Universidad Tecnológica de México, Ciudad de México, México.
Clinical Nutrition Unit, Hospital General de México "Dr. Eduardo Liceaga", México.
Nutr Cancer. 2022;74(1):82-89. doi: 10.1080/01635581.2020.1869792. Epub 2021 Jan 16.
The aim of the study was to determine the prevalence of cancer cachexia according to the clinical stage and determine differences in body composition, usual energy intake, and pro-inflammatory profile between cachectic and non-cachectic patients newly diagnosed with head and neck squamous cell carcinoma (HNSCC). A cross-sectional study was conducted in adult patients diagnosed with HNSCC admitted to the oncology unit before starting cancer treatment. Cancer cachexia was assessed according to Fearon criteria, and patients were divided into two groups: cachectic and non-cachectic patients. Body composition measured by bioelectrical impedance, energy intake, and biochemical and inflammatory markers were assessed. Comparative analyses were performed Student's-T test, using one-way ANOVA, chi-square and Mann Whitney-U test. Of the 79 consecutive patients included in the analysis, 72% ( = 57; 61 ± 15 years) were classified as cachectic and 28% ( = 22;59 ± 10 years) as non-cachectic. According to clinical stage, the prevalence of cachexia was stage I = 8.8%, stage II = 15.8%, stage III = 33.3% and stage IV = 42.1% ( = 0.564) and phase angle showed to be different between these groups ( < 0.05). Body composition showed that fat-free mass and total body water were significantly lower in patients with cachexia ( < 0.05). No differences were observed in phase angle, food intake or inflammatory markers between cachectic and non-cachectic patients. Cancer-cachexia is prevalent in all clinical stages in newly diagnosed patients with HNSCC. Early identification of cancer cachexia will allow initiate specialized nutrition support in a timely manner.
本研究旨在根据临床分期确定癌症恶病质的患病率,并确定新诊断为头颈部鳞状细胞癌(HNSCC)的恶病质和非恶病质患者之间的身体成分、通常能量摄入和促炎特征的差异。对在开始癌症治疗前入住肿瘤病房的成年 HNSCC 患者进行了横断面研究。根据 Fearon 标准评估癌症恶病质,将患者分为两组:恶病质患者和非恶病质患者。通过生物电阻抗法测量身体成分、能量摄入以及生化和炎症标志物。采用 Student's-T 检验、单因素方差分析、卡方检验和 Mann Whitney-U 检验进行比较分析。在纳入分析的 79 例连续患者中,72%( = 57;61±15 岁)被归类为恶病质患者,28%( = 22;59±10 岁)为非恶病质患者。根据临床分期,恶病质的患病率为 I 期 = 8.8%、II 期 = 15.8%、III 期 = 33.3%和 IV 期 = 42.1%( = 0.564),并且这些组之间的相位角存在差异( < 0.05)。身体成分显示,恶病质患者的去脂体重和总体水量明显较低( < 0.05)。恶病质和非恶病质患者之间在相位角、食物摄入量或炎症标志物方面没有差异。癌症恶病质在新诊断的 HNSCC 患者的所有临床分期中均很常见。早期识别癌症恶病质将能够及时启动专门的营养支持。