title: Tumor-associated metabolic alterations in patients with gastric and esophageal cancer.
abstract: OBJECTIVE
  This study was conducted to elucidate tumor-induced alterations in pace maker enzymes and possible effects of pre-operative nutritional support on those enzymes in gastrointestinal (GI) cancer patients.
  
  
  METHODS
  Three pacemaker enzymes; phosphoenolpyruvate carboxykinase (PEPck) for gluconeogenesis, malic enzyme for de novo fatty acid synthesis, and lipoprotein lipase (LPL) for triglyceride clearance in liver and adipose tissues were examined in 22 patients with gastrointestinal cancers, both with or without pre-operative total parenteral nutritional support. Five patients with normal nutrition and liver function but undergoing cholecystectomy were used as controls.
  
  
  RESULTS
  Activity of hepatic malic enzyme was significantly decreased (p < 0.05) and activity of hepatic PEPck was slightly elevated in patients with advanced stage cancer. LPL activity in the abdominal subcutaneous tissue was increased by advanced tumor bearing (p < 0.05). Pre-operative total parenteral nutrition for 1 week resulted in significant stimulation of LPL activity in adipose tissue from patients with advanced cancer compared to that from controls (6.53 +/- 4.99 U/g tissue and 1.32 +/- 0.18 U/g tissue, respectively).
  
  
  CONCLUSIONS
  Effects of tumor bearing on key regulatory enzymes were evident only at the advanced stages. Pre-operative hyperalimentation may increase fat storage at the peripheral tissue by stimulating tissue LPL activity even at the advanced stage disease.
authors.affiliation: First Department of Surgery, Yokohama City University School of Medicine, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Noguchi
authors.forename: T
authors.initials: T
authors.lastname: Yoshikawa
authors.forename: D
authors.initials: D
authors.lastname: Marat
authors.forename: T
authors.initials: T
authors.lastname: Makino
authors.forename: K
authors.initials: K
authors.lastname: Nomura
authors.forename: A
authors.initials: A
authors.lastname: Tsuburaya
authors.forename: T
authors.initials: T
authors.lastname: Ito
authors.forename: A
authors.initials: A
authors.lastname: Matsumoto
mesh_terms: D000328:Adult; D000368:Aged; D004938:Esophageal Neoplasms / Q000201:enzymology* / Q000473:pathology; D005260:Female; D005943:Gluconeogenesis; D006801:Humans; D008071:Lipoprotein Lipase / Q000378:metabolism*; D008293:Malates / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010289:Parenteral Nutrition, Total; D010730:Phosphoenolpyruvate Carboxylase / Q000378:metabolism*; D013274:Stomach Neoplasms / Q000201:enzymology* / Q000473:pathology
chemical_list: D008293:Malates; D008071:Lipoprotein Lipase; D010730:Phosphoenolpyruvate Carboxylase