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炎症和激素在伴有恶病质的转移性癌症患者中的预后作用。

The prognostic role of inflammation and hormones in patients with metastatic cancer with cachexia.

作者信息

Bilir Cemil, Engin Huseyin, Can Murat, Temi Yasemin Bakkal, Demirtas Derya

机构信息

Division of Medical Oncology, Department of Internal Medicine, Bulent Ecevit University School of Medicine, Sultan Orhan Mh 1145 sk No:14, Zonguldak, Turkiye,

出版信息

Med Oncol. 2015 Mar;32(3):56. doi: 10.1007/s12032-015-0497-y. Epub 2015 Feb 1.

Abstract

We wanted to investigate the possible etiologic factors of cachexia. Forty-six patients diagnosed with cancer cachexia and 34 healthy controls were included in the study. Serum total testosterone, free testosterone, interleukin 1 (IL) alpha and beta, IL6, tumor necrosis factor (TNF) alpha, orexin, galanin, neuropeptide Y, tumor necrosis factor-like weak inducer of apoptosis and tumor necrosis factor receptor-associated factor 6, and C-reactive protein (CRP) levels were investigated. There were 36 male and 10 female patients in the cachexia group, and 24 male and 10 female patients in the control group. Median overall survival (OS) of the cachexia group after the diagnosis of cachexia was 8 (1-25) months. There were statistically significant relationships between OS and BMI, serum CRP, TRAF-6, albumin, and LDH levels in the cachexia group. In addition to cachexia, serum CRP, testosterone, and TNF alpha levels were statistically significantly correlated with OS in refractory cachexia. TRAF-6 levels was significantly correlated with type of cancer (P = 0.02). Although cachexia presents with a multifactorial ethio-pathogenesis, few of them affect the OS. Our novel results were that serum CRP, albumin, LDH, and TRAF-6 levels have a higher association with OS in patients with cancer cachexia compared to the many other parameters. An ongoing cachexia also called refractory cachexia is a recent definition. This end-stage term of cancer duration may be predicted by decreasing serum testosterone and increasing serum TNF alpha levels, as well as serum CRP levels.

摘要

我们想要研究恶病质可能的病因。本研究纳入了46例被诊断为癌症恶病质的患者和34名健康对照者。检测了血清总睾酮、游离睾酮、白细胞介素1(IL)α和β、IL6、肿瘤坏死因子(TNF)α、食欲素、甘丙肽、神经肽Y、肿瘤坏死因子样凋亡弱诱导剂、肿瘤坏死因子受体相关因子6以及C反应蛋白(CRP)水平。恶病质组有36例男性和10例女性患者,对照组有24例男性和10例女性患者。恶病质组在诊断恶病质后的中位总生存期(OS)为8(1 - 25)个月。恶病质组的OS与BMI、血清CRP、TRAF - 6、白蛋白和乳酸脱氢酶(LDH)水平之间存在统计学显著相关性。除恶病质外难治性恶病质患者的血清CRP、睾酮和TNFα水平与OS在统计学上显著相关。TRAF - 6水平与癌症类型显著相关(P = 0.02)。尽管恶病质呈现多因素病因发病机制,但其中很少因素影响OS。我们的新结果是,与许多其他参数相比,癌症恶病质患者的血清CRP、白蛋白、LDH和TRAF - 6水平与OS的关联更高。一种持续存在的恶病质也称为难治性恶病质是最近的定义。癌症病程的这个终末期可能通过血清睾酮降低、血清TNFα水平升高以及血清CRP水平升高来预测。

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