胃癌术前营养支持辅助化疗

Preoperative parenteral nutrition adjuvant chemtherapy of gastric cancer

25例AGC患者,随机分为对照组,静脉营养支持组,化疗组,和静脉营养支持加化疗组。于治疗前后,分别测定血清PA、TFN和NK、LAK细胞活性。FCM测定胃癌细胞和正常胃粘膜细胞DNA含量,倍体类型及细胞周期各时相比例;发现治疗5天后,静脉营养支持组PA、TFN、NK、LAK活性和肿瘤细胞S％及S+G2q-M％明显增高(P<0.005～0.05)。化疗组血清PA明显下降(P<0.001),静脉营养支持加化疗组肿瘤细胞S％和S+G2+M％显著下降(p分别<0.05和o.025),两组其它指标未见明显改变。提示静脉营养支持能促进AGC患者蛋白质合成,改善其免疫功能,同时也一过性的刺激了胃癌细胞的增殖;静脉营养支持加化疗既能维持AGC患者的营养状况和免疫功能,又抑制了胃癌细胞增殖。

25 cases of AGC patients were divided into four groups randomly, namely, control, parenteral nutrition (PN) , chemotherapy and PN+ chemotherapy groups. Peripheral serum prealbu-min (PA), transferin (TFN), NK,LAK activities were measured. DNA contents and ploidy and cell cycles of gastric mucosal and cancerous cells were analysed. each before and after 5 day s' treatment. The results show that PA, TFN, NK, LAK activities and cancer cell S%, S + G2 + M% were markedly increased after 5 day s' PN ( P <0. 005 or P <0. 05); The value of PA was decreased in chemotherapy group ( P <0. 001) and cancer cell S%, S+G2 + M% were markedly decreased in PN+ chemotherapy group ( P <0. 05, 0. 025)( other mesurements have no changes in these two groups. The results demonstrated that parenteral nutrition may make an improvement in the protein systhesis and immunological function in AGC patients. Simultaneously, a stimulating effect may be present in tumor cell kinetics and the effects of chemotherapeutic agents may be enhanced by parenteral nutrition.