Morelli Ilaria, Greto Daniela, Visani Luca, Lombardi Giuseppe, Scorsetti Marta, Clerici Elena, Navarria Pierina, Minniti Giuseppe, Livi Lorenzo, Desideri Isacco
Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy.
Azienda Ospedaliero-Universitaria Careggi, Radiation Oncology Unit, Florence, Italy.
Clin Nutr ESPEN. 2025 Apr;66:269-280. doi: 10.1016/j.clnesp.2025.01.043. Epub 2025 Jan 24.
Multiple inflammatory and nutritional biomarkers have been established as independent prognostic factors across various solid tumors, but their role in outcomes prediction for glioma is still under investigation. Aim of the present systematic review is to report the available evidence regarding the impact of nutritional assessment and intervention for glioma prognosis and patients' quality of life (QoL).
Our systematic review conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The PubMed and EMBASE databases were searched to identify studies assessing the impact of nutritional status and intervention and hematological biomarkers on survival outcomes and quality of life in patients with newly diagnosed gliomas. In the search strategy Medical Subject Headings (MeSH) terms were used. Search terms included ("nutritional status" or "nutritional assessment" or "nutritional intervention") AND ("glioma" or "glioblastoma" or "high-grade glioma" or "low-grade glioma" or "anaplastic astrocytoma" or "anaplastic oligodendroglioma") AND ("prognosis" or "survival outcomes"). The quality of each study was investigated based on the Newcastle-Ottawa Scale (NOS) criteria. Selected papers were in English and included publications in humans. This study was registered on PROSPERO (Registration No. CRD42024555442).
Our search retrieved 20 papers published between 2015 and 2023, all aiming at investigating correlations between hematological biomarkers (albumin, prealbumin, fibrinogen) and/or nutritional tools (Controlling Nutritional Score, CONUT; Prognostic Nutritional Index, PNI) and survival outcomes and quality of life of glioma patients. Nutritional intervention as well was evaluated for outcomes prediction. Overall, most papers contributed to the evidence of how nutritional assessment and inflammatory biomarkers could play an independent prognostic role also in the management of glioma patients.
PNI, CONUT score and hematological biomarkers (e.g. albumin, globulin, neutrophils, lymphocytes) may serve as useful predictors in patients with gliomas, potentially influencing clinical decisions. Additional large-scale studies are required to validate these findings and determine the mechanisms by which nutritional status, systemic inflammation and immune status affect prognosis in glioma patients.
多种炎症和营养生物标志物已被确立为各类实体瘤的独立预后因素，但其在胶质瘤预后预测中的作用仍在研究中。本系统评价的目的是报告关于营养评估和干预对胶质瘤预后及患者生活质量（QoL）影响的现有证据。
我们的系统评价符合系统评价和Meta分析的首选报告项目（PRISMA）指南。检索了PubMed和EMBASE数据库，以识别评估营养状况和干预以及血液生物标志物对新诊断胶质瘤患者生存结局和生活质量影响的研究。在检索策略中使用了医学主题词（MeSH）。检索词包括（“营养状况”或“营养评估”或“营养干预”）以及（“胶质瘤”或“胶质母细胞瘤”或“高级别胶质瘤”或“低级别胶质瘤”或“间变性星形细胞瘤”或“间变性少突胶质细胞瘤”）以及（“预后”或“生存结局”）。根据纽卡斯尔-渥太华量表（NOS）标准对每项研究的质量进行了调查。入选论文为英文且包括针对人类的出版物。本研究已在PROSPERO注册（注册号CRD42024 ******）。
我们的检索共获得20篇2015年至2023年间发表的论文，所有论文均旨在研究血液生物标志物（白蛋白、前白蛋白、纤维蛋白原）和/或营养工具（控制营养评分，CONUT；预后营养指数，PNI）与胶质瘤患者生存结局和生活质量之间的相关性。还对营养干预进行了结局预测评估。总体而言，大多数论文为营养评估和炎症生物标志物如何在胶质瘤患者管理中发挥独立预后作用提供了证据。
PNI、CONUT评分和血液生物标志物（如白蛋白、球蛋白、中性粒细胞、淋巴细胞）可能是胶质瘤患者有用的预测指标，可能影响临床决策。需要更多大规模研究来验证这些发现，并确定营养状况、全身炎症和免疫状态影响胶质瘤患者预后的机制。
