Medical Oncology Unit, Umberto I Hospital, Enna, Italy.
Clinical Pathology Unit, Michele Chiello Hospital, Enna, Italy.
Anticancer Res. 2023 Jun;43(6):2821-2829. doi: 10.21873/anticanres.16451.
BACKGROUND/AIM: Chronic inflammation and cytokine storm can cause uncontrolled events in cancer. Pro-inflammatory molecules released by malignant cells send signals to the brain, liver, and neuroendocrine cells, interfering with appetite and promoting anorexia. Malnutrition in cancer patients is associated with increased treatment toxicity, reduced physical efficiency, and decreased survival. Therefore, early recognition of malnutrition could improve quality of life, treatment compliance, and survival. The aim of the study was to explore the relationship between inflammatory parameters with disease stage and nutritional status in patients with solid cancers.
We screened 77 consecutive patients from 3 clinical Institutions in Sicily, Italy, with solid tumors who were either in follow-up after curative treatment or being treated for metastatic disease using the Mini Nutritional Assessment (MNA) questionnaire. Inflammatory parameters, including interleukin 6 (IL6), C-reactive protein (CRP), β2-microglobulin, ferritin, and transferrin were evaluated.
A statistically significant difference was found in mean values of IL6, CRP, β2-microglobulin, ferritin, and transferrin between patients without evidence of disease and metastatic patients. Among the metastatic group, there was a significant difference in mean values of these inflammatory parameters between patients with malnutrition and those with normal nutritional status. The difference in average IL6, CRP, β2-microglobulin, and ferritin between patients at risk of malnutrition and those with normal nutritional status was also significant. However, the difference between patients at risk of malnutrition and those with malnutrition was not significant.
IL6, CRP, transferrin, ferritin, and β2-microglobulin are functional inflammatory parameters that indicate risk of malnutrition and support the MNA screening test to identify patients with solid tumors who require nutritional support.
背景/目的：慢性炎症和细胞因子风暴会导致癌症失控。恶性细胞释放的促炎分子向大脑、肝脏和神经内分泌细胞发送信号，干扰食欲并导致厌食。癌症患者的营养不良与治疗毒性增加、身体效率降低和生存率降低有关。因此，早期识别营养不良可以提高生活质量、治疗依从性和生存率。本研究旨在探讨炎症参数与实体瘤患者疾病分期和营养状况的关系。
我们筛选了来自意大利西西里岛 3 家临床机构的 77 例连续实体瘤患者，他们要么在根治性治疗后进行随访，要么正在接受转移性疾病的治疗，使用迷你营养评估 (MNA) 问卷。评估了炎症参数，包括白细胞介素 6 (IL6)、C 反应蛋白 (CRP)、β2-微球蛋白、铁蛋白和转铁蛋白。
无疾病证据的患者和转移性患者的 IL6、CRP、β2-微球蛋白、铁蛋白和转铁蛋白的平均值存在统计学差异。在转移性组中，营养不良和营养正常的患者之间这些炎症参数的平均值存在显著差异。营养不良风险患者和营养正常患者之间的平均 IL6、CRP、β2-微球蛋白和铁蛋白差异也具有统计学意义。然而，营养不良风险患者和营养不良患者之间的差异不具有统计学意义。
IL6、CRP、转铁蛋白、铁蛋白和 β2-微球蛋白是功能性炎症参数，可提示营养不良风险，并支持 MNA 筛查试验来识别需要营养支持的实体瘤患者。
