogenesis[J].J Immunother Cancer,2016,19(4):40.
15 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.
16 Zhao H,Zhao L,Zhou Z,et al.The roles of connective tissue growth factor in the development of anastomotic esophageal strictures[J].Arch Med Sci,2015,11(4):770-778.
17 Bowen JM,White I,Smith L,et al.Pre-therapy mRNA expression of TNF is associated with regimen-related gastrointestinal toxicity in patients with esophageal cancer:apilot study[J].Support Care Cancer,2015,23(11):3165-3172.