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癌症恶病质/体重减轻综合征:探讨非小细胞肺癌患者炎症细胞因子单核苷酸多态性 (SNPs) 的相关性。

The cancer anorexia/weight loss syndrome: exploring associations with single nucleotide polymorphisms (SNPs) of inflammatory cytokines in patients with non-small cell lung cancer.

机构信息

Division of Medical Oncology, Mayo Clinic, Rochester, MN 55905, USA.

出版信息

Support Care Cancer. 2010 Oct;18(10):1299-304. doi: 10.1007/s00520-009-0748-6. Epub 2009 Dec 15.

Abstract

OBJECTIVE

The cancer anorexia/weight loss syndrome commonly occurs in patients with non-small cell lung cancer (NSCLC) and is characterized by loss of weight and appetite as well as diminished survival. The current study explored whether any of 22 single nucleotide polymorphisms (SNPs) of certain previously implicated inflammatory cytokines (interleukin-1 beta, interleukin-1RN, interleukin-6, and tumor necrosis factor) are associated with this syndrome.

PATIENTS AND METHODS

All NSCLC patients who had been enrolled in the Mayo Clinic Lung Cancer Cohort, had completed a health-related questionnaire approximately 6 months after enrollment, and had blood drawn were included in this study, thus yielding a sample size of 471 patients.

RESULTS

Sixty-six (14%) patients manifested weight loss shortly after diagnosis, and 152 (32%) reported appetite loss. Only tumor necrosis factor alpha rs800629 was associated with anorexia (odds ratio: 0.46; 95% confidence interval: 0.29, 0.72; p < 0.001); patients who were heterozygous and minor homozygous were less likely to suffer anorexia. Otherwise, there were no statistically significant associations between any of the other 21 SNPs and weight loss and/or anorexia. In univariate analyses, weight loss, anorexia, more advanced cancer stage, and interleukin-1 beta rs1143627 were associated with a worse survival, and interleukin-6 rs2069835 was associated with better survival. However, in multivariate analyses, cancer stage and patient age were the only statistically significant predictors of worse survival.

CONCLUSION

No specific SNP was associated with all aspects of the cancer anorexia/weight loss syndrome, but rs800629 may merit further study in cancer-associated anorexia.

摘要

目的

癌症厌食/体重减轻综合征常见于非小细胞肺癌(NSCLC)患者,其特征是体重和食欲下降以及生存时间缩短。本研究探讨了先前涉及的某些炎症细胞因子(白细胞介素-1β、白细胞介素-1RN、白细胞介素-6 和肿瘤坏死因子)的 22 个单核苷酸多态性(SNP)中是否有任何一个与该综合征有关。

患者和方法

所有已被纳入梅奥诊所肺癌队列的 NSCLC 患者,在入组后大约 6 个月完成了一份健康相关问卷,并且抽取了血液,都包含在这项研究中,因此得出了 471 例患者的样本量。

结果

66 例(14%)患者在诊断后不久出现体重减轻,152 例(32%)报告食欲减退。只有肿瘤坏死因子-α rs800629 与厌食症相关(比值比:0.46;95%置信区间:0.29,0.72;p < 0.001);杂合子和轻度纯合子患者不太可能患厌食症。否则,其他 21 个 SNP 与体重减轻和/或厌食症之间没有统计学上的显著关联。在单变量分析中,体重减轻、厌食症、更晚期的癌症分期和白细胞介素-1β rs1143627 与较差的生存相关,白细胞介素-6 rs2069835 与较好的生存相关。然而,在多变量分析中,癌症分期和患者年龄是与较差生存相关的唯一统计学显著预测因素。

结论

没有特定的 SNP 与癌症厌食/体重减轻综合征的所有方面都有关联,但 rs800629 可能值得进一步研究癌症相关的厌食症。

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