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癌症中营养状况的临床价值:其影响是什么以及如何影响疾病进展和预后?

Clinical Value of Nutritional Status in Cancer: What is its Impact and how it Affects Disease Progression and Prognosis?

作者信息

Mantzorou Maria, Koutelidakis Antonios, Theocharis Stamatios, Giaginis Constantinos

机构信息

a Department of Food Science and Nutrition , University of the Aegean , Lemnos , Greece.

b First Department of Pathology , Medical School, University of Athens , Athens , Greece.

出版信息

Nutr Cancer. 2017 Nov-Dec;69(8):1151-1176. doi: 10.1080/01635581.2017.1367947. Epub 2017 Oct 30.

Abstract

Malnutrition is a common finding in cancer patients, which can affect disease progression and survival. This review aims to critically summarize the prognostic role of nutritional status, from Body Mass Index (BMI) and weight loss to nutrition screening tools and biochemical indices, in cancer patients. According to the currently available data, Prognostic Nutritional Index (PNI) was a significant prognostic factor of patients' survival, both in univariate and multivariate analyses. Pre-operative albumin was also correlated with worse outcomes, being an independent prognostic factor of survival in several studies. BMI was also well-studied, with contradictory results. Although, lower BMI was found to be an independent prognostic factor of shorter survival in some studies, in others it did not have an impact on survival. In this aspect, this review highlights the significant prognostic role of nutritional status in the disease progression and survival of cancer patients. Further, good-quality prospective studies are needed in order to draw precise conclusions on the prognostic role of specific nutritional assessment tools, and biochemical indices associated with the nutritional status in more cancer types, such as liver, breast and prostate cancer, and hematological malignancies.

摘要

营养不良是癌症患者的常见表现,它会影响疾病进展和生存。本综述旨在批判性地总结营养状况在癌症患者中的预后作用,包括体重指数(BMI)、体重减轻、营养筛查工具和生化指标等方面。根据现有数据,在单因素和多因素分析中,预后营养指数(PNI)都是患者生存的重要预后因素。术前白蛋白水平也与较差的预后相关,在多项研究中是生存的独立预后因素。BMI也得到了充分研究,但结果相互矛盾。虽然在一些研究中发现较低的BMI是生存时间较短的独立预后因素,但在其他研究中它对生存没有影响。在这方面,本综述强调了营养状况在癌症患者疾病进展和生存中的重要预后作用。此外,需要高质量的前瞻性研究,以便就特定营养评估工具以及与更多癌症类型(如肝癌、乳腺癌和前列腺癌以及血液系统恶性肿瘤)营养状况相关的生化指标的预后作用得出精确结论。

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