Effect of immune enhanced enteral nutrition on immune function in postoperative patients with gastric cancer:a Meta-analysis
10.3760/cma.j.issn.1006-9801.2017.06.010
- VernacularTitle:免疫增强型肠内营养对胃癌患者术后免疫功能影响的Meta分析
- Author:
Jinxi WANG
;
Lei ZHAO
;
Qiang GUO
;
Kun ZHANG
;
Xiaodong MA
- Keywords:
Gastric neoplasms;
Immune enhanced enteral nutrition;
Enteral nutrition;
Meta-analysis;
Randomized controlled trials
- From:
Cancer Research and Clinic
2017;29(6):398-403
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of immune enhanced enteral nutrition on immune function in postoperative patients with gastric cancer by using meta-analysis. Methods The databases of PubMed, the Cochrane Library, CNKI, CBM, VIP and Wanfang Data were used to search randomized controlled trials (RCT) about the effect of immune enhanced enteral nutrition and conventional enteral nutrition on immune function in postoperative patients with gastric cancer. The retrieval time span was from inception to Sept 1, 2016. The studies were screened according to the inclusion and exclusion criteria, the data were extracted and the quality was evaluated by 2 reviewers independently. Besides, the meta-analysis was conducted by using RevMan 5.3 software. Results Meta-analysis included 5 RCT, 216 cases in total. The results showed that the immune parameters of immune enhanced enteral nutrition such as IgA (MD=0.18, 95 % CI 0.09-0.27, P< 0.001), IgG (MD= 0.76, 95 % CI 0.43-1.09, P< 0.001), IgM (MD= 0.13, 95%CI 0.07-0.20, P<0.001), CD3 (MD=4.74, 95%CI 2.99-6.48, P<0.001), CD4 (MD=3.6, 95%CI 2.14-5.06, P< 0.001), CD4/CD8 (MD= 0.58, 95 %CI 0.20-0.97, P< 0.003) were significantly higher than those of conventional enteral nutrition after 9 or 10 days of gastric surgery. The CD8 level of conventional enteral nutrition were higher than immune enhanced enteral nutrition after 9 or 10 days of gastric surgery (MD = -1.26, 95 %CI-2.21 - -0.30, P= 0.01). The difference between two groups had no statistical significance in immune parameters such as IgA, IgG, IgM, CD3, CD4, CD8, CD4/CD8 after 1 day of gastric surgery (P>0.05). Regarding to cellular factor, the IL-6 level of immune enhanced enteral nutrition was lower than conventional enteral nutrition after 9 days of gastric surgery (MD=-77.40, 95 %CI-112.25 - -42.55, P< 0.001). The difference between two groups enteral nutrition had no statistical significance about IL-6, TNF-αafter 1 day of gastric surgery, TNF-α, IL-2 after 9 days of gastric surgery (P> 0.05). Conclusion Immune enhanced enteral nutrition for postoperative patients with gastric cancer can improve and enhance the immune function under stress, and reduce the excessive inflammatory reaction, which is more conducive to the safety of patients with gastric cancer.
