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晚期结直肠癌患者营养状况及血清脂肪因子水平与化疗疗效的关系

Relationships between nutritional status and serum adipokine levels with chemotherapy efficacy in late-stage colorectal cancer patients.

作者信息

Zhang Wendi, Wang Shanshan

机构信息

Department of Infectious Diseases (Hepatology), Affiliated Hospital of Shaoxing University, 999 Zhongxing South Road, Shaoxing, 312000, Zhejiang, China.

出版信息

Int J Colorectal Dis. 2025 Jan 28;40(1):25. doi: 10.1007/s00384-024-04791-9.

Abstract

OBJECTIVE

Colorectal cancer (CRC) is a common cancer, with chemotherapy as its major therapy. Nutritional status (NS) and adipokines implicated in CRC. We explored the impacts of NS indicators (hemoglobin, albumin, and prealbumin) and serum adipokine (visfatin, adiponectin, and resistin) level on chemotherapy efficacy in late-stage CRC patients.

METHODS

Late-stage CRC patients were divided into the effective and ineffective groups based on chemotherapy efficacy, with clinical data, NS indicator, and serum adipokine levels documented. They were divided into hemoglobin, albumin, prealbumin, visfatin, adiponectin, and resistin high and low expression groups, with their relationships with clinical parameters and chemotherapy efficacy analyzed. Independent risk factors (IRFs) affecting chemotherapy efficacy in late-stage CRC patients were analyzed by logistic multivariate regression.

RESULTS

Hemoglobin, albumin, prealbumin, and adiponectin levels were reduced, while NRS 2002 ≥ 3 proportion, visfatin, and resistin levels were increased in the ineffective group versus the effective group. Areas under receiver operating characteristic curve of hemoglobin, albumin, prealbumin, visfatin, adiponectin, and resistin in diagnosing ineffective chemotherapy were 0.80, 0.88, 0.86, 0.88, 0.83, and 0.83, respectively. NS indicator and serum adipokine levels were markedly associated with chemotherapy efficacy in late-stage CRC patients. Highly expressed albumin and prealbumin were protective factors for effective chemotherapy, and highly expressed visfatin and resistin were risk factors for effective chemotherapy.

CONCLUSION

NS indicators and serum adipokine level are correlated with the chemotherapy efficacy in late-stage CRC patients, and both have diagnostic value for chemotherapy efficacy. Albumin, prealbumin, visfatin, and resistin are independent influencing factors affecting chemotherapy efficacy in late-stage CRC patients.

摘要

目的

结直肠癌(CRC)是一种常见癌症,化疗是其主要治疗方法。营养状况(NS)和脂肪因子与CRC有关。我们探讨了NS指标(血红蛋白、白蛋白和前白蛋白)及血清脂肪因子(内脂素、脂联素和抵抗素)水平对晚期CRC患者化疗疗效的影响。

方法

根据化疗疗效将晚期CRC患者分为有效组和无效组,记录其临床资料、NS指标及血清脂肪因子水平。将患者分为血红蛋白、白蛋白、前白蛋白、内脂素、脂联素和抵抗素高表达组与低表达组,分析它们与临床参数及化疗疗效的关系。通过逻辑多元回归分析影响晚期CRC患者化疗疗效的独立危险因素(IRF)。

结果

与有效组相比,无效组的血红蛋白、白蛋白、前白蛋白和脂联素水平降低,而NRS 2002≥3的比例、内脂素和抵抗素水平升高。血红蛋白、白蛋白、前白蛋白、内脂素、脂联素和抵抗素诊断化疗无效的受试者工作特征曲线下面积分别为0.80、0.88、0.86、0.88、0.83和0.83。NS指标和血清脂肪因子水平与晚期CRC患者的化疗疗效显著相关。高表达的白蛋白和前白蛋白是化疗有效的保护因素,高表达的内脂素和抵抗素是化疗有效的危险因素。

结论

NS指标和血清脂肪因子水平与晚期CRC患者的化疗疗效相关,且对化疗疗效均具有诊断价值。白蛋白、前白蛋白、内脂素和抵抗素是影响晚期CRC患者化疗疗效的独立影响因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5de/11775029/8947c4013b5a/384_2024_4791_Fig1_HTML.jpg

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