title: The effect of perioperative immunonutrition on the phagocytic activity of blood platelets in advanced gastric cancer patients.
abstract: OBJECTIVE
  Perioperative immunonutrition can influence the phagocytic activity of platelets in advanced gastric cancer.
  
  
  METHODS
  51 patients with stage IV gastric cancer divided into four groups depending on the clinical status and 40 normal donors were analyzed. Patients of groups I and II underwent palliative gastrectomy. Patients of groups III and IV had exploratory laparotomy. Perioperative immunonutrition was administered as follows: group I--TPN, II--oral arginine, peripheral TPN, III--TPN preoperatively, and IV--without nutrition. The phagocytic activity of blood platelets was determined before and after nutritional therapy and was assessed by measuring the fraction of phagocytic thrombocytes (%phag) and the phagocytic index (Ixphag).
  
  
  RESULTS
  The percentage of phagocytizing platelets and the phagocytic index prior to and after the surgery amounted to the following: group I--1.136-1.237, P = NS, and 1.007-1.1, P = NS, respectively, II--1.111-1.25, P < 0.05, and 1.011-1.083, P < 0.05, III--1.112-1.186, P = NS, and 0.962-1.042, P = NS, and IV--1.085-0.96, P = NS, and 1.023-1.04, P = NS.
  
  
  CONCLUSIONS
  The phagocytic activity of platelets in patients with advanced gastric cancer is significantly impaired. Perioperative immunonutrition with oral arginine-rich diet can partially improve the phagocytic activity of blood platelets. This trial is registered with Clinicaltrials.gov--NCT01704664.
authors.affiliation: 2nd Department of General and Gastroenterological Surgery, Medical University of Bialystok, M. Sklodowskiej-Curie 24A Street, 15-276 Bialystok, Poland.
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Kamocki
authors.affiliation: Department of Clinical Laboratory Diagnostics, Medical University of Bialystok, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Matowicka-Karna
authors.affiliation: 2nd Department of General and Gastroenterological Surgery, Medical University of Bialystok, M. Sklodowskiej-Curie 24A Street, 15-276 Bialystok, Poland.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Gryko
authors.affiliation: 2nd Department of General and Gastroenterological Surgery, Medical University of Bialystok, M. Sklodowskiej-Curie 24A Street, 15-276 Bialystok, Poland.
authors.forename: Konrad
authors.initials: K
authors.lastname: Zareba
authors.affiliation: 2nd Department of General and Gastroenterological Surgery, Medical University of Bialystok, M. Sklodowskiej-Curie 24A Street, 15-276 Bialystok, Poland.
authors.forename: Boguslaw
authors.initials: B
authors.lastname: Kedra
authors.affiliation: Department of Clinical Laboratory Diagnostics, Medical University of Bialystok, Poland.
authors.forename: Halina
authors.initials: H
authors.lastname: Kemona
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001792:Blood Platelets / Q000276:immunology*; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009752:Nutritional Status / Q000276:immunology*; D059035:Perioperative Period; D010587:Phagocytosis / Q000276:immunology*; D010976:Platelet Count; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000276:immunology* / Q000473:pathology* / Q000601:surgery; D055815:Young Adult