Changes in the nutritional status of nine vitamins in patients with esophageal cancer during chemotherapy

Table 1 Baseline data of esophageal cancer patients (n = 203)

Clinical features	n	(%)
Gender
Males	181	89.16
Females	22	10.84
Age
< 60 yr	94	46.31
≥ 60 yr	109	53.69
Tumor stage
II	16	7.88
III	98	48.28
IV	68	33.50
Uncertain	21	10.34
Pathologic type
Squamous cell carcinoma	192	94.58
Nonsquamous cell carcinoma	11	5.42
Treatment
Induction chemotherapy	168	82.76
Postoperative adjuvant chemotherapy	15	7.39
Postrelapse chemotherapy	20	9.85
Primary tumor site
Cervical	14	6.90
Upper thoracic	28	13.79
Middle thoracic	77	37.93
Lower thoracic	84	41.38

Table 2 Changes in body mass index and hematological indicators in esophageal cancer patients before and after chemotherapy [n (%)]

Item	Before chemotherapy	After chemotherapy	χ2/Z	P value
Body mass index (kg/m2)			-2.646	0.008
< 18.5	25 (12.32)	22 (10.84)
18.5-23.9	103 (50.74)	123 (60.59)
> 23.9	75 (36.95)	58 (28.57)
Hemoglobin (g/L)			55.710	< 0.001
Decreased	119 (58.62)	182 (89.66)
Normal	84 (41.38)	21 (10.34)
Serum albumin (g/L)			2.717	0.099
Decreased	34 (16.75)	47 (23.15)
Normal	169 (83.25)	156 (76.85)
Serum calcium (mmol/L)			4.780	0.029
Decreased	21 (10.34)	36 (17.73)
Normal	182 (89.66)	167 (82.27)
Blood phosphorus (mmol/L)			2.382	0.123
Decreased	23 (11.33)	13 (6.40)
Normal	180 (88.67)	190 (93.60)

Table 3 Vitamin concentrations in esophageal cancer patients before and after chemotherapy

Item	Before chemotherapy (Q1-Q3) median	After chemotherapy (Q1-Q3) median	Z	P value
Vitamin A (μmol/L)	(0.561-0.980) 0.741	(0.528-0.858) 0.678	-3.465	0.001
Vitamin D (nmol/L)	(33.618-49.939) 41.383	(33.235-46.473) 38.832	-1.599	0.110
Vitamin E (μg/mL)	(10.898-11.673) 11.267	(10.905-11.867) 11.298	-1.678	0.093
Vitamin B9 (nmol/L)	(14.529-23.014) 18.718	(13.859-22.037) 17.539	-1.578	0.115
Vitamin B12 (pg/mL)	(491.023-598.303) 557.219	(491.112-590.338) 546.789	-0.326	0.745
Vitamin B1 (nmol/L)	(75.056-97.909) 84.070	(75.826-93.322) 83.095	-1.477	0.140
Vitamin C (μmol/L)	(34.324-38.543) 36.075	(33.299-37.849) 35.259	-3.824	< 0.001
Vitamin B2 (μg/L)	(4.182-5.050) 4.501	(4.105-4.761) 4.284	-2.631	0.009
Vitamin B6 (nmol/L)	(29.702-33.645) 31.747	(28.875-32.868) 31.363	-2.351	0.019

Q1-Q3: Quartiles 1-3.

Table 4 Vitamin deficiencies in esophageal cancer patients before and after chemotherapy, n (%)

Item	Before chemotherapy		After chemotherapy		χ2	P value
	Normal	Deficiency	Normal	Deficiency
Vitamin A (μmol/L)	163 (81.50)	37 (18.50)	158 (79.00)	42 (21.00)	0.485	0.486
Vitamin D (nmol/L)	194 (95.57)	9 (4.43)	191 (94.09)	12 (5.91)	0.235	0.629
Vitamin C (μmol/L)	155 (76.35)	48 (23.65)	133 (65.52)	70 (34.48)	6.682	0.010
Vitamin B2 (μg/L)	139 (68.47)	64 (31.53)	108 (53.20)	95 (46.80)	9.677	0.002

Table 5 Changes in hematological indicators in esophageal cancer patients before and after chemotherapy

Item	Before chemotherapy (mean ± SD)	After chemotherapy (mean ± SD)	t	P value
Hemoglobin (g/L)	130.070 ± 16.484	115.010 ± 14.584	15.342	< 0.001
Total protein (g/L)	66.572 ± 5.726	64.499 ± 5.528	5.032	< 0.001
Serum albumin (g/L)	38.880 ± 4.138	37.546 ± 3.719	4.355	< 0.001
Blood calcium (mmol/L)	2.240 ± 0.128	2.207 ± 0.132	2.835	0.005
Blood phosphorus (mmol/L)	1.130 ± 0.200	1.180 ± 0.184	-2.818	0.005

SD: Standard deviation.

Table 6 Factors affecting various indicators in esophageal cancer patients during chemotherapy

Item	Gender (Males/females)		Age (≥ 60 yr/< 60 yr)		Tumor grades (grades II/III/IV)		Tumor location (cervical/upper, middle, lower thoracic)
	F	P value	F	P value	F	P value	F	P value
Body mass index	0.014	0.904	0.042	0.837	0.672	0.512	0.718	0.542
Hemoglobin	0.044	0.834	0.757	0.385	0.747	0.475	0.195	0.900
Serum albumin	0.707	0.402	3.387	0.067	0.210	0.811	2.554	0.057
Vitamin A	5.407	0.021	0.059	0.809	0.151	0.860	0.692	0.558
Vitamin D	0.594	0.442	0.326	0.568	6.899	0.001	0.324	0.808
Vitamin C	3.774	0.053	0.537	0.464	2.633	0.075	2.261	0.083
Vitamin B2	0.178	0.674	0.863	0.354	0.381	0.684	2.273	0.081

The descriptive statistics of each indicator before and after chemotherapy are shown in Tables 3 and 5.

Table 7 Relationships between the differences in vitamins before and after chemotherapy and the difference in body mass index before and after chemotherapy in esophageal cancer patients

Difference in vitamin concentration	Difference in BMI
	r	P value
Vitamin A	0.240	0.001
Vitamin D	-0.080	0.259
Vitamin E	-0.095	0.177
Vitamin B9	-0.016	0.824
Vitamin B12	-0.053	0.449
Vitamin B1	0.021	0.771
Vitamin C	0.188	0.007
Vitamin B2	-0.102	0.149
Vitamin B6	-0.078	0.269

BMI: Body mass index.

Table 8 Regression analysis of the relationships between the concentrations of various vitamins and body mass index in 203 esophageal cancer patients

Independent variables (differences)	Dependent variable (difference in BMI)
	B (coefficient)	t	P value
Constant	0.365	4.978	< 0.001
Vitamin A	0.304	1.877	0.062
Vitamin D	-0.009	-2.355	0.020
Vitamin C	0.026	1.793	0.074

BMI: Body mass index.