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越南食管癌患者的营养评估及其与体能和格拉斯哥预后评分的关系。

Nutrition assessment and its relationship with performance and Glasgow prognostic scores in Vietnamese patients with esophageal cancer.

作者信息

Quyen Tran Chau, Angkatavanich Jongjit, Thuan Tran Van, Xuan Vo Van, Tuyen Le Danh, Tu Do Anh

机构信息

Department of Nutrition and Dietetics, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand.

National Institute of Nutrition, Hanoi, Vietnam.

出版信息

Asia Pac J Clin Nutr. 2017 Jan;26(1):49-58. doi: 10.6133/apjcn.122015.02.

Abstract

BACKGROUND AND OBJECTIVES

To determine the nutritional status of patients with esophageal cancer, and to investigate its relationship with performance status and prognosis.

METHODS AND STUDY DESIGN

This clinical, cross-sectional study was conducted from August 2014 to February 2015 at National Cancer Hospital, Hanoi, Vietnam. Stage III/IV esophageal cancer patients were assessed for their nutritional status (patient-generated subjective global assessment (PG-SGA) and SGA scores, BMI, mid-arm circumference (MAC), energy and protein intakes, weight changes, Karnofsky and Eastern cooperative oncology group performance scores (KPS/ECOG), and Glasgow prognostic score (GPS).

RESULTS

Sixty-four male patients were enrolled. The mean ± standard deviation of PG-SGA score was 9.88±4.41. SGA revealed 44% as class B and 6.2% as class C. The BMI revealed 43.8% of patients were underweight. MAC measurement revealed 29.7% of undernourished patients. Patients with an energy intake <25 kcal/kg/d comprised 54.7%, and 48.4% with <1 g/kg/day of protein. Totally, 68.8%, 84.4% and 92.2% patients exhibited weight loss past 2-weeks, one-month and six-months, respectively. The PG-SGA and SGA strongly correlated with the KPS (r=-0.717 and 0.632, both p<0.001) and ECOG (r=0.672 and 0.626, both p<0.001), but were weakly correlated with the GPS (r=0.332 and 0.278, p<0.01 and 0.05). The KPS, ECOG, BMI, MAC, energy and protein intakes, and weight change were not correlated with the GPS.

CONCLUSIONS

Malnutrition, weight change, and insufficient intake were noteworthy in esophageal cancer patients. The PG-SGA and SGA were strongly correlated with the performance status, but weakly correlated with prognostic indices.

摘要

背景与目的

确定食管癌患者的营养状况,并研究其与体能状态和预后的关系。

方法与研究设计

这项临床横断面研究于2014年8月至2015年2月在越南河内国家癌症医院进行。对III/IV期食管癌患者的营养状况进行评估(患者主观整体评定法(PG-SGA)和主观全面评定法(SGA)评分、体重指数(BMI)、上臂中部周长(MAC)、能量和蛋白质摄入量、体重变化、卡诺夫斯基评分和东部肿瘤协作组体能状态评分(KPS/ECOG)以及格拉斯哥预后评分(GPS))。

结果

纳入64例男性患者。PG-SGA评分的平均值±标准差为9.88±4.41。SGA显示44%为B级,6.2%为C级。BMI显示43.8%的患者体重过轻。MAC测量显示29.7%的患者营养不良。能量摄入量<25千卡/千克/天的患者占54.7%,蛋白质摄入量<1克/千克/天的患者占48.4%。在过去2周、1个月和6个月时,分别有68.8%、84.4%和92.2%的患者体重减轻。PG-SGA和SGA与KPS(r=-0.717和0.632,均p<0.001)和ECOG(r=0.672和0.626,均p<0.001)密切相关,但与GPS弱相关(r=0.332和0.278,p<0.01和0.05)。KPS、ECOG、BMI、MAC、能量和蛋白质摄入量以及体重变化与GPS均无相关性。

结论

食管癌患者存在营养不良、体重变化和摄入不足的情况值得关注。PG-SGA和SGA与体能状态密切相关,但与预后指标弱相关。

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