Kosacka Monika, Weryńska Bozena, Gołecki Marcin, Jankowska Renata, Passowicz-Muszyńska Ewa
Katedra i Klinika Pulmonologii i Nowotworów Płuc Akademii Medycznej we Wrocławiu Kierownik.
Pneumonol Alergol Pol. 2008;76(5):360-5.
The cachexia-anorexia syndrome (CACS) is common and important implication of cancer. It occurs in 30% to 80% cancer patients. At the time of diagnosis of lung cancer CACS is not yet very important problem, but the weight loss increases with progression of the cancer. CACS is characterized by anorexia, weight loss, weakness, impaired immune system and metabolic dysfunction. Weight loss is a potent stimulus to food intake in normal humans. The persistence of anorexia in cancer patients, therefore, implies a failure of this adaptive feeding response. The weight loss in patients with CACS differs from that in simple starvation or anorexia nervosa. Most research effort has focused on the role of cytokines as mediators of CACS. The role of TNF-alpha, IL-1 and IL-6 in CACS development has been evaluated and confirmed in many research, but some investigators suggest that the changes in cytokines' levels could be the result rather than the cause of CACS. A few of the latest studies concentrate on the role of nuclear factor kappa B and prevention of CACS by its inhibitors. CACS is an independent predictor of shorter survival and increases the risk of treatment failure and toxicity.
恶病质-厌食综合征(CACS)是癌症常见且具有重要影响的症状。它在30%至80%的癌症患者中出现。在肺癌诊断时,CACS还不是非常严重的问题,但体重减轻会随着癌症进展而增加。CACS的特征包括厌食、体重减轻、虚弱、免疫系统受损和代谢功能障碍。体重减轻是正常人体食物摄入的有力刺激因素。因此,癌症患者持续存在的厌食意味着这种适应性进食反应的失败。CACS患者的体重减轻与单纯饥饿或神经性厌食症患者的体重减轻不同。大多数研究工作都集中在细胞因子作为CACS介质的作用上。肿瘤坏死因子-α、白细胞介素-1和白细胞介素-6在CACS发展中的作用已在许多研究中得到评估和证实,但一些研究人员认为细胞因子水平的变化可能是CACS的结果而非原因。一些最新研究集中在核因子κB的作用及其抑制剂对CACS的预防作用上。CACS是生存期缩短的独立预测因素,会增加治疗失败和毒性的风险。