br The protocol of the study was approved by
The protocol of the study was approved by the Local Bioethics Committee (opinion no. KBET/98/B/2014). All procedures performed in this study involving human participants were in accordance with the
1964 Helsinki Declaration and its later amendments or comparable ethical standards. All the study participants provided informed written consent.
2.4. Statistical analysis
Statistica for Windows, version 13.0 Pl (StatSoft Inc., Tulsa, OK, USA, Jagiellonian University license) was used for database manage-ment and statistical analysis. Normal distribution of quantitative vari-ables was verified with Shapiro-Wilk test, and the statistical char-acteristics were presented as means and standard deviations (SD). Variables that did not satisfy the criteria of normality were presented as median (Me) and maximum and minimum value (min-max), DP from EGG was subjected to log-normal 3X FLAG Peptide prior to further ana-lyses. Depending on the distribution type, the significance of intragroup differences was verified with one-way ANOVA followed by Tukey’s post-hoc test was performed to examine the differences between groups A, B, C and the control group, when normality was present. The one-way ANOVA on ranks (Kruskal –Wallis test) was performed to evaluate the differences between all the investigated groups in variables without normal distribution. The power of associations between the values of EGG parameters, the severity of dyspeptic symptoms and HRV para-meters were estimated on the basis of Spearman’s coefficients of rank correlation. The results of all tests were considered significant at p≤0.05.
Abnormal EGG is defined as less than 70% of 2–4cpm slow waves percentage time (normogastria) . According to this definition, in-dividuals with GI malignancies presented with abnormal EGG record-ings significantly more often than the healthy controls. None of the subjects from the control group showed the evidence of EGG abnorm-alities in either preprandial or postprandial state. In contrast, abnormal EGG recordings were obtained from 14 (46.6%) patients with colon cancer, 15 (50%) with rectal and 12 (60%) with gastric cancer ex-amined in a preprandial state, and from 14 (46.6%), 11 (36.6%) and 9 (45%) patients examined in a postprandial state, respectively. Also, the prevalence of abnormal EGG recordings in all cancer patients, irre-spective of the malignancy location, was significantly higher than in the controls, in both preprandial or postprandial period. During
prior to and Tachygastria
from each study group, determined Normogastria [%]
parameters of Bradygastria
Table 4Electrogastrographic EGG
Group AMe[min-max] Group BMe[min-max] Group CMe[min-max] ControlMe [min-max] p ANOVAA&Controlp B&ControlpC&Controlp
A&B, A&C and B frequency, DP – (ANOVA analysis). The significant differences between groups cpm – normogastria, 4–9 cpm – tachygastria, DF – dominant groups A&B&C&Control cpm – bradygastria, 2–4 Legend: Me – median value; min – minimum; max – maximum; p < 0. - significant differences between patients05 &C were not found. Pre – preprandial state, Post – postprandial state. Percentage EGG classification range 1.8–2dominantpower,ACSWC–averagepercentageofslow-wavecoupling;NS–nonsignificant.
Abnormal EGG response to the test meal was defined as a lack of increase in DP [1,2]. A power ratio of DP < 1 correlates with a de-creased distal gastric motor response to meal. Whereas all healthy controls showed normal response to the test meal, abnormal DP re-sponses were documented in 18 (60%) patients from group A, 16 (53.3%) from group B and 14 (70%) from group C. Abnormal EGG responses to the test meal occurred significantly more often in gastric cancer patients than in individuals with colorectal malignancies (p < 0.05). Changes in EGG parameters documented after adminis-tering the standard meal are summarized in Table 4 and Fig. 2 and 3. When compared to GI cancer patients overall, EGG recordings from healthy controls included a larger proportion of regular 3-cpm slow waves. Overall, EGG abnormalities were found in 41 (51.3%) study subjects (coexistence of the disorder in response to a meal and per-centage of normogastria time > 70%).
3.3. Dyspeptic symptom score
Most individuals with GI malignancies in our study did not show an evidence of dyspeptic symptoms. The most frequently reported ailment was bloating, present in 52.5% of all cancer patients. In turn, vomiting was of extremely rare evidence (8.75%). The results are presented in Table 5.
Bloating was the main symptom reported by patients from group A, the severity of dyspeptic symptoms (bloating and abdominal dis-comfort) in this group was the highest. Subjects from group B most often reported bloating, heartburn and epigastric pain. Epigastric pain as well as feeling of food retention in the stomach and bloating were predominant symptoms in more than half of the patients from group C. The results are summarized in Table 5 and Table 6.