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Factors related to impaired bactericidal activity in patients with esophageal cancer
Y Shigemitsu1, T Saito, T Kinoshita
1First Department of Surgery, Oita Medical University, Japan.
Abstract:
We examined the possible factors that could contribute to the impairment of polymorphonuclear neutrophil (PMN) bactericidal activities in patients with esophageal cancer, based on the discovery that a depression of the intracellular killing (KI) activity, with an elevation of the superoxide anion-producing capacity (SOP), of PMN is associated with the occurrence of infectious complications following surgery for esophageal cancer. KI, SOP, and myeloperoxidase (MPO) activity were measured in 30 patients with esophageal cancer and 33 patients with gastric cancer. Sex, age, and cancer stage were not significantly associated with impaired bactericidal activities; however, malnutrition was significantly correlated with both a depression in KI (r = 0.58, P < 0.001) and an elevation in SOP (r = -.36, P < 0.05) in the patients with esophageal cancer, but not in those with gastric cancer. The incidence of chronic obstructive pulmonary disease (COPD) was significantly higher in the esophageal cancer patients whose SOP was elevated, at 39% versus 0% (P < 0.05). These results suggest that malnutrition and probably also latent infections associated with COPD contribute to the impaired bactericidal activities of PMN in patients with esophageal cancer.
Insights
Malnutrition and chronic obstructive pulmonary disease (COPD) impair polymorphonuclear neutrophil (PMN) bactericidal activity in esophageal cancer patients. These factors contribute to increased infectious complications after surgery.
Area of Science:
- Immunology
- Oncology
- Pulmonology
Background:
- Impaired polymorphonuclear neutrophil (PMN) bactericidal activity, characterized by reduced intracellular killing (KI) and elevated superoxide anion production (SOP), is linked to surgical infectious complications in esophageal cancer.
- Understanding the factors contributing to this immune dysfunction is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the factors associated with impaired PMN bactericidal activities in patients with esophageal cancer.
- To compare these factors with those in patients with gastric cancer.
Main Methods:
- Measured intracellular killing (KI), superoxide anion-producing capacity (SOP), and myeloperoxidase (MPO) activity in PMNs from 30 esophageal cancer patients and 33 gastric cancer patients.
- Assessed correlations with sex, age, cancer stage, malnutrition, and chronic obstructive pulmonary disease (COPD).
Main Results:
- Malnutrition significantly correlated with decreased KI and increased SOP in esophageal cancer patients (P < 0.001 and P < 0.05, respectively).
- No significant associations were found between malnutrition and PMN activity in gastric cancer patients.
- Elevated SOP in esophageal cancer patients was associated with a higher incidence of COPD (39% vs. 0%, P < 0.05).
Conclusions:
- Malnutrition is a significant factor contributing to impaired PMN bactericidal activity in esophageal cancer.
- Latent infections associated with COPD may also play a role in the compromised immune function observed in these patients.
- These findings highlight the importance of addressing malnutrition and underlying respiratory conditions to mitigate infectious risks in esophageal cancer patients.