The Study Of Relationship Between Intestinal Permeability And Nutritional Status, Immune Function, Inflammatory Reaction In Gastrointestinal Cancer Patients

Objective To study the relationship between intestinal permeability and nutritional status, immune function, and inflammatory reaction in patients with gastrointestinal cancer.Methods 124 patients with gastrointestinal cancer were divided into the normal nutrition (NN), the borderline or mild malnutritio(nBMM)and the severe malnutrition(SM)groups by Nutritional Risk Index. The Lactulose/Mannitol(L/M) and the markers of nutritional status, immune function, and inflammatory reaction were detected in each group, and the correlation between intestinal permeability and nutritional status, immune function, and inflammatory reaction were studied.Results The PAB and ALB in SM group were lower than those in BMM group and NN group(P<0.01);the TF in SM group was lower than that in NN group(P<0.01);the TF in SM group was lower than that in BMM group(P<0.05);the ALB in BMM group was lower than that in NN group(P<0.01); the PAB and TF in BMM group were lower than those in NN group(P<0.05).The IgA in SM group and BMM group was lower than that in NN group(P<0.05);the TLC,CD3 ,CD4 and CD4/CD8 in SM group were lower than those in NN group(P<0.01);the CD3 and CD4 in SM group were lower than those in BMM group(P<0.05);the TLC in SM group was lower than that in BMM group(P<0.05);the TLC and CD4 in BMM group were lower than those in NN group(P<0.05).The CRP in SM group was higher than that in BMM group and NN group(P<0.01);the CRP in BMM group was higher than that in NN group(P<0.05).The L/M in SM group was higher than that in BMM group(P<0.05);The L/M in SM group was higher than that in NN group(P<0.01);the L/M in BMM group was higher than that in NN group(P<0.01).The negative linear correlations can be found between L/M and ALB, TF, IgG, IgA, CD3, CD4 and CD4/CD8(P<0.01), as do between L/M and PAB as well as TLC(P<0.05), the positive cases between L/M and CD8 as well as CRP in SM group(P<0.01). The negative linear correlations can be found between L/M and TF, IgG, IgA, TLC, CD4, and CD4/CD8(P<0.01), as do between L/M and PAB, ALB and CD3(P<0.05), the positive cases between L/M and CD8 as well as CRP in BMM group(P<0.01). The negative linear correlations can be found between L/M and PAB, ALB, TF, IgG, IgA, TLC, CD3, CD4 and CD4/CD8(P<0.01), the positive cases between L/M and CD8 as well as CRP in NN group(P<0.01).Conclusion The gut barrier impairment of patients with gastrointestinal cancer companying the severe malnutrition is worse than those companying the borderline or mild malnutrition; the degrees of gut barrier impairment are negatively correlated with their own nutritional status and immune function, and positively correlated with their own inflammatory reaction.