Preoperative and postoperative levels of plasma protein and amino acid in esophageal and lung cancer patients

Abstract

The metabolic changes following thoracic surgery in three groups of patients (esophageal cancer, lung cancer, and hiatus hernia) have been studied. Before operation patients with esophageal cancer, but not those with lung cancer, had significantly lower plasma total protein and albumin than patients with hiatus hernia. After surgery plasma albumin and total protein fell in both esophageal cancer and hiatus hernia patients, a development attributed to poor nutrition and restricted calorie diet in these two groups of patients respectively. With the exception of alanine and arginine in lung cancer patients, and free tryptophan in lung and esophageal cancer patients, the preoperative concentrations of all plasma amino acids were similar in both groups of cancer patients and in those with hiatus hernia. After operation the concentrations of glutamine, total tryptophan, alanine, glycine, and arginine fell sharply, whereas those of phenylalanine, lysine, valine, and leucine were slightly or not at all affected by surgery. The immediate postoperative fall of plasma free amino acids is thought to be due to the increased rate of gluconeo-genesis. The rise of free fraction of plasma tryptophan after surgery is related to the raised level of plasma free fatty acids and increased secretions of catecholamines, which is believed to follow surgery. Cancer 623355360, 1988. ATIENTS with esophageal cancer are frequently P malnourished as a result of reduced food intake, and their rehabilitation after surgery is often protracted. After esophagectomy fat absorption has been reported to be impaired.' These workers have also reported that after esophagectomy there is a rise in the excretion of the nitrogen in the feces. Although Wu and Bauer observed a relatively large increase in the plasma free amino acid levels to accompany tumor growth,2 recent studies by Norten et al., have shown that cancer patients with no or minimum body weight loss maintained their plasma free amino acid levels within normal range.3 Of the amino acids, the metabolism of tryptophan in malignant disease has attracted much interest in recent years. However, most of the studies on tryptophan metabolism have been carried out in patients with cancer of the bladder or It seemed to be of particular interest to study the metabolism of this amino acid in patients with esophageal cancer because its concentration in the plasma is reduced sharply by a reduced food intake and in particular

Tyrosine, Phenylalanine, and Tryptophan in Gastroesophageal Malignancy: A Systematic Review

“…This study showed that tryptophan levels were significantly reduced in patients with esophageal cancer compared with controls (P ¼ 3.2EÀ0.5; fold change À1.2). This finding was supported by other groups, including Zhang and colleagues (21) and Naini and colleagues (33), who demonstrated decreased serum levels of tryptophan in these patients (Zhang VIP 3.35, P ¼ 0.000; Naini P < 0.05 for free tryptophan levels. Total tryptophan levels showed no significant change).…”

Clinical Implementation of Metabolomics

“…In previous studies, the alterations in PFAA profiles in cancer patients sometimes seem inconsistent, and some discrepancies existed between our study and those reported Lai et al, 2005;Naini et al, 1988;Norton et al, 1985;Proenza et al, 2003;Vissers et al, 2005). This discrepancy may be due not only to the statistical aspect of data, for example, sample size, the biased distribution of cancer stages, etc., but also to some other factors such as amino acid measurement methods.…”

“…Several investigators have reported changes in plasma free amino acid (PFAA) profiles in cancer patients Lai et al, 2005;Lee et al, 2003;Maeda et al, 2010;Naini et al, 1988;Norton et al, 1985;Okamoto et al, 2009;Proenza et al, 2003;Vissers et al, 2005;Zhang & Pang, 1992). Despite evidence of a relationship between PFAA profiles and some types of cancer, few studies have explored the use of PFAA profiles for diagnosis because although PFAA profiles differ significantly between patients, the differences in individual amino acids do not always provide sufficient discrimination abilities by themselves Lai et al, 2005;Naini et al, 1988;Norton et al, 1985;Proenza et al, 2003;Vissers et al, 2005).…”

“…Despite evidence of a relationship between PFAA profiles and some types of cancer, few studies have explored the use of PFAA profiles for diagnosis because although PFAA profiles differ significantly between patients, the differences in individual amino acids do not always provide sufficient discrimination abilities by themselves Lai et al, 2005;Naini et al, 1988;Norton et al, 1985;Proenza et al, 2003;Vissers et al, 2005). To address this issue, we have studied using diagnostic indices based on PFAA concentrations that compress multidimensional information from PFAA profiles into a single dimension to maximize the differences between patients and controls.…”

High plasma arginine concentrations in critically ill patients suffering from hepatic failure

“…In a study in rats, we observed a reduced blood flow to the small intestine when plasma concentrations of arginine were low in the presence of low-grade endotoxemia (Prins et al, 2000a). Circulating arginine is reduced in a number of clinical conditions, for example, after thoracoabdominal aortic surgery (Nijveldt et al, 2000), after surgery for esophageal and lung cancer (Naini et al, 1988), after trauma (Houdijk et al, 1998), during sepsis (Freund et al, 1978), and in severe burns (Yu et al, 1995). Because of the many physiological functions of arginine, low levels of this amino acid may be related to the high morbidity and mortality rates in these patient groups.…”