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评估营养和炎症状态以确定结直肠癌手术患者中营养不良的患病率。

Assessment of Nutritional and Inflammatory Status to Determine the Prevalence of Malnutrition in Patients Undergoing Surgery for Colorectal Carcinoma.

作者信息

Daniele Antonella, Divella Rosa, Abbate Ines, Casamassima Addolorata, Garrisi Vito Michele, Savino Eufemia, Casamassima Porzia, Ruggieri Eustachio, DE Luca Raffaele

机构信息

National Cancer Research Centre, Istituto Tumori "Giovanni Paolo II", Bari, Italy

National Cancer Research Centre, Istituto Tumori "Giovanni Paolo II", Bari, Italy.

出版信息

Anticancer Res. 2017 Mar;37(3):1281-1287. doi: 10.21873/anticanres.11445.

Abstract

BACKGROUND/AIM: Colorectal Cancer is the fourth most frequent cause of cancer death worldwide and its incidence increases from 50 years of age. It is often associated with protein-caloric malnutrition and 20% of cancer deaths occur due to this event. The aim of this study was to assess the prevalence of malnutrition and inflammatory status in 78 patients undergoing surgery for colorectal carcinoma.

PATIENTS AND METHODS

Nutritional Status was assessed by Mini Nutritional Assessment (MNA). Serum levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were measured by ELISA, while albumin, C-reactive protein (CRP) and transferrin (TRF) were tested using an immunometric assay.

RESULTS

The mean MNA score in colorectal patients was 20.4±8.4, while 23/78 patients (29.4%) were well nourished, 36/78 (46.1%) were at risk of malnutrition and 19/78 (24.3%) were malnourished, reporting in the previous six months from the date of diagnosis a significant weight loss (>10 kg), muscle mass loss and severe reduction of food intake due to loss of appetite and altered taste perception. The serum means of IL-6, TNF-α and CRP, were significantly higher in colorectal patients compared to the control group (p<0.001, p<0.0001, p<0.0001, respectively) while lower TRF, albumin and HCT serum levels in cancer patients vs. healthy subjects (p<0.0001; p<0.0001 and p<0.0001) were found.

CONCLUSION

more than 50% of colorectal cancer patients were malnourished or at risk of malnutrition and reported an imbalance between nutritional and inflammatory status. They, therefore, require a nutritional intervention before treatment in order to have a more effective response and improve quality of life.

摘要

背景/目的:结直肠癌是全球第四大常见癌症死因,其发病率从50岁起开始上升。它常与蛋白质 - 热量营养不良相关,20%的癌症死亡归因于此。本研究旨在评估78例接受结直肠癌手术患者的营养不良患病率和炎症状态。

患者与方法

通过微型营养评定法(MNA)评估营养状况。采用酶联免疫吸附测定法(ELISA)检测血清白细胞介素 - 6(IL - 6)和肿瘤坏死因子 - α(TNF - α)水平,同时使用免疫比浊法检测白蛋白、C反应蛋白(CRP)和转铁蛋白(TRF)。

结果

结直肠癌患者的平均MNA评分为20.4±8.4,其中23/78例患者(29.4%)营养良好,36/78例(46.1%)存在营养不良风险,19/78例(24.3%)营养不良,自诊断之日起的前六个月内体重显著下降(>10kg)、肌肉量减少且因食欲不振和味觉改变导致食物摄入量严重减少。与对照组相比,结直肠癌患者的血清IL - 6、TNF - α和CRP均值显著更高(分别为p<0.001、p<0.0001、p<0.0001),而癌症患者的TRF、白蛋白和血细胞比容(HCT)血清水平低于健康受试者(p<0.0001;p<0.0001和p<0.0001)。

结论

超过50%的结直肠癌患者营养不良或有营养不良风险,且营养与炎症状态失衡。因此,他们在治疗前需要进行营养干预,以便获得更有效的反应并改善生活质量。

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