Colorectal and Anal Surgery, Deyang People's Hospital, No. 173, North Taishan Road, Jingyang District, Deyang, 618000, China.
Colorectal and Anal Surgery, Jiangbei Hospital of Traditional Chinese Medicine, Chongqing, 400020, China.
BMC Cancer. 2024 Sep 2;24(1):1089. doi: 10.1186/s12885-024-12858-7.
The aim of this study is to investigate the impact of arginine on immune function and postoperative complications in colorectal cancer (CRC) patients.
We conducted a comprehensive search to identify eligible RCTs in various databases, such as PubMed, Cochrane Library, EMBASE, Web of Science, MEDLINE, China National Knowledge Infrastructure (CNKI), Wanfang, VIP Medicine Information System (VIP), and Chinese Biomedical Database (CBM). This study aimed to examine IgA, IgG, and IgM levels as well as CD4 and CD8 counts as well as the CD4/CD8 ratio. Anastomotic leaking, length of stay (LOS), and surgical site infection (SSI) were included as secondary outcomes. Stata (StataCorp, version 14.0) was utilized for data analysis. To ensure the results were reliable, we used meta-regression, sensitivity analysis, and publication bias analysis.
A total of 24 publications (including 1883 patients) out of 681 that were retrieved fulfilled the inclusion criteria. The arginine group showed notable improvements in humoral immunity, with gains in IgA (SMD=0.45, 95% CI: 0.30-0.60), IgG (SMD=0.80, 95% CI: 0.64-0.96), and IgM (SMD=0.66, 95% CI: 0.39-0.93). With regards to cellular immunity, the arginine group exhibited a substantial increase in the CD4 T cell count (SMD = 1.03, 95% CI: 0.67-1.38) compared to the control group. However, the CD4/CD8 ratio decreased significantly (SMD=1.37, 95% CI: 0.88-1.86) in the same arginine group, indicating a change in the balance between these two cell types. Additionally, the CD8 T cell count showed a notable decrease (SMD=-0.70, 95% CI: -1.09 to -0.32) in the arginine group when compared to the control group. Anastomotic leakage was also considerably lower in the arginine group (SMD=-0.05, 95% CI: -0.08 to -0.02), the rate of SSIs was lower (RR = -0.02, 95% CI: -0.05-0), and the length of time patients spent in the hospital was shorter (SMD=-0.15, 95% CI: -0.38 to -0.08).
After radiation treatment for CRC, arginine improves immune function and decreases the risk of infection problems.
Registration with PROSPERO for this meta-analysis is number CRD42024520509.
本研究旨在探讨精氨酸对结直肠癌（CRC）患者免疫功能和术后并发症的影响。
我们在多个数据库（如 PubMed、Cochrane 图书馆、EMBASE、Web of Science、MEDLINE、中国国家知识基础设施（CNKI）、万方、VIP 医学信息系统（VIP）和中国生物医学数据库（CBM））中进行了全面检索，以确定合格的 RCT。本研究旨在检查 IgA、IgG 和 IgM 水平以及 CD4 和 CD8 计数以及 CD4/CD8 比值。吻合口漏、住院时间（LOS）和手术部位感染（SSI）为次要结局。使用 Stata（StataCorp，版本 14.0）进行数据分析。为确保结果可靠，我们使用了元回归、敏感性分析和发表偏倚分析。
共检索到 681 篇文献，其中 24 篇（包括 1883 名患者）符合纳入标准。精氨酸组的体液免疫明显改善，IgA（SMD=0.45，95%CI：0.30-0.60）、IgG（SMD=0.80，95%CI：0.64-0.96）和 IgM（SMD=0.66，95%CI：0.39-0.93）均有升高。在细胞免疫方面，精氨酸组的 CD4 T 细胞计数（SMD=1.03，95%CI：0.67-1.38）明显高于对照组。然而，同一精氨酸组的 CD4/CD8 比值显著下降（SMD=1.37，95%CI：0.88-1.86），表明这两种细胞类型之间的平衡发生了变化。此外，与对照组相比，精氨酸组的 CD8 T 细胞计数（SMD=-0.70，95%CI：-1.09 至-0.32）明显下降。精氨酸组的吻合口漏发生率也明显较低（SMD=-0.05，95%CI：-0.08 至-0.02），SSI 发生率较低（RR=-0.02，95%CI：-0.05-0），患者住院时间较短（SMD=-0.15，95%CI：-0.38 至-0.08）。
结直肠癌患者接受放疗后，精氨酸可改善免疫功能，降低感染问题风险。
本荟萃分析已在 PROSPERO 上注册，注册号为 CRD42024520509。
