The value of enteral immunonutrition in therapeutic hepatectomy for patients with primary liver cancer / 重庆医科大学学报

ABSTRACT

Objective: The aim of this study was to investigate the immune function and prognosis for patients with primary hepatic cancer who implemented the perioperative enteral immunonutrition support for hepatectomy.Methods: 58 cases of patients with primary hepatic cancer in our hospital in 2003 treated with liver resection were randomly divided into nutritional support fur immune nutrition group and conventional control group.Immune function was detected on admission,1st day and 7th after surgery;5-year follow-up was performed to compare the prognosis of the two groups. Results: Concentration level of CD3+,CD4+,CD8+and CD4+ICD8+in preoperative hepatectomy were the same between the two groups. On the first day after surgery,CD3+,CD4+,CD8+content decreased significantly; there was no difference between the two groups. On the 7th day after surgery,CD3+,CD4+,CD8+content increased;and the intervention group increased more significantly.1,2,3,4,and 5-year survival rates in intervention group and control group were 82.8%,70.2%, 39.6%,22.6%.20.6%and 74.6%,50.1%,25.4%,21.5%,19.5%.The survival rate was higher in the intervention group than the control group at 1-year,2-year and 3-year,while the 4 and 5-yearsurvival rate of the two groups was same,and the intervention group had better overall survival compared with the control group(X~2=3.547,P=0.025).The OR value for enteral immunonutrition support impacting postoperative survival was 0.649 after multivariate analysis adjusted.with 95.0%CI of 0.614-0.686.Conclusion:Enteral immunonutrition support can ameliorate immune suppression in hepatectomy for patients with primary liver cancer during perioperative period,and it also Can improve postoperative survival.