Division of Endocrinology, Diabetes and Clinical Nutrition, Department of General Internal Medicine, Bern University Hospital, 3010 Bern, Switzerland.
Support Care Cancer. 2010 May;18 Suppl 2:S17-27. doi: 10.1007/s00520-009-0805-1. Epub 2010 Jan 20.
Malnutrition is a common and under-recognized problem in cancer patients. It has been correlated to a large number of physical, psychological, and clinically relevant adverse effects in oncology patients, including impaired tolerance to anticancer therapy, adverse reactions, and reduced quality of life. Consequently, tailored strategies to identify patients at nutritional risk are essential to implement nutritional support effectively and to reduce cancer morbidity.
A screening tool should be an easy, standardized, rapid, noninvasive, and cost-effective diagnostic tool to identify cancer patients at nutritional risk in daily clinical practice. If patients at risk for malnutrition are identified early, many cases may be treated or prevented, with beneficial effects on patient outcome and subsequent reductions of health care costs.
This article discusses the Malnutrition Universal Screening Tool, the Nutritional Risk Screening, the Mini Nutritional Assessment--Short Form, the scored Patient-Generated Subjective Global Assessment (PG-SGA), and the Malnutrition Screening Tool (MST) in an oncology setting.
Clinical institutions should implement an appropriate and validated screening tool and assessment protocol, which should contain an action plan. To date, the MST and the PG-SGA are the best validated screening tools for use in oncology patients. The PG-SGA is an assessment tool with screening components, whereas the MST is a pure screening tool and, therefore, quick and easy to use for trained as well as untrained staff. Further validation of all nutrition screening tools is needed, as well as further research to evaluate the benefits of nutrition screening and support with regard to outcomes.
营养不良是癌症患者中常见且未被充分认识的问题。它与肿瘤患者大量的身体、心理和临床相关的不良影响相关，包括对癌症治疗的耐受性降低、不良反应和生活质量下降。因此，制定针对特定患者的营养风险识别策略对于有效实施营养支持和降低癌症发病率至关重要。
筛查工具应该是一种简便、标准化、快速、非侵入性且具有成本效益的诊断工具，用于在日常临床实践中识别有营养风险的癌症患者。如果能够早期识别出有营养不良风险的患者，许多病例可能得到治疗或预防，从而对患者的预后产生有益影响，并随后降低医疗保健成本。
本文讨论了营养不良通用筛查工具、营养风险筛查、迷你营养评估-简短形式、评分患者主观整体评估（PG-SGA）以及肿瘤患者中使用的营养不良筛查工具（MST）。
临床机构应实施适当且经过验证的筛查工具和评估方案，其中应包含行动计划。迄今为止，MST 和 PG-SGA 是肿瘤患者中经过最佳验证的筛查工具。PG-SGA 是一种具有筛查成分的评估工具，而 MST 是一种纯筛查工具，因此对于经过培训和未经培训的人员来说，使用起来既快速又简单。需要进一步验证所有营养筛查工具，并进一步研究评估营养筛查和支持对结局的益处。
