Triantafillidis John K, Malgarinos Konstantinos
"Metropolitan General" Hospital, Holargos, 15562 Athens, Greece.
Hellenic Society for Gastrointestinal Oncology, Iera Odos 354, Haidari, 12461 Athens, Greece.
Biomedicines. 2024 Dec 18;12(12):2876. doi: 10.3390/biomedicines12122876.
Enteral immune nutrition has attracted considerable attention over the past few years regarding its perioperative role in patients undergoing major surgery for digestive cancer. Today, the term enteral immune nutrition refers to the perioperative administration of nutritional preparations containing, among others, specific ingredients such as glutamine, omega-3 polyunsaturated fatty acids, and arginine. They provide nutritional support and exert pharmacological effects through the substances contained in these preparations. Their administration to patients with gastric cancer is necessary as malnutrition and other metabolic disorders are frequent symptoms with effects on the level of immune responses, affecting the function of intestinal permeability and, therefore, the effectiveness of chemotherapy. Existing clinical data and data from all meta-analyses published so far support the view that enteral immune nutrition enhances the immune responses of gastric cancer patients, and reduces the rate of postoperative complications, and the duration of hospitalization without, however, improving patient survival. The content of enteral immune nutrition, dose, administration interval, and the effect on patient survival should be more precisely determined through relevant extensive multicenter studies. This systematic review describes and analyses the clinical results and the findings of relevant meta-analyses of the application of enteral immune nutrition in gastric cancer patients, emphasize the importance of this therapeutic intervention for disease progression, and attempts to provide practical guidelines for applying enteral immune nutrition in daily clinical practice.
在过去几年中，肠内免疫营养在接受消化道癌大手术患者的围手术期作用方面引起了相当大的关注。如今，肠内免疫营养一词是指围手术期给予含有谷氨酰胺、ω-3多不饱和脂肪酸和精氨酸等特定成分的营养制剂。它们通过这些制剂中所含的物质提供营养支持并发挥药理作用。对胃癌患者进行此类营养制剂的补充是必要的，因为营养不良和其他代谢紊乱是常见症状，会影响免疫反应水平，影响肠道通透性功能，进而影响化疗效果。现有的临床数据以及迄今为止发表的所有荟萃分析数据均支持以下观点：肠内免疫营养可增强胃癌患者的免疫反应，降低术后并发症发生率和缩短住院时间，然而，却不能提高患者生存率。应通过相关广泛的多中心研究更精确地确定肠内免疫营养的成分、剂量、给药间隔以及对患者生存的影响。本系统评价描述并分析了肠内免疫营养应用于胃癌患者的临床结果及相关荟萃分析的结果，强调了这种治疗干预对疾病进展的重要性，并试图为在日常临床实践中应用肠内免疫营养提供实用指南。
