br Corresponding author at Department of Oncology Cracow University
Corresponding author at: Department of Oncology, Cracow University Hospital, 10 Sniadeckich St., 31-531, Cracow, Poland.
E-mail address: [email protected] (A.L. Zygulska).
1 Passed away before the study was finished.
Available online 21 November 2018
human studies [6,7]. An increase in the percentage of normal slow waves, Tretinoin frequency (DF) and DP, as well as a concomitant decrease in the severity of dysrhythmia, were typically observed in healthy subjects as a gastric myoelectric response to food [16,17]. Gastric myoelectric activity has been sporadically studied in GI cancer patients [13,18]. Statistically significant positive correlations were found between the feeling of fullness in the epigastric region and the percentage of preprandial bradygastria in gastric cancer and rectal cancer patients [18–21]. On the other hand, tachygastria and reduction of gastric motility were documented after neoadjuvant chemor-adiotherapy due to esophageal cancer. Individuals with this malignancy showed a decrease in DF and lower prevalence of normogastria at 3 and 6 months post-surgery, with subsequent normalization of these para-meters at 12 months . In another study, gastric cancer patients after total or distal gastrectomy presented with lower power amplitude and lower power content of normogastria than the healthy controls and individuals subjected to total colectomy . According to literature, tachygastria, bradygastria, dysrhythmia and gastric outlet obstruction may occur in up to 88.6% of cancer patients, and abnormal EGG find-ings co-exist with dysmotility-like symptoms .
Frequency domain analysis of heart rate variability (HRV) provides information on autonomic balance and is suitable for quantification of sympathetic and parasympathetic tone. HRV monitoring can be used to non-invasively examine the cardiac autonomic innervation and vege-tative modulation of the sinus node. Hence, HRV is often included in studies on various autonomic disorders. Moreover, this method seems to be appropriate for evaluating cancer-specific changes in the auto-nomic activity [23,24].
Both, sympathetic and parasympathetic, components of the auto-nomic nervous system play vital roles during development and spread of solid tumors, albeit at different stages of tumorigenesis. Likewise in leukocyte and fibroblast migration, neurotransmitters also regulate the migratory activity of cancer cells. The phenomenon refers to cancer cells migrating along nerve fibers as perineural invasion, that is asso-ciated with poorer prognosis [25,26].
The aim of this study was to analyze an association between gastric motility and dyspeptic symptoms in patients with colorectal and gastric malignancies, who additionally had performed the estimation of the autonomic nervous system activity based on HRV. To the best of our knowledge, it is the first published study analyzing changes of gastric myoelectric activity in this group of cancer patients.
2. Material and methods
The inclusion criteria of the study were as follows: 1) histological evidence of gastric or colorectal carcinoma, 2) lack of neoplastic ca-chexia, 3) at least 18 years of age, 4) discontinuation of all medications with potential effect on gastric motility and autonomic system activity 3 days prior to the study, 5) Eastern Cooperative Oncology Group (ECOG) performance status of 1 or 0, and 6) written informed consent.
The exclusion criteria included cardiovascular disorders, neurolo-gical disorders, gastrointestinal disorders other than carcinoma, dia-betes mellitus, obesity (Body Mass Index > 30 kg/m2), tobacco smoking, alcohol abuse, intake of medications with an established ef-fect on gastric myoelectric measurements, previous history of abdom-inal surgery other than anticancer treatment, pregnancy and chronic