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胃癌患者早期营养筛查的重要性。

Importance of early nutritional screening in patients with gastric cancer.

机构信息

Clinical Nutrition Unit, National Cancer Institute, Via Venezian 1, 20133 Milan, Italy.

出版信息

Br J Nutr. 2011 Dec;106(12):1773-8. doi: 10.1017/S0007114511002509. Epub 2011 Jun 17.

Abstract

In the present study, we evaluated the relationship between nutritional status, disease stage and quality of life (QoL) in 100 patients recently diagnosed with gastric carcinoma. The patients' nutritional status was investigated with anthropometric, biochemical, inflammatory and functional variables; and we also evaluated the nutritional risk with the Nutritional Risk Screening 2002. Oncological staging was standard. QoL was evaluated using the Functional Assessment of Anorexia/Cachexia Therapy questionnaire. The statistical correlation between nutritional risk score (NRS) and oncological characteristics or QoL was evaluated using both univariable and multivariable analyses. Weight loss and reduction of food intake were the most frequent pathological nutritional indicators, while biochemical, inflammatory and functional variables were in the normal range. According to NRS, thirty-six patients were malnourished or at risk for malnutrition. Patients with NRS ≥ 3 presented a significantly greater percentage of stage IV gastric cancer and pathological values of C-reactive protein, while no correlation was found with the site of tumour. NRS was negatively associated with QoL (P < 0·001) and this relation was independent from oncological and inflammatory variables as confirmed by multivariable analysis. In the present study, we found that in patients with gastric cancer malnutrition is frequent at diagnosis and this is likely due to reduction in food intake. Moreover, NRS is directly correlated with tumour stage and inversely correlated with QoL, which makes it a useful tool to identify patients in need of an early nutritional intervention during oncological treatments.

摘要

在本研究中,我们评估了 100 例近期诊断为胃癌患者的营养状况、疾病分期与生活质量(QoL)之间的关系。通过人体测量学、生化、炎症和功能变量评估患者的营养状况;我们还使用 2002 年营养风险筛查(Nutritional Risk Screening 2002,NRS)评估营养风险。采用标准的肿瘤分期方法。使用厌食/恶病质治疗的功能评估问卷(Functional Assessment of Anorexia/Cachexia Therapy questionnaire)评估 QoL。使用单变量和多变量分析评估 NRS 与肿瘤特征或 QoL 之间的统计相关性。体重减轻和食物摄入量减少是最常见的病理性营养指标,而生化、炎症和功能变量均处于正常范围。根据 NRS,36 例患者存在营养不良或存在营养不良风险。NRS≥3 的患者Ⅳ期胃癌和 C 反应蛋白的病理值显著更高,而与肿瘤部位无关。NRS 与 QoL 呈负相关(P<0·001),多变量分析证实这种关系独立于肿瘤和炎症变量。在本研究中,我们发现胃癌患者在诊断时经常存在营养不良,这可能是由于食物摄入量减少所致。此外,NRS 与肿瘤分期直接相关,与 QoL 呈负相关,这使其成为一种有用的工具,可以识别在肿瘤治疗期间需要早期营养干预的患者。

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