Lai S L, Perng R P
Chest Department, Veterans General Hospital-Taipei, Taiwan, ROC.
Zhonghua Yi Xue Za Zhi (Taipei). 1998 Mar;61(3):134-40.
Weight loss, disease extent, performance status and sex have emerged as prognostic factors for lung cancer. The assessment of performance status is rather subjective and crude. Parameters of nutritional status were used in this study to represent the performance status of patients. The prevalence of protein-calorie malnutrition in lung cancer patients and the impact of this on patient survival were also investigated.
Nutritional status was assessed in 150 newly diagnosed lung cancer patients. Anthropometric and biochemical parameters measured were: weight/height ratio, percent of standard triceps skin-fold thickness, percent of standard arm muscle circumference, serum albumin, transferrin, creatinine height index and total lymphocyte count. Performance status and survival time were estimated for all patients.
The prevalence of abnormality in each nutritional parameter ranged from 15 to 31%. Most of the patients (59%) had at least one abnormal nutritional parameter. A low profile of performance status was associated with lower nutritional parameters such as triceps skin-fold thickness, percent of standard arm muscle circumference, serum albumin and creatinine height index. Patients who died within six months after diagnosis had significantly lower values of all nutritional parameters than those who survived more than six months. Patients with more abnormal parameters tended to have poorer survival rates.
Both anthropometric and biochemical nutritional parameters might be reliable indicators for the assessment of performance status and survival for patients with lung cancer.
体重减轻、疾病范围、体能状态和性别已成为肺癌的预后因素。体能状态的评估相当主观且粗略。本研究使用营养状况参数来代表患者的体能状态。还调查了肺癌患者中蛋白质 - 热量营养不良的患病率及其对患者生存的影响。
对150例新诊断的肺癌患者进行营养状况评估。测量的人体测量学和生化参数包括:体重/身高比、三头肌皮褶厚度占标准值的百分比、上臂肌肉周长占标准值的百分比、血清白蛋白、转铁蛋白、肌酐身高指数和淋巴细胞总数。评估了所有患者的体能状态和生存时间。
每个营养参数的异常患病率在15%至31%之间。大多数患者(59%)至少有一项营养参数异常。低水平的体能状态与较低的营养参数相关,如三头肌皮褶厚度、上臂肌肉周长占标准值的百分比、血清白蛋白和肌酐身高指数。诊断后六个月内死亡的患者所有营养参数值均显著低于存活超过六个月的患者。营养参数异常较多的患者生存率往往较差。
人体测量学和生化营养参数都可能是评估肺癌患者体能状态和生存情况的可靠指标。