Ferrigno D, Buccheri G
Cuneo Lung Cancer Study Group, Division of Respiratory Medicine, S. Croce e Carle Hospital, Italy.
Support Care Cancer. 2001 Oct;9(7):522-7. doi: 10.1007/s005200100268.
There is evidence that malnutrition is an important cause of morbidity and mortality in lung cancer patients and may have an impact on the clinical course of disease. The simplest way to assess nutritional status at the patient's bedside remains recourse to anthropometric measurements. This study was carried out in order to assess the clinical and prognostic significance of triceps skinfold thickness (TST), arm circumference (AC), and wrist circumference (WC) in lung cancer. The patient population was a consecutive series of 388 patients seen for a newly diagnosed primary non-small-cell lung cancer during the last 4 years. A set of 22 anthropometric, clinical, physical, laboratory, radiological, and pathological variables was prospectively recorded for all patients. Patients were carefully followed up, and their subsequent clinical course was recorded. The median values of TST, WC and AC were 8 mm (range 2-25 mm), 18 cm (range 10-27 cm), and 25 cm (range 15-35 cm), respectively. In 107 patients (27.6% of the total) TST values were below the reference value, and 37 of these patients also had a pathologically low small circumference. In all, AC was below the normality range in 60 of the 388 subjects (15.5%). Among the three variables, the strongest relationships were those between AC and WC (r(s)=0.541), and between TST and AC (r(s)=0.521). Univariate analyses of survival showed that TST was strongly predictive of a better prognosis (P<0.001), while WC was unrelated to outcome (P=0.101). Patients with higher values of AC had significantly longer survival than patients with lower values (P<0.018). The multivariate model, in contrast, did not confirm the prognostic capability of any of the anthropometric measures. These data indicate that the anthropometric measures may be significant predictors of survival, although not independently of the other prognostic factors.
有证据表明,营养不良是肺癌患者发病和死亡的重要原因,且可能对疾病的临床进程产生影响。在患者床边评估营养状况的最简单方法仍是采用人体测量法。本研究旨在评估肺癌患者肱三头肌皮褶厚度(TST)、上臂围(AC)和腕围(WC)的临床及预后意义。研究对象为过去4年中连续收治的388例新诊断的原发性非小细胞肺癌患者。前瞻性记录了所有患者的22项人体测量、临床、体格检查、实验室、影像学和病理学变量。对患者进行了仔细随访,并记录了他们随后的临床病程。TST、WC和AC的中位数分别为8毫米(范围2 - 25毫米)、18厘米(范围10 - 27厘米)和25厘米(范围15 - 35厘米)。107例患者(占总数的27.6%)的TST值低于参考值,其中37例患者的小周长也在病理水平偏低。总体而言,388名受试者中有60名(15.5%)的AC低于正常范围。在这三个变量中,AC与WC之间的相关性最强(r(s)=0.541),TST与AC之间的相关性次之(r(s)=0.521)。生存单因素分析显示,TST强烈预示预后较好(P<0.001),而WC与预后无关(P = 0.101)。AC值较高的患者生存时间显著长于AC值较低的患者(P<0.018)。相比之下,多变量模型未证实任何人体测量指标的预后能力。这些数据表明,人体测量指标可能是生存的重要预测因素,尽管并非独立于其他预后因素。