a Department of Palliative Medicine , National Cancer Center Hospital East , Kashiwa , Japan.
b bDivision of Biomarker Discovery, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Kashiwa, Japan.
Nutr Cancer. 2018 Nov-Dec;70(8):1283-1289. doi: 10.1080/01635581.2018.1557213. Epub 2019 Jan 20.
Although transthyretin (TTR) is a nutritional indicator and is influenced by systemic inflammation, it may be a good prognostic indicator for cancer patients in palliative care settings. This study investigates the correlation between low TTR levels and survival among cancer patients in palliative care settings.
This was a sub-analysis of a prospective, multicenter cohort study. Patients who had advanced-stage cancer and who were newly referred to palliative care services were eligible to participate; however, those receiving anti-tumor therapy were excluded. Survival analyses were performed to clarify predictors of poor prognosis.
A total of 144 patients were enrolled (45.1% female; median age, 72 years). Cox regression analysis revealed that low TTR levels (<10.9 mg/l) (hazard ratio 1.74, P = 0.025), poor muscle power (1.71, P = 0.045), and fatigue (1.89, P = 0.024) were predictors of poor prognosis. Median survival in patients with low TTR levels (<10.9 mg/l) was 26 days, which was significantly shorter than those with high TTR levels (≥10.9 mg/l) (50 days; P < 0.001).
Low TTR levels may be indicators for poor prognosis among cancer patients in palliative care settings.
尽管转甲状腺素（TTR）是一种营养指标，并且受全身炎症的影响，但它可能是姑息治疗环境中癌症患者的良好预后指标。本研究调查了姑息治疗环境中癌症患者低 TTR 水平与生存之间的相关性。
这是一项前瞻性、多中心队列研究的亚分析。有晚期癌症且新转诊至姑息治疗服务的患者有资格参加；然而，正在接受抗肿瘤治疗的患者被排除在外。进行生存分析以阐明预后不良的预测因素。
共纳入 144 名患者（45.1%为女性；中位年龄为 72 岁）。Cox 回归分析显示，低 TTR 水平（<10.9mg/l）（危险比 1.74，P=0.025）、肌肉力量差（1.71，P=0.045）和疲劳（1.89，P=0.024）是预后不良的预测因素。TTR 水平低（<10.9mg/l）的患者中位生存时间为 26 天，明显短于 TTR 水平高（≥10.9mg/l）的患者（50 天；P<0.001）。
低 TTR 水平可能是姑息治疗环境中癌症患者预后不良的指标。
