1 Department of Food Sciences and Nutrition, School of Environmental Sciences, Mukogawa Women's University, Nishinomiya, Japan.
2 Department of General Surgery, Takatsuki Hospital, Osaka, Japan.
Nutr Clin Pract. 2017 Oct;32(5):645-651. doi: 10.1177/0884533617724742. Epub 2017 Aug 29.
In recent years, the number of patients with cancer has increased. These patients are prone to sarcopenia as a result of the decrease in muscle mass and muscle weakness that occur in cancer cachexia. Amino Index Cancer Screening is carried out to evaluate cancer cachexia risk by examining amino acid concentration and analyzing amino acid balance.
We conducted a retrospective chart review of consecutive patients with unresectable advanced gastrointestinal cancer (stage IV) receiving chemotherapy treatment (December 2012-September 2015) in an outpatient or in-hospital setting at our institution (N = 46). Data included characteristics, psoas muscle area per computed tomography, and biochemical blood test and serum amino acid profiles. Method 1: Comparison of biomarkers between 2 groups: psoas muscle index change rate (ΔPMI) decrease vs increase. Method 2.1: Correlation between ΔPMI and biomarkers. Method 2.2: Multiple regression of ΔPMI and biomarkers.
EAA/TAA ratio (essential amino acids/total amino acids) in the decrease group was significantly higher than that in the increase group. Among all parameters, serum C-reactive protein (CRP), leucine, and isoleucine were negatively related to ΔPMI (correlation coefficients = -0.604, -0.540, -0.518; P = .004, .011, .016, respectively). On multiple regression analysis, serum CRP value was strongly related to ΔPMI ( r = 0.452, β = -0.672, P = .001).
Higher serum EAA/TAA ratio and CRP were associated with depletion in psoas muscle area, which led to a diagnosis of sarcopenia, in patients with advanced gastrointestinal cancers. These parameters at baseline could be predictors of cancer cachexia.
近年来，癌症患者数量增加。这些患者由于癌症恶病质导致肌肉质量下降和肌肉无力，容易出现肌肉减少症。氨基酸指数癌症筛查通过检查氨基酸浓度和分析氨基酸平衡来评估癌症恶病质的风险。
我们对在我院门诊或住院接受化疗治疗的不可切除晚期胃肠道癌（IV 期）连续患者（2012 年 12 月至 2015 年 9 月）进行了回顾性图表审查（N = 46）。数据包括特征、CT 检查的腰大肌面积和生化血液检查及血清氨基酸谱。方法 1：两组标志物比较：腰大肌指数变化率（ΔPMI）下降与增加。方法 2.1：ΔPMI 与标志物的相关性。方法 2.2：ΔPMI 和标志物的多元回归。
下降组的 EAA/TAA 比值（必需氨基酸/总氨基酸）显著高于增加组。在所有参数中，血清 C 反应蛋白（CRP）、亮氨酸和异亮氨酸与 ΔPMI 呈负相关（相关系数分别为-0.604、-0.540、-0.518；P 值分别为 0.004、0.011、0.016）。多元回归分析显示，血清 CRP 值与 ΔPMI 密切相关（r = 0.452，β = -0.672，P = 0.001）。
较高的血清 EAA/TAA 比值和 CRP 与晚期胃肠道癌患者腰大肌面积减少相关，导致肌肉减少症的诊断。这些基线参数可能是癌症恶病质的预测指标。
