Modulation of postoperative immune and inflammatory response by immune-enhancing enteral diet in gastrointestinal cancer patients

Table 1 Characteristics in 2 groups of GI cancer

Characteristics	Supplemented (n = 25)	Control (n = 23)
Age/y	55.2 ± 12.1	52.6 ± 9.8
M/F	16/9	15/8
Site of cancer
Stomach	14	13
Colorectum	8	7
Pancreas	3	3
Type of operation
Gastrectomy (subtotal or total)	14	13
Miles or Dixon procedure	8	7
Pancreatoduodenectomy	3	3
Time of surgery/min	220 ± 45	245 ± 60
Operative blood loss/mL	400 ± 325	450 ± 400
Transfused patients	22	20

Table 2 Composition of Diets

Variables	Composition of formula (per 100 mL)
	Supplemented	Control
Calories (kcal)	100	125
Protein (g)	4.00	7.50
Glutamine	0.40	1.30
Arginine	0.16	0.89
Fat (g)	3.89	4.17
LCT	3.89	2.45
MCT	0.00	1.72
EPA	0.00	0.079
DHA	0.00	0.030
n6:n3	5:1	3.45:1
β carotene (mg)	-	0.40 (66.70 μg RE)
Vit. E (mg TE)	0.81	4.92
Vit. C (mg)	5.00	13.30
Osmolarity (mOsm/L)	250	380

Table 3 Variations of glutamine, arginie, PGE 2, and acute phasere actents

Variables	Period	Supplemented	Control	P
GLN (nm/mL)	Baseline	558.7 ± 62.5	584.1 ± 51.5	NS
	D 1	386.0 ± 74.6	412.4 ± 65.3	NS
	D 8	722.4 ± 116.5	555.0 ± 72.2	< 0.05
ARG (nm/mL)	Baseline	62.7 ± 21.0	58.5 ± 23.1	NS
	D 1	56.2 ± 18.6	50.9 ± 20.0	NS
	D 8	115.4 ± 47.2	66.7 ± 31.1	< 0.001
PGE2 (pg/mL)	Baseline	62.2 ± 26.4	73.7 ± 42.1	NS
	D 1	167.7 ± 73.8	184.4 ± 91.3	NS
	D 8	85.5 ± 53.0	112.6 ± 84.0	NS
CRP (g/L)	Baseline	0.4 ± 0.1	0.3 ± 0.1	NS
	D 1	4.8 ± 2.3	4.6 ± 1.8	NS
	D 8	2.0 ± 1.1	3.9 ± 2.3	< 0.05
α1-antitrypsin (g/L)	Baseline	15.5 ± 0.2	13.2 ± 0.2	NS
	D 1	42.0 ± 3.4	40.9 ± 4.7	NS
	D 8	28.2 ± 2.8	30.0 ± 3.1	NS
Fibrinogen	Baseline	32.4 ± 3.3	30.6 ± 3.1	NS
	D 1	36.8 ± 4.2	35.5 ± 4.4	NS
	D 8	34.5 ± 3.5	35.0 ± 3.9	NS

Table 4 Variations of lymphocytes

Variables	Period	Supplemented	Control	P
Total lymphocytes No. cells × 109/cm3	Baseline	1.62 ± 0.41	1.73 ± 0.38	NS
	D 1	1.12 ± 0.39	1.55 ± 0.33	NS
	D 8	1.55 ± 0.33	1.18 ± 0.35	< 0.05
CD3 (%)	Baseline	72.2 ± 11.1	69.0 ± 9.8	NS
	D 1	60.1 ± 8.8	57.7 ± 10.3	NS
	D 8	76.4 ± 14.5	60.3 ± 9.3	< 0.05
CD4 (%)	Baseline	45.0 ± 8.5	42.5 ± 9.2	NS
	D 1	38.2 ± 9.4	37.7 ± 9.0	NS
	D 8	57.5 ± 7.8	40.0 ± 8.6	< 0.05
CD8 (%)	Baseline	23.3 ± 7.4	24.5 ± 7.7	NS
	D 1	22.7 ± 8.0	22.2 ± 8.0	NS
	D 8	19.6 ± 6.6	23.1 ± 5.9	< 0.05
CD4/CD8	Baseline	1.9 ± 0.8	1.7 ± 0.7	NS
	D 1	1.7 ± 1.2	1.7 ± 0.9	NS
	D 8	2.9 ± 1.4	1.7 ± 0.8	< 0.01
NK cells (%)	Baseline	17.7 ± 7.1	18.3 ± 6.9	NS
	D 1	11.1 ± 8.2	10.2 ± 7.2	NS
	D 8	16.6 ± 5.4	11.1 ± 4.3	< 0.05

Table 5 Variations of cytokines (pg/mL)

Variables	Period	Supplemented	Control	P
IL-1	Baseline	2520 ± 566	2480 ± 502	NS
	D 1	1375 ± 304	1528 ± 312	NS
	D 8	2020 ± 385	2155 ± 450	NS
IL-2	Baseline	1255 ± 226	1310 ± 252	NS
	D 1	892 ± 173	900 ± 186	NS
	D 8	990 ± 201	1156 ± 192	NS
IL-6	Baseline	405 ± 141	432 ± 128	NS
	D 1	365 ± 110	389 ± 143	NS
	D 8	277 ± 106	762 ± 199	< 0.001
TNF-α	Baseline	260 ± 96	236 ± 101	NS
	D 1	178 ± 85	159 ± 93	NS
	D 8	202 ± 104	345 ± 133	< 0.050