The effect of low-nitrogen and low-calorie parenteral nutrition combined with enteral nutrition on inflammatory cytokines and immune functions in patients with gastric cancer: a double blind placebo trial

OBJECTIVE: The aim of this study is to investigate the effect of low-nitrogen and low-calorie parenteral nutrition (PN) combined with enteral nutrition (EN) on the inflammatory cytokines and immune function in patients with gastric cancer. PATIENTS AND METHODS: Between May 2012 and May 2014, 90 patients undergoing surgery for gastric cancer in our institution were involved in this double blind placebo study and randomly divided into experimental group and control group, 45 patients of each group. Patients in the control group would receive total parenteral nutrition (TPN) whereas patients in the experimental group would be supported with low-nitrogen and low-calorie PN combined with EN. RESULTS: On the 7th postoperative day 7, levels of IgA, IgM and IgG in experimental group were significantly higher than those in the control group and preoperative values (p < 0.05). CRP level was significantly lower than that of controls and preoperatively (p < 0.05). Levels of IL-2 and TNF-alpha were significantly higher than those of controls and preoperatively (p < 0.05). CONCLUSIONS: As low-nitrogen and low-calorie PN combined with EN can effectively improve the immune function, reduce the inflammatory reactions and improve the postoperative quality of life (QoL) and prognosis in patients with gastric cancer, it is suitable for clinical application.