Witvliet-van Nierop J E, Lochtenberg-Potjes C M, Wierdsma N J, Scheffer H J, Kazemier G, Ottens-Oussoren K, Meijerink M R, de van der Schueren M A E
Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center, Amsterdam, Netherlands.
Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, Netherlands.
Gastroenterol Res Pract. 2017;2017:6193765. doi: 10.1155/2017/6193765. Epub 2017 Aug 20.
To provide a comprehensive quantitative assessment of nutritional status, digestion and absorption, and quality of life (QoL) in patients with locally advanced pancreatic cancer (LAPC).
Sixteen patients with LAPC were prospectively assessed for weight loss (WL), body mass index (BMI), fat-free mass index (FFMI), handgrip strength (HGS), dietary macronutrient intake, serum vitamin levels, resting and total energy expenditure (REE and TEE, indirect calorimetry), intestinal absorption capacity and fecal losses (bomb calorimetry), exocrine pancreatic function (fecal elastase-1 (FE1)), and gastrointestinal quality of life (GIQLI).
Two patients had a low BMI, 10 patients had WL > 10%/6 months, 8 patients had a FFMI < P10, and 8 patients had a HGS < P10. Measured REE was 33% higher ( = 0.002) than predicted REE. TEE was significantly higher than daily energy intake ( = 0.047). Malabsorption (<85%) of energy, fat, protein, and carbohydrates was observed in, respectively, 9, 8, 12, and 10 patients. FE1 levels were low (<200 g/g) in 13 patients. Total QoL scored 71% (ample satisfactory).
Patients with LAPC have a severely impaired nutritional status, most likely as a result of an increased REE and malabsorption due to exocrine pancreatic insufficiency. The trial is registered with PANFIRE clinicaltrials.gov NCT01939665.
对局部晚期胰腺癌（LAPC）患者的营养状况、消化吸收及生活质量（QoL）进行全面定量评估。
前瞻性评估16例LAPC患者的体重减轻（WL）、体重指数（BMI）、去脂体重指数（FFMI）、握力（HGS）、膳食常量营养素摄入量、血清维生素水平、静息和总能量消耗（REE和TEE，间接测热法）、肠道吸收能力和粪便损失（弹式量热法）、胰腺外分泌功能（粪便弹性蛋白酶-1（FE1））以及胃肠道生活质量（GIQLI）。
2例患者BMI较低，10例患者WL>10%/6个月，8例患者FFMI<P10，8例患者HGS<P10。测得的REE比预测的REE高33%（P = 0.002）。TEE显著高于每日能量摄入量（P = 0.047）。分别在9例、8例、12例和10例患者中观察到能量、脂肪、蛋白质和碳水化合物的吸收不良（<85%）。13例患者的FE1水平较低（<200μg/g）。总生活质量评分为71%（相当满意）。
LAPC患者营养状况严重受损，很可能是由于REE增加和胰腺外分泌功能不全导致的吸收不良所致。该试验已在PANFIRE clinicaltrials.gov上注册，注册号为NCT01939665。
