Gan QH, Li SQ, Gan XL, Jiang ZQ, Jian ZY. Parenteral nutrition with n-3 polyunsaturated fatty acids on nutrition inflammatory and immune status of gastrointestinal cancer patients: Meta-analysis. World J Gastrointest Surg 2025; 17(5): 105743 [DOI: 10.4240/wjgs.v17.i5.105743]
Corresponding Author of This Article
Zhi-Yuan Jian, Department of Gastrointestinal Surgery, Guilin Medical University, No. 15 Lequn Road, Guilin 541001, Guangxi Zhuang Autonomous Region, China. jianzhiyuan2001@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. May 27, 2025; 17(5): 105743 Published online May 27, 2025. doi: 10.4240/wjgs.v17.i5.105743
Parenteral nutrition with n-3 polyunsaturated fatty acids on nutrition inflammatory and immune status of gastrointestinal cancer patients: Meta-analysis
Qin-Hu Gan, Xin-Li Gan, Zhi-Qing Jiang, Zhi-Yuan Jian, Department of Gastrointestinal Surgery, Guilin Medical University, Guilin 541001, Guangxi Zhuang Autonomous Region, China
Shu-Qun Li, Department of Hepatobiliary and Pancreatic Surgery, Guilin Medical University, Guilin 541001, Guangxi Zhuang Autonomous Region, China
Author contributions: Gan QH designed the study; Li SQ, Gan XL, and Jiang ZQ analyzed the data; Gan QH and Jian ZY wrote the manuscript; and all authors read and approved the final manuscript.
Supported by the Guangxi Medical and Health Key (Cultivation) Discipline Construction Project; Guilin Scientific Research and Technology Development Program Project, No. 20210227-7-8.
Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhi-Yuan Jian, Department of Gastrointestinal Surgery, Guilin Medical University, No. 15 Lequn Road, Guilin 541001, Guangxi Zhuang Autonomous Region, China. jianzhiyuan2001@163.com
Received: February 12, 2025 Revised: March 18, 2025 Accepted: April 8, 2025 Published online: May 27, 2025 Processing time: 100 Days and 0.6 Hours
Abstract
BACKGROUND
The incidence of malignant tumors in the digestive system is increasing and is a threat to human health. However, the long duration from tumor detection to radical resection, stress responses due to surgical trauma, and insufficient nutritional intake increases the risk of malnutrition, immune function reduction, postoperative complications, and intestinal dysfunction among patients.
AIM
To systematically investigate the association of parenteral nutrition enriched with n-3 polyunsaturated fatty acids (PUFAs) with the nutritional status of patients after gastrointestinal treatment.
METHODS
Randomized controlled trials associated with PUFA-enriched parenteral nutrition administration in patients with digestive system malignancies were retrieved from online databases such as PubMed, EMBASE, ScienceDirect, Cochrane Library, China Knowledge Network, China VIP, Wanfang, and China Biomedical Literature Database, with the retrieval time from database inception to present. Two researchers independently extracted data. Each article’s bias risk was assessed by referring to the Cochrane Handbook version 5.3 criteria and RevMan5.4 was used for data analysis.
RESULTS
This meta-analysis involved six randomized controlled trials involving a total of 505 cases. Random-effects model analysis indicated remarkably better improvements in various inflammatory factors in the study group (P < 0.05). Meta-analysis of nutritional indicators revealed that the study group had higher total protein, albumin, and prealbumin levels, as well as lower transferrin levels compared to the control group (P < 0.05). Meanwhile, meta-analysis of T-cell subsets revealed no remarkable inter-group difference in post-treatment CD8+ cells (P > 0.05). Moreover, the meta-analysis identified a notably lower incidence of adverse reactions in the study group (P < 0.05).
CONCLUSION
Administration of PUFAs helps improve the nutritional status of patients with digestive malignancies in the perioperative period. It promotes immune function recovery, reduces the inflammatory response, and decreases the risk of adverse effects. These beneficial effects make it worth investigating and promoting their use in appropriate patient populations. However, further validation via high-quality studies with long intervention time and extended follow-up periods is required.
Core Tip: Nutritional support is an important measure that can improve immunity, reduce the incidence of infectious or non-infectious complications, and enhance the prognosis of patients with malignant tumors. In this study, we conducted a meta-analysis of randomized controlled trials in patients with digestive system malignancies who received n-3 polyunsaturated fatty acids to resolve these ambiguities and evaluate the clinical significance of n-3 polyunsaturated fatty acids in these patients.
