Association of bacterial translocation with cachexia and its influence on the outcome of gastric cancer patients / 中华临床营养杂志

ABSTRACT

ObjectiveTo investigate the association of bacterial translocation (BT) with cachexia and its impact on the outcome of gastric cancer patients.MethodsSixty cachectic gastric cancer patients,50 age- and sex-matched non-cachectic gastric cancer patients,and 55 healthy controls were enrolled in this study between January 2008 and July 2009.Polymerase chain reaction was performed to detect bacterial DNA in the peripheral blood of cancer patients and healthy controls,Cytokine levels were tested by enzyme-linked immunosorbent assay.Flow cytometry was used to detect immune indicators.All the enrolled patients were followed up for two years,and the two-year survival rate was calculated.ResultsThe BT ratio was significantly higher in cachectic patients than in non-cachectic patients (25.0％ vs.8.0％,P =0.019) and healthy controls (25.0％ vs.0.0％,P =0.000).BT-positive cachectic patients had significantly higher levels of IL-1α,IL-6,TNF-α,and IFN-γ compared with BT-negative cachectic patients ( P =0.012,0.003,0.036,and 0.017,respectively ) and BT-positive non-cachectic patients ( P =0.011,0.034,0.000,and 0.022,respectively).The two-year survival rate in BT-positive cachectic patients was significantly lower than in BT-negative cachectic patients (P =0.023 ).The levels of CD3 +T,CD4+ T,natural killer cells,and CD4 + T/CD8 + T in gastric cancer patients were significantly lower than in healthy controls ( P =0.023,0.031,0.016,0.041,respectively),whereas CD8 + T level was significantly higher in gastric cancer patients than in healthy controls (P =0.038).ConclusionBT may contribute to the development of cancer cachexia and influence the long-term survival of locally advanced gastric cancer patients.