Nourissat A, Mille D, Delaroche G, Jacquin J P, Vergnon J M, Fournel P, Seffert P, Porcheron J, Michaud P, Merrouche Y, Chauvin F
Institut de Cancérologie de la Loire, Saint Etienne, France.
Ann Oncol. 2007 Nov;18(11):1882-6. doi: 10.1093/annonc/mdm355. Epub 2007 Sep 17.
In routine practice, the evaluation of the nutritional status of patients with cancer is not always performed although there is frequent modification as disease progresses. The validated screening and evaluation tools currently available are time-consuming and costly. In this study we analysed factors that could be used to identify patients likely to need nutritional surveillance or intervention.
A cross-sectional survey was carried out for 2 weeks in June 2006 on 477 patients with cancer.
30.2% of the patients had lost more than 10% of their body weight since the start of the illness. After adjustment, the factors significantly associated with weight loss were: depressive state (OR = 3.49; P = 0.002), digestive or ENT tumours (OR = 3.20; P = <0.001), chemotherapy (OR = 2.66; P = 0.011), male gender (OR = 2.30; P = 0.001) and professional status (OR = 2.08; P = 0.02). Using a logistic model, we calculated the risk of weight loss as a function of the presence of the identified predictive factors.
We report a simple screening tool, which will not replace the available evaluation methods but will enable targeting of the patients most likely, after a specific evaluation, to benefit from nutritional intervention. This remains to be validated in further prospective studies.
在常规临床实践中，尽管随着疾病进展患者的营养状况经常发生变化，但对癌症患者营养状况的评估并非总能得到实施。目前可用的经过验证的筛查和评估工具既耗时又昂贵。在本研究中，我们分析了可用于识别可能需要营养监测或干预的患者的因素。
2006年6月，对477例癌症患者进行了为期2周的横断面调查。
自患病以来，30.2%的患者体重减轻超过10%。经过调整后，与体重减轻显著相关的因素有：抑郁状态（比值比[OR]=3.49；P=0.002）、消化或耳鼻喉肿瘤（OR=3.20；P<0.001）、化疗（OR=2.66；P=0.011）、男性（OR=2.30；P=0.001）和职业状况（OR=2.08；P=0.02）。使用逻辑模型，我们根据已确定的预测因素的存在情况计算了体重减轻的风险。
我们报告了一种简单的筛查工具，它不会取代现有的评估方法，但能在特定评估后，针对最有可能从营养干预中获益的患者。这仍有待在进一步的前瞻性研究中得到验证。
