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Chinese Journal of Oncology Prevention and Treatment ›› 2019, Vol. 11 ›› Issue (1): 68-75.doi: 10.3969/j.issn.1674-5671.2019.01.12

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Meta-analysis of immune-enhanced enteral nutrition on immune function after radical gastrectomy in Chinese

  

  • Online:2019-02-25 Published:2019-03-28

Abstract: Objective To evaluate the immune function of patients with gastric cancer who were given immune-enhanced enteral nutrition preparation after radical gastrectomy. Methods CNKI,WanFang,VIP,CBM,PubMed and EMBASE databases were searched to collect randomized controlled trials (RCTs) on immunological function of patients after radical gastrectomy with immune-enhanced enteral nutrition from inception to July,2018. Retrieve objects were Chinese population. According to the literature inclusion criteria and exclusion criteria,screened the literature,extracted the data and evaluated the risk of bias in the literature.Meta-analysis was conducted by RevMan 5.3 software. Results A total of 10  RCTs were included in the study,involving 534 patients,of whom,283 cases underwent immune-enhanced enteral nutrition(experimental group) and 251 cases underwent conventional enteral nutrition (control group). The quality of the literatures was B grade. Meta-analysis of cellular immune indicators showed that the level of CD3 in the experimental group on the first day after surgery was lower than that in the control group(MD=-2.06,95%CI:-3.68--0.43,P=0.01),while the other indicators were not statisti-cally significant. The levels of CD3,CD4,CD4/CD8 and NK in the experimental group were higher than those in the control group on 7-10 days after surgery (MDCD3=6.74,95%CI:1.36-12.12,P<0.01;MDCD4=5.93,95%CI:3.68-8.19,P<0.001;MDCD4/CD8=0.53,95%CI:0.33-0.73,P<0.001;MDNK=1.40,95%CI:0.05-2.76,P<0.05),but the level of CD8 was no significant difference between the two groups(MD=2.00,95%CI:-2.87-6.88,P=0.42). Meta-analysis of humoral immune indicators showed that there was no significant difference in IgA,IgM and IgG level between the experimental group and the control group on the first day after operation. However,the IgA,IgM and IgG level in the experimental group were higher than those in the control group on 7-10 days after surgery(MDIgA=0.33,95%CI:0.24-0.41,P<0.001;MDIgM=0.21,95%CI:0.14-0.27,P<0.001;MDIgG=1.91,95%CI:1.11-2.72,P<0.001). Conclusions After radical surgery for gastric cancer,the immune-enhanced enteral nutrition preparations have advantages over conventional enteral nutrition preparations in improving immune function of patients after 7-10 days,but the effect on the first day after surgery is not obvious.

Key words: Gastric neoplasms, Chinese population, Enteral nutrition, Immune function, Meta-analysis

CLC Number: 

  • R735.2