| Objective:There often exist emaciation,anemia and hypoproteinemia in patients with advanced gastric cancer before operation, and their immune function is also decreased. What's more, patients' postoperative immune function is further decreased with the improvement of radical degree of gastric cancer and the increase of operational injury. Therefore, the occurrence of complications and the rate of death increase in patients during the postoperative period. At present, the treatment of malignant tumor is still mainly surgical operation in addition to other treatments at domestic and abroad region. However, malnutrition and hypoproteinemia not only prohibit the tumor from being operated, but also affect the effects of radiotherapy and chemotherapy. Recombinant human growth hormone (rhGH) promote anabolism and the healing of injury, improve the immune function of the body and decrease postoperative fatigue syndrome, which are all finished through insulin-like growth factors (IGFs) and have been proved in clinical application of non-cancer patients. If rhGH can be applied to cancer patients, it is no doubt that the complications and therate of death after operation can be reduced. In addition, it can also supply a good condition for the afterward radiotherapy and chemotherapy. But growth hormone (GH) is a kind of strongly promoting mitosis, whose potent improvement of tumor cell's growth and diffusion make surgeons worry. To solve this contradictory, in 2000 Tacke proved that short application of rhGH to operative patients with gastric and colonic cancer has no the risk of increasing tumor's long-term recurrence and also has no any serious side effect. Therefore, we have studied rhGH through short terms and small doses application in patients with advanced gastric cancer after operation combined with Low nitrogen hapocaloric parenteral nutrition,intraperitoneal thermochemotherapy, our experiment detected dynamically the changes of T lymphocyte subset ,immunoglobin and the level of albumin,transferrin of patients with advanced gastric cancer during the period of postoperation by short application of rhGH ,estimated the subjective feeling of fatigue and investigated the weight of all patients to study the value of rhGH in the treatment of malignant tumor.Methods:Thirty patients (n=30,M/F 22/8,middle ages 56 years) with advanced gastric cancer who have accepted radical resection and have been proved by pathology were randomly divided into rhGH group (n=12,M/F 9/3,mean ages 50.6±11.3years,weight 55.6±7.3Kg) and control group (n=18, M/F 13/5,mean ages 54.7±10.6years, weight 56.４±6.9Kg).All patients have no endocrine diseases,metabolic disease,auto-immune disease and their blood glucose,agammaglobulinemia and electrolyte, are all normal before operation. Low nitrogen hapocaloric parenteral nutrition (1d-5d) and intraperitoneal thermochemotherapy (1d-5d) are given to all patients after operation. In the control group, 1ml of normal saline is injected in subcutis at 9:00 from the postoperative second day to the sixth day .In the rhGH group, 4IU(1ml) rhGH (Saizen, serono company) replaces 1ml normal saline, other steps are the same as the control group. Fasting peripheral vein blood is drawn respectively in the first day before operation,the third day and the seventh day after operation. And then to detected the levels of T lymphocyte subset,serous immunoglobin and albumin,transferrin. The patients' subjective feeling of fatigue is estimated preoperatively and on the seventh day after operation and the weigh of patients is recorded in the seventh day. All dates are processed with SPSS 10.0 to makeT-test, there is statistically significant when P value is less than 0.05.Results: In the third day after operation, T lymphocyte subset (CD3+,CD4+,CD4+/CD8+), serous immunoglobin (IgG,IgA,IgM) and albumin,transferrin of two groups all decrease significantly compared with preoperation, there is no significant difference between two groups(p<0.05). In the seventh day after operation, T ly... |
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