Department of Radiotherapy, Chinese PLA General Hospital, Beijing 100853, China.
Department of Health Service, The Guard Bureau of Joint Staff Department of Chinese PLA, Beijing 100017, China.
World J Gastroenterol. 2021 May 21;27(19):2366-2375. doi: 10.3748/wjg.v27.i19.2366.
Many studies have investigated the relationships between vitamins and esophageal cancer (EC). Most of these studies focused on the roles of vitamins in the prevention and treatment of EC, and few studies have examined the changes in vitamin nutritional status and their influencing factors before and after chemotherapy for EC. Chemotherapy may have a considerable effect on EC patients' vitamin levels and hematological indicators.
To research the nutritional status of multiple vitamins in EC patients during chemotherapy and to assess its clinical significance.
EC patients admitted to our center from July 2017 to September 2020 were enrolled in this study. Serum concentrations of nine vitamins (A, D, E, B, B, B, C, B and B), hemoglobin, total protein, albumin, blood calcium, blood phosphorus concentrations and body mass index (BMI) were measured in all EC patients. The changes in nine vitamins, hematological indicators and BMI were compared before and after two cycles of chemotherapy. The possible influential factors were analyzed.
In total, 203 EC patients receiving chemotherapy were enrolled in this study. Varying degrees of vitamin A, D, C and B deficiency and weight loss were found in these patients, and the proportions of vitamin B and vitamin C deficiencies increased significantly after chemotherapy (both < 0.05). Serum concentrations of vitamins A, C, B and B and BMI before and after chemotherapy were statistically significant (all < 0.05). Multivariate analysis showed that vitamin A levels significantly differed between male and female EC patients, whereas vitamin D concentration significantly differed in EC patients in different stages (all < 0.05). Correlations were observed between the changes in serum concentrations of vitamin A and C before and after two cycles chemotherapy and the change in BMI ( < 0.05). Hemoglobin, total protein, serum albumin and blood calcium concentrations significantly decreased in EC patients after chemotherapy (all < 0.05), while the blood phosphorus level significantly increased after chemotherapy ( < 0.05). Using the difference in vitamin concentrations as the independent variables and the difference in BMI as the dependent variable, logistic regression analysis revealed statistically significant differences for vitamin A, vitamin D and vitamin C (F = 5.082, = 0.002).
Vitamin A, D, C and B were mainly deficient in patients with EC during chemotherapy. Multivitamin supplementation may help to improve the nutritional status, chemotherapy tolerance and efficacy.
许多研究调查了维生素与食管癌（EC）之间的关系。这些研究大多集中在维生素在预防和治疗 EC 中的作用，很少有研究探讨 EC 化疗前后维生素营养状况的变化及其影响因素。化疗可能对 EC 患者的维生素水平和血液学指标产生显著影响。
研究 EC 患者化疗期间多种维生素的营养状况，并评估其临床意义。
本研究纳入 2017 年 7 月至 2020 年 9 月在我院就诊的 EC 患者。检测所有 EC 患者血清中 9 种维生素（A、D、E、B1、B2、B6、C、B12 和叶酸）、血红蛋白、总蛋白、白蛋白、血钙、血磷浓度和体重指数（BMI）。比较化疗前 2 个周期和化疗后 2 个周期的 9 种维生素、血液学指标和 BMI 的变化，并分析可能的影响因素。
共纳入 203 例接受化疗的 EC 患者。这些患者均存在不同程度的维生素 A、D、C 和 B 缺乏和体重减轻，且化疗后维生素 B 和维生素 C 缺乏的比例显著增加（均<0.05）。化疗前后血清维生素 A、C、B1 和 B12 浓度和 BMI 差异均有统计学意义（均<0.05）。多因素分析显示，男性和女性 EC 患者的维生素 A 水平显著不同，而不同分期的 EC 患者的维生素 D 浓度差异显著（均<0.05）。两次化疗前后血清维生素 A 和 C 浓度的变化与 BMI 的变化呈正相关（均<0.05）。化疗后 EC 患者血红蛋白、总蛋白、血清白蛋白和血钙浓度均显著降低（均<0.05），而血磷浓度化疗后显著升高（<0.05）。以维生素浓度的差值为自变量，BMI 的差值为因变量，进行 logistic 回归分析，维生素 A、维生素 D 和维生素 C 差异有统计学意义（F=5.082，=0.002）。
EC 患者化疗期间主要缺乏维生素 A、D、C 和 B。补充多种维生素可能有助于改善营养状况、化疗耐受性和疗效。
