Stehr Sebastian N, Heller Axel R
Department of Anesthesiology and Intensive Care Medicine, University Hospital Carl Gustav Carus, Fetscherstrasse 74, D-01309 Dresden, Germany.
Clin Chim Acta. 2006 Nov;373(1-2):1-8. doi: 10.1016/j.cca.2006.04.024. Epub 2006 May 16.
Epidemiological studies have indicated that a high intake of saturated fat and/or animal fat increases the risk of colon and breast cancer. Laboratory and clinical investigations have shown a reduced risk of colon carcinogenesis after alimentation with omega-3 fatty acids, as found in fish oil. Mechanisms accounting for these anti-tumor effects are reduced levels of PGE(2) and inducible NO synthase as well as an increased lipid peroxidation, or translation inhibition with subsequent cell cycle arrest. Further, omega-3 eicosapentaenoic acid is capable of down-regulating the production and effect of a number of mediators of cachexia, such as IL-1, IL-6, TNF-alpha and proteolysis-inducing factor. In patients with advanced cancer, it is possible to increase energy and protein intake via an enteral or parenteral route, but this seems to have little impact on progressive weight loss. Fish oil administration improved patients' conditions in cancer cachexia and during radio- and chemotherapy. In patients undergoing tumor resection surgery we observed improvement of liver and pancreas biochemical indices when omega-3 fatty acids were administered. This paper is a review of recent developments in the field of nutrition in cancer patients with emphasis on the acute phase response following cancer surgery and the beneficial aspects of fish oil administration.
流行病学研究表明,大量摄入饱和脂肪和/或动物脂肪会增加患结肠癌和乳腺癌的风险。实验室和临床研究显示,食用鱼油中含有的ω-3脂肪酸后,结肠癌发生风险降低。这些抗肿瘤作用的机制包括前列腺素E2(PGE(2))和诱导型一氧化氮合酶水平降低、脂质过氧化增加,或翻译抑制及随后的细胞周期停滞。此外,ω-3二十碳五烯酸能够下调多种恶病质介质的产生和作用,如白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和蛋白水解诱导因子。对于晚期癌症患者,通过肠内或肠外途径增加能量和蛋白质摄入是可行的,但这似乎对进行性体重减轻影响不大。服用鱼油可改善癌症恶病质患者以及接受放疗和化疗患者的状况。在接受肿瘤切除手术的患者中,我们观察到服用ω-3脂肪酸后肝脏和胰腺生化指标有所改善。本文综述了癌症患者营养领域的最新进展,重点关注癌症手术后的急性期反应以及服用鱼油的益处。