A systematic review and meta-analysis of the n-3 polyunsaturated fatty acids effects on inflammatory markers in colorectal cancer
A systematic review and meta-analysis of the n-3 polyunsaturated fatty acids effects on inflammatory markers in colorectal cancer
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DOI：
10.1016/j.clnu.2015.04.013
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发表时间：
2016-04-01
影响因子：
6.3
通讯作者：
Trindade, Erasmo B. S. M.
中科院分区：
文献类型：
--
作者：
Mocellin, Michel C.;Camargo, Carolina Q.;Trindade, Erasmo B. S. M.
背景：癌症与炎症密切相关，炎症过程的加剧会导致肿瘤的进展和癌症患者更差的预后。科学文献表明，n-3多不饱和脂肪酸(PUFA)具有抗炎作用，因此在某些癌症的治疗中可能是有用的佐剂。目的：对截至2014年9月的文献进行系统回顾和荟萃分析，以评价n-3多不饱和脂肪酸对结直肠癌患者炎症介质的影响。结果：代表475名结直肠癌患者的9项试验评价了n-3PUFA对细胞因子(n=6)和/或急性时相蛋白(n=5)水平的影响。N-3多不饱和脂肪酸降低IL-6水平(SMD2.34；95%CI-4.37，-0.31；p=0.024)，升高白蛋白(SMD0.31；95%CI0.06，0.56；p=0.014)。在分层分析中，术后服用0.2g/kg鱼油的外科患者IL-6水平降低(SMD0.65；95%可信区间-1.06，-0.24；p=0.002)，而术前口服2.5g/d EPA+DHA的外科患者白蛋白浓度升高(SMD0.34；95%可信区间0.02，0.66；p=0.038)。在接受化疗的患者中，在9周内补充0.6g/d的环丙沙星+二羟基喜树碱可降低C反应蛋白水平(SMD0.95；95%CI-1.73，-0.17；P=0.017)，降低C反应蛋白/白蛋白比率(SMD0.95；95%CI-1.73，-0.18；结论：n-3多不饱和脂肪酸对结直肠癌患者的某些炎症介质有好处，但这些好处是特定的补充方案所特有的，包括持续时间、剂量和给药途径，以及所采用的伴随的抗癌治疗。(C)2015年爱思唯尔有限公司和欧洲临床营养和代谢学会。版权所有。
Background: Cancer and inflammation are closely related and an exacerbated inflammatory process can lead to tumor progression and a worse prognosis for the patient with cancer. Scientific literature has shown evidence that n-3 polyunsaturated fatty acids (PUFA) have anti-inflammatory action, and for this reason could be useful as an adjuvant in the treatment of some cancers.Objective: A systematic review and meta-analysis of the literature was conducted until September, 2014, to evaluate the effects of n-3 PUFA on inflammatory mediators in colorectal cancer (CRC) patients.Patients and methods: Clinical trials were systematically searched in three electronic databases and screening reference lists. Random meta-analysis model was used to calculate the overall and stratified effect sizes.Results: Nine trials, representing 475 patients with CRC, evaluated effects of n-3 PUFA on cytokines (n = 6) and/or acute phase proteins (n = 5) levels. n-3 PUFA reduce the levels of IL-6 (SMD -2.34; 95% CI -4.37, -0.31; p = 0.024) and increase albumin (SMD 0.31; 95% CI 0.06, 0.56; p = 0.014) in overall analyses. In stratified analyses, reduction in IL-6 levels occurs in surgical patients that received 0.2 g/kg of fish oil parenterally at postoperative period (SMD -0.65; 95% CI -1.06, -0.24; p = 0.002), while, increase in albumin concentration occurs in surgical patients that received >= 2.5 g/d of EPA + DHA orally at preoperative period (SMD 0.34; 95% CI 0.02, 0.66; p = 0.038). In patients undergoing chemotherapy, the supplementation of 0.6 g/d of EPA + DHA during 9 week reduces CRP levels (SMD -0.95; 95% CI -1.73, -0.17; p = 0.017), and CRP/albumin ratio (SMD -0.95; 95% CI -1.73, -0.18; p = 0.016).Conclusions: The results suggest benefits on some inflammatory mediators with the use of n-3 PUFA on CRC patients, but these benefits are specific to certain supplementation protocols involving duration, dose and route of administration, and also, the concomitant anti-cancer treatment adopted. (C) 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.