Division of Human Nutrition, Stellenbosch University, Stellenbosch, South Africa.
Melanie Levy Dietician, 1 Mid Way Road, Glenhazel, Johannesburg, South Africa.
J Cancer Res Clin Oncol. 2023 Dec;149(19):17511-17527. doi: 10.1007/s00432-023-05465-9. Epub 2023 Oct 31.
Emerging biomarkers of cancer cachexia and their roles in sarcopenia and prognosis are poorly understood. Baseline assessments of anthropometrics, sarcopenia, cachexia status and biomarkers of cachexia were measured in patients with advanced cancer and healthy controls. Thereafter, relationships of the biomarkers with cachexia and sarcopenia were explored.
A prospective case-control design was used, including 40 patients with advanced cancer and 40 gender, age-matched controls. Bioelectrical impedance [skeletal muscle index (SMI)] and hand dynamometry [hand grip strength (HGS)] assessed sarcopenia and a validated tool classified cancer cachexia. Albumin, lymphocyte and platelet counts, haemoglobin, C-reactive protein (CRP), pro-inflammatory cytokines/chemokines and citrullinated histone H3 (H3Cit) were measured.
Patients had significantly lower SMI (6.67 kg/m versus 7.67 kg/m, p = < 0.01) and HGS (24.42 kg versus 29.62 kg) compared to controls, with 43% being sarcopenic. Significant differences were found for albumin, lymphocyte and platelet counts, haemoglobin, CRP, and tumour necrosis factor α (TNFα), (p < 0.01). Interleukin (IL)-6 (p < 0.04), IL-8 (p = 0.02), neutrophil/lymphocyte ratio (NLR), p = 0.02, platelet/lymphocyte (PLR) ratio, p < 0.01 and systemic immune inflammatory index (SII), p < 0.01 differed significantly. No difference was observed for CXC motif chemokine ligand 5 [CXCL5 or epithelial neutrophil-activating peptide 78 (ENA78)] or H3Cit. Albumin and haemoglobin correlated negatively with total protein, skeletal muscle mass and SMI (all p < 0.01). The presence of sarcopenia associated significantly with albumin, haemoglobin and CRP.
Significant relationships and differences of haemoglobin, CRP and albumin supports future use of these biomarkers in cancer cachexia. CXCL5 and H3Cit as valuable biomarkers in cancer cachexia remains to be defined.
癌症恶病质的新兴生物标志物及其在肌肉减少症和预后中的作用仍知之甚少。本研究在晚期癌症患者和健康对照者中基线评估了人体测量学、肌肉减少症、恶病质状态和恶病质生物标志物，并进一步探讨了这些标志物与恶病质和肌肉减少症的关系。
采用前瞻性病例对照设计，纳入 40 例晚期癌症患者和 40 例性别、年龄匹配的对照者。生物电阻抗[骨骼肌指数（SMI）]和握力计[握力（HGS）]评估肌肉减少症，采用经过验证的工具对癌症恶病质进行分类。测定白蛋白、淋巴细胞和血小板计数、血红蛋白、C 反应蛋白（CRP）、促炎细胞因子/趋化因子和瓜氨酸化组蛋白 H3（H3Cit）。
与对照组相比，患者的 SMI（6.67 kg/m 比 7.67 kg/m，p < 0.01）和 HGS（24.42 kg 比 29.62 kg）显著降低，其中 43%为肌肉减少症。白蛋白、淋巴细胞和血小板计数、血红蛋白、CRP 和肿瘤坏死因子-α（TNFα）差异有统计学意义（p < 0.01）。白细胞介素（IL）-6（p < 0.04）、IL-8（p = 0.02）、中性粒细胞/淋巴细胞比值（NLR）（p = 0.02）、血小板/淋巴细胞比值（PLR）（p < 0.01）和全身免疫炎症指数（SII）（p < 0.01）差异有统计学意义。趋化因子 CXC 模体配体 5 [CXCL5 或上皮中性粒细胞激活肽 78（ENA78）]或 H3Cit 无差异。白蛋白和血红蛋白与总蛋白、骨骼肌量和 SMI 呈负相关（均 p < 0.01）。肌肉减少症的存在与白蛋白、血红蛋白和 CRP 显著相关。
血红蛋白、CRP 和白蛋白的显著相关性和差异支持这些生物标志物在癌症恶病质中的进一步应用。CXCL5 和 H3Cit 作为癌症恶病质的有价值的生物标志物仍有待确定。
