The operative injury affects the immune system what results in cytokine production--mediators of immune response. Intensity of this reaction depends on the extent of surgery, the time of procedure and actual status of the immune system. In gastric cancer patients malnutrition is diagnosed in as much as 60-80% and increases postoperative morbidity, and the time to functional recovery. The implementation of immunonutrition correlates with the improvement of postoperative course. The aim of this study was to evaluate the influence of immunonutrition on postoperative cytokine (IL-6, IL-10, TNF-alpha) plasma levels in gastric cancer patients.
Material and methods: The group of 99 gastric cancer patients was enrolled. In 54 patients standard postoperative enteral nutrition and in 45 patients immunonutrition was administered. Preoperatively and in 1., 3. and 7. postoperative day plasma levels of IL6, IL10 and TNFalpha were measured.
Results: The mean absolute levels of IL-6 and TNF-alpha did not differ statistically between the groups. However, the increment of changes of these cytokines was higher in immunonutrition group reaching statistical significance at day 7 for TNF-alpha (26 pg/ml for immunonutrition vs -10 pg/ml for standard nutrition p = 0.024). IL-10 levels were significantly higher in immunonutrition group at 1. and 3. postoperative days.
Conclusions: The postoperative profile of proinflammatory cytokines did not differ significantly between immunonutrition and standard nutrition groups. The increase of IL-10 plasma levels in early postoperative period in immunonutrition patients may suggest that one of the effects of this therapy is the inhibition of early inflammatory reaction.