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浅析恶液质:癌症患者恶液质发生率及其相关危险因素的叙述性综述。

Breaking Down Cachexia: A Narrative Review on the Prevalence of Cachexia in Cancer Patients and Its Associated Risk Factors.

机构信息

Faculty of Pharmacy, Universiti Teknologi MARA Selangor, Bandar Puncak Alam, Malaysia.

Cardiology Therapeutics Research Initiative Group, Faculty of Pharmacy, Universiti Teknologi MARA Selangor, Bandar Puncak Alam, Malaysia.

出版信息

Nutr Cancer. 2024;76(5):404-418. doi: 10.1080/01635581.2024.2321654. Epub 2024 Mar 28.

Abstract

Cachexia is an irreversible condition that involves a significant loss of body weight, muscle mass, and adipose tissue. It is a complex condition that involves a variety of metabolic, hormonal, and immune-related factors, with the precise mechanisms not yet fully understood. In this review, the prevalence of cachexia in different types of cancer as well as the potential risk factors was evaluated from literature retrieved from databases such as ScienceDirect, PubMed and Scopus. Potential risk factors evaluated here include tumor-related factors such as location, and stage of the cancer, as well as patient-related factors such as age, gender, and comorbidities. Several findings were observed where cachexia is more prevalent in male cancer patients than females, with higher incidences of weight loss and poorer outcomes. This may be due to the different muscle compositions between gender. Additionally, cachexia is more prevalent at the later stages, which may be brought about by the late-stage diagnosis of certain cancers. The anatomical location of certain cancers such as the pancreas and stomach may play a significant factor in their high prevalence of cachexia. These are sites of the synthesis of digestive enzymes and hormones regulating appetite. Cachexia is an issue faced by cancer patients which could affect their recovery. However, it is poorly understood, which limit therapeutic options. Hence, understanding this disease from different perspectives (clinical and pre-clinical), and bridging those findings could further improve our comprehension and consequently improve therapeutic options.

摘要

恶病质是一种不可逆转的状态,涉及体重、肌肉质量和脂肪组织的大量流失。它是一种复杂的病症,涉及多种代谢、激素和免疫相关因素,其确切机制尚未完全阐明。在这篇综述中,从 ScienceDirect、PubMed 和 Scopus 等数据库中检索到的文献评估了恶病质在不同类型癌症中的流行情况以及潜在的危险因素。这里评估的潜在危险因素包括肿瘤相关因素,如癌症的位置和阶段,以及患者相关因素,如年龄、性别和合并症。有几项发现表明,男性癌症患者比女性更容易发生恶病质,体重减轻和预后较差的发生率更高。这可能是由于性别之间肌肉成分的不同。此外,恶病质在晚期更为普遍,这可能是由于某些癌症的晚期诊断所致。某些癌症(如胰腺和胃)的解剖位置可能是其恶病质高发的重要因素。这些是消化酶和调节食欲的激素合成的部位。恶病质是癌症患者面临的一个问题,可能会影响他们的康复。然而,目前对它的了解还很有限,这限制了治疗选择。因此,从不同的角度(临床和临床前)理解这种疾病,并将这些发现联系起来,可以进一步提高我们的理解,从而改善治疗选择。

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