Gee Caroline, Fleuret Catherine, Wilson Ana, Levine Daniel, Elhusseiny Ramy, Muls Ann, Cunningham David, Kohoutova Darina
The Royal Marsden Hospital NHS Foundation Trust, Fulham Road, Chelsea, London SW3 6JJ, UK.
St Marks Hospital, Watford Road, Harrow, Middlesex, London HA1 3UJ, UK.
Cancers (Basel). 2021 Dec 10;13(24):6213. doi: 10.3390/cancers13246213.
The aim was to establish prevalence of bile acid malabsorption (BAM) and management in patients who underwent treatment for malignancy. Retrospective evaluation of data in patients seen within six months (August 2019-January 2020) was carried out. Demographic, nuclear medicine (Selenium Homocholic Acid Taurine (SeHCAT) scan result), clinical (previous malignancy, type of intervention (medication, diet), response to intervention) and laboratory (vitamin D, vitamin B12 serum levels) data were searched. In total, 265 consecutive patients were reviewed. Out of those, 87/265 (33%) patients (57 females, 66%) were diagnosed with BAM. Mean age was 59 +/- 12 years. The largest group were females with gynaecological cancer (35), followed by haematology group (15), colorectal/anal (13), prostate (9), upper gastrointestinal cancer (6), another previous malignancy (9). Severe BAM was most common in haematology (10/15; 67%) and gynaecological group (21/35; 60%). Medication and low-fat diet were commenced in 65/87 (75%), medication in 10/87 (11%), diet in 6/87 (7%). Colesevelam was used in 71/75 (95%). Symptoms improved in 74/87 (85%) patients. Vitamin D insufficiency/deficiency was diagnosed in 62/87 (71%), vitamin B12 deficiency in 39/87 (45%). BAM is a common condition in this cohort however treatments are highly effective.
目的是确定接受恶性肿瘤治疗的患者胆汁酸吸收不良（BAM）的患病率及管理情况。对2019年8月至2020年1月六个月内就诊患者的数据进行回顾性评估。检索了人口统计学、核医学（硒同型胆酸牛磺酸（SeHCAT）扫描结果）、临床（既往恶性肿瘤、干预类型（药物、饮食）、对干预的反应）和实验室（维生素D、维生素B12血清水平）数据。总共对265例连续患者进行了评估。其中，87/265（33%）例患者（57名女性，占66%）被诊断为BAM。平均年龄为59±12岁。最大的一组是患有妇科癌症的女性（35例），其次是血液学组（15例）、结直肠/肛门组（13例）、前列腺组（9例）、上消化道癌症组（6例）、其他既往恶性肿瘤组（9例）。严重BAM在血液学组（10/15；67%）和妇科组（21/35；60%）中最为常见。65/87（75%）例患者开始使用药物和低脂饮食，10/87（11%）例患者仅使用药物，6/87（7%）例患者仅采用饮食调整。75例患者中有71例（95%）使用了考来维仑。74/87（85%）例患者症状改善。62/87（71%）例患者被诊断为维生素D不足/缺乏，39/87（45%）例患者被诊断为维生素B12缺乏。BAM在该队列中是一种常见疾病，但治疗效果显著。
