Li Na, Lu Jiajia, Xia Duanxiang, Jiang Xuetong, Wen Xiaomeng, Qin Xia, Chen Ying, Wang Teng
Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi, China.
Wuxi Medical College, Jiangnan University, Wuxi, China.
J Gastrointest Oncol. 2022 Feb;13(1):197-209. doi: 10.21037/jgo-21-904.
Due to individual heterogeneity, patients at the same stage of colorectal cancer (CRC) who receive the same chemotherapy may experience different symptom clusters. Identifying the precise factors that predict symptom clusters is of great clinical significance for precision care and for improving the quality of life of patients. The present study investigated the relationship between serum biomarkers and adjuvant chemotherapy-related symptom clusters in radically resected CRC patients.
Serum biomarkers and clinical/pathological characteristics of the radical resected CRC patients were collected before the first cycle of adjuvant chemotherapy. A demographic questionnaire and M.D. Anderson Gastrointestinal Cancer Symptom Scale (MDASI-GI) were performed on the third day after chemotherapy and exploratory factor analysis was performed to determine the symptoms clusters. Multiple linear regression and correlation analysis were also performed to evaluate the correlation between serum biomarkers and chemotherapy-related symptom clusters.
A total of 4 chemotherapy-related symptom clusters were determined in the enrolled radical resected CRC patients, including a fatigue-psychological symptom cluster, gastrointestinal symptom cluster, neurotoxic symptom cluster, and constipation-abdominal distension symptom cluster. Further analysis showed that the gastrointestinal symptom cluster was significantly associated with age, gender, weight change status, neutrophil to lymphocyte ratio (NLR), and body mass index (BMI). Additionally, the fatigue-psychological symptom cluster was found to be significantly associated with high NLR. The neurotoxic symptom cluster was found to be significantly associated with low hemoglobin level.
Serum biomarkers and clinical characteristics of the radical resected CRC patients could be used to predict chemotherapy-related symptoms clusters.
由于个体异质性，处于相同阶段的结直肠癌（CRC）患者接受相同化疗时可能会出现不同的症状群。确定预测症状群的精确因素对于精准医疗和提高患者生活质量具有重要的临床意义。本研究调查了根治性切除的CRC患者血清生物标志物与辅助化疗相关症状群之间的关系。
在辅助化疗的第一个周期之前，收集根治性切除的CRC患者的血清生物标志物以及临床/病理特征。在化疗后第三天进行人口统计学调查问卷和MD安德森胃肠癌症状量表（MDASI-GI）调查，并进行探索性因素分析以确定症状群。还进行了多元线性回归和相关性分析，以评估血清生物标志物与化疗相关症状群之间的相关性。
在纳入的根治性切除的CRC患者中总共确定了4个化疗相关症状群，包括疲劳-心理症状群、胃肠道症状群、神经毒性症状群和便秘-腹胀症状群。进一步分析表明，胃肠道症状群与年龄、性别、体重变化状态、中性粒细胞与淋巴细胞比率（NLR）和体重指数（BMI）显著相关。此外，发现疲劳-心理症状群与高NLR显著相关。发现神经毒性症状群与低血红蛋白水平显著相关。
根治性切除的CRC患者的血清生物标志物和临床特征可用于预测化疗相关症状群。
