肠内营养对有营养风险的术前新辅助治疗直肠癌患者营养状况及肿瘤细胞增殖活性的影响  

Effect of enteral nutrition on nutritional status and tumor cell proliferation activity in rectal cancer patients with nutritional risk treated with preoperative neoadjuvant therapy

作　　者：肖大春 何干[1] 李启刚[1] 石浩 张成熙 徐兴船 Xiao Dachuan;He Gan;Li Qigang;Shi Hao;Zhang Chengxi;Xu Xingchuan(Department of Gastrointestinal Surgery,the Yongchuan Hospital Affiliated to Chongqing Medical University,Chongqing 402160,China)

机构地区：[1]重庆医科大学附属永川医院胃肠外科,402160

出　　处：《中国医师进修杂志》2019年第9期816-820,共5页Chinese Journal of Postgraduates of Medicine

基　　金：重庆医科大学附属永川医院科研项目(YJLCX201612).

摘　　要：目的探讨肠内营养对有营养风险的术前接受新辅助治疗直肠癌患者肿瘤细胞增殖活性的影响。方法选取2016年1月至2018年1月重庆医科大学附属永川医院收治的有营养风险且术前需要接受新辅助治疗的直肠癌患者66例。将患者按随机数字法分为试验组(肠内营养联合术前新辅助治疗)和对照组(单纯新辅助治疗),每组33例。治疗前后分别采用免疫组织化学法检测增殖细胞核抗原(PCNA)和Ki-67抗原的表达情况;观察两组患者治疗前后白蛋白、前白蛋白变化情况,并进行营养风险筛查2002(NRS2002)评估。结果两组治疗前PCNA和Ki-67抗原表达情况比较差异无统计学意义(P>0.05);试验组治疗后PCNA和Ki-67抗原的表达明显低于对照组,差异有统计学意义(P<0.05)。两组治疗前NRS2002评分、白蛋白和前白蛋白比较差异无统计学意义(P>0.05);试验组治疗后NRS2002评分明显低于对照组[(1.58 ± 0.50)分比(3.65 ± 0.72)分],白蛋白和前白蛋白明显高于对照组[(35.92 ± 2.77)g/L比(31.12 ± 1.76)g/L和(204.58 ± 23.86)mg/L比(157.46 ± 18.99)mg/L],差异有统计学意义(P<0.01)。结论肠内营养可降低有营养风险的术前新辅助治疗直肠癌患者肿瘤细胞增殖活性,改善患者营养状况。Objective To explore the effect of enteral nutrition on tumor cell proliferation activity in rectal cancer patients with nutritional risk treated with preoperative neoadjuvant therapy. Methods Sixty-six rectal cancer patients with nutritional risk treated with preoperative neoadjuvant therapy from January 2016 to January 2018 in the Yongchuan Hospital Affiliated to Chongqing Medical University were selected. The patients were divided into experimental group (enteral nutrition combined with neoadjuvant therapy) and control group (simple adjuvant therapy) according to the random digits table method, with 33 cases in each group. The expressions of proliferating cell nuclear antigen (PCNA) and Ki-67 antigen before and after treatment were detected by immunohistochemical method;the albumin and prealbumin before and after treatment were observed, and the nutrition risk screening 2002 (NRS2002) was evaluated. Results There were no statistical differences in the expressions of PCNA and Ki-67 antigen before treatment between 2 groups (P>0.05);the expressions of PCNA and Ki-67 antigen after treatment in experimental group were significantly lower than those in control group, and there were statistical differences (P<0.05). There were no statistical differences in the NRS2002 score, albumin and prealbumin before treatment between 2 groups (P>0.05);the NRS2002 score after treatment in experimental group was significantly lower than that in control group:(1.58 ± 0.50) scores vs.(3.65 ± 0.72) scores, the albumin and prealbumin after treatment were significantly higher than those in control group:(35.92 ± 2.77) g/L vs.(31.12 ± 1.76) g/L and (204.58 ± 23.86) mg/L vs.(157.46 ± 18.99) mg/L, and there were statistical differences (P<0.01). Conclusions Enteral nutrition can reduce the proliferation activity of tumor cell in rectal cancer patients with nutritional risk treated with preoperative neoadjuvant therapy, and it can improve the nutritional status of patients.

关 键 词：直肠肿瘤 肠道营养 肿瘤辅助疗法 细胞增殖 营养状况 

分 类 号：R735.37[医药卫生—肿瘤]