title: Relationship between immunological parameters and the severity of neutropenia and effect of enteral nutrition on immune status during neoadjuvant chemotherapy on patients with advanced esophageal cancer.
abstract: OBJECTIVE
  Chemotherapy may cause various toxicities as well as impair immunological function. However, little is known about the relationship between toxicities and immunological parameters or the effect of enteral nutrition (EN) on immunological status during chemotherapy.
  
  
  METHODS
  91 patients who received neoadjuvant chemotherapy (NACT) for esophageal cancer were randomly assigned to receive either EN or parenteral nutrition (PN). Immunological parameters, including total lymphocyte count (TLC), type 1 and type 2 CD4-positive T cells (Th1/Th2) balance, human leukocyte antigen (HLA)-DR expression on monocytes, natural killer cell activity, and phytohemagglutinin-stimulated lymphocyte proliferation were measured at baseline and day 14 of the first chemotherapy cycle.
  
  
  RESULTS
  In the PN group, patients with grade 3-4 neutropenia showed significantly lower TLC, HLA-DR expression, and Th1/Th2 balance at day 14 compared to those with grade 0-2 neutropenia. Among pretherapeutic factors, Th1/Th2 balance was the only factor significantly associated with the severity of neutropenia. Concerning the comparison of immunological parameters between the EN and PN groups, HLA-DR expression at day 14 was significantly higher in the EN group.
  
  
  CONCLUSIONS
  Baseline Th1/Th2 balance predicted the severity of neutropenia, and EN significantly reduced the decline of monocyte HLA-DR expression in patients with esophageal cancer receiving NACT.
authors: Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Higashinari-ku, Osaka, Japan. motoori-ma@mc.pref.osaka.jp
authors: Masaaki
authors: M
authors: Motoori
authors: Masahiko
authors: M
authors: Yano
authors: Takushi
authors: T
authors: Yasuda
authors: Hiroshi
authors: H
authors: Miyata
authors: Ying Feng
authors: YF
authors: Peng
authors: Makoto
authors: M
authors: Yamasaki
authors: Osamu
authors: O
authors: Shiraishi
authors: Koji
authors: K
authors: Tanaka
authors: Osamu
authors: O
authors: Ishikawa
authors: Hitoshi
authors: H
authors: Shiozaki
authors: Yuichiro
authors: Y
authors: Doki
mesh_terms: D004750:Enteral Nutrition; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000276:immunology*; D005260:Female; D006684:HLA-DR Antigens / Q000276:immunology; D006801:Humans; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000187:drug effects / Q000276:immunology; D015999:Multivariate Analysis; D020360:Neoadjuvant Therapy; D009503:Neutropenia / Q000276:immunology*; D018417:Th1 Cells / Q000187:drug effects / Q000276:immunology; D018418:Th2 Cells / Q000187:drug effects / Q000276:immunology
chemical_list: D006684:HLA-DR Antigens