Department of Surgery, Ystad Hospital, VO Kirurgi, Lasarettet i Ystad, Kristianstadvägen 3, 271 33, Ystad, Sweden.
Institution of Clinical Sciences, Lund University, Lund, Sweden.
World J Surg. 2021 Sep;45(9):2793-2803. doi: 10.1007/s00268-021-06146-9. Epub 2021 May 9.
Patients with midgut neuroendocrine tumours (NETs) suffer from decreased health-related quality of life (HRQoL), in large part due to bowel symptoms. However, it is unknown which bowel symptoms affect HRQoL the most. An enhanced understanding of this is essential to better focus treatment on this aspect of the disease. This study aimed to determine which bowel symptoms affect HRQoL the most in patients with midgut NETs.
Consenting patients with midgut NET completed the Memorial Sloan Kettering Bowel Function Instrument and the HRQoL questionnaire (EORTC QLQ-C30). The correlation between bowel symptoms and HRQoL was analysed using multiple linear regression, adjusting for age, Charlson Comorbidity Index score, presence of metastatic disease, chromogranin A, and BMI yielding ß-coefficients with 95% confidence intervals.
Totally, 119 patients with midgut NET completed the questionnaires and were included in the study. Loose stool and bowel frequency ≥ 3/day were the most common bowel symptoms, reported by 47% and 56% of patients, respectively. However, sensitivity to certain types of food and beverages, a feeling of incomplete emptying of the bowel, and soiling were the symptoms most strongly correlated with decreased HRQoL, especially within domains concerning role and social function, with ß-coefficients for the strongest correlated symptoms of 15.0 and 14.6, respectively.
While symptoms concerning stool consistency and frequency are common in patients with midgut NET, our study suggests that other, more socially stigmatising symptoms affect patients' HRQoL more. Our findings could help caregivers understand patients' perceptions of the disease and provide avenues for more directed therapies.
患有中肠神经内分泌肿瘤（NET）的患者生活质量相关健康状况（HRQoL）下降，在很大程度上是由于肠道症状。然而，尚不清楚哪些肠道症状对 HRQoL 的影响最大。深入了解这一点对于更好地关注疾病的这一方面至关重要。本研究旨在确定中肠 NET 患者中哪些肠道症状对 HRQoL 的影响最大。
同意参加的中肠 NET 患者完成了纪念斯隆凯特琳肠道功能量表和 HRQoL 问卷（EORTC QLQ-C30）。使用多元线性回归分析肠道症状与 HRQoL 之间的相关性，调整年龄、Charlson 合并症指数评分、转移性疾病的存在、嗜铬粒蛋白 A 和 BMI，得出具有 95%置信区间的β系数。
共有 119 名中肠 NET 患者完成了问卷调查并被纳入研究。稀便和每天排便≥3 次是最常见的肠道症状，分别有 47%和 56%的患者报告。然而，对某些类型的食物和饮料敏感、感觉肠道排空不完全和弄脏是与 HRQoL 下降最相关的症状，尤其是在角色和社会功能方面，相关性最强的症状的β系数分别为 15.0 和 14.6。
虽然中肠 NET 患者的粪便稠度和频率相关症状常见，但我们的研究表明，其他更具社会污名化的症状对患者的 HRQoL 影响更大。我们的研究结果可以帮助护理人员了解患者对疾病的看法，并为更有针对性的治疗提供途径。
