321 cases of patients with malignant tumor body composition analysis
Zhang Lingling1，2, Wang Lijiao2, Du Hongzhen2, Li Na1, An Yonghui1, Li Zengning2
1.Department of Oncology, The First Hospital of Hebei Medical University, Shijiazhuang 050031, Hebei,China；2.Department of Clinical Nutrition, The First Hospital of Hebei Medical University, Shijiazhuang 050031, Hebei,China
Abstract：Objective Investigate and analyze the body composition results of patients with malignant tumors, and explore the differences in body composition between different nutritional statuses and systemic inflammatory responses to provide a basis for improving the accuracy of individualized clinical treatment. Methods To collect patients with malignant tumors who were hospitalized in the Department of Oncology of the First Hospital of Hebei Medical University from October 2017 to December 2018, and conduct general data survey, body composition analysis, nutritional status assessment, and systemic inflammatory response within 24hours of admission Evaluation and laboratory related index testing. Compare the differences in body composition between different genders, ages, nutritional status, and systemic inflammation. Results 321 patients were included, including 186males and 135 females. The statistical differences in body composition parameters between men and women of different age groups, different BMI, and PG-SGA are mainly reflected in intracellular and extracellular water, protein, body fat mass, skeletal muscle mass, upper arm muscle circumference, etc. Only the extracellular water ratio was statistically different between the same sex and different age groups；the extracellular water ratio, body fat mass, visceral fat area, upper arm circumference, etc. between the three groups of mGPS were statistically different, and the Increase and show a downward trend. Conclusion Different genders, PG-SGA, BMI, and mGPS groupings have a greater impact on body composition of patients with malignant tumors, and as the nutritional status of patients deteriorates and the degree of inflammation increases, the deterioration of nutritional indicators related to body composition worsens. Correcting the malnutrition and inflammation of the patient as soon as possible can significantly improve the patients body composition and provide support for effective individualized clinical treatment.
基金资助:河北省重点研发计划项目健康医疗与生物医药专项（182777127D）
通讯作者:
李增宁，电子邮箱：lizengning@126.com
引用本文:
张玲玲，王丽娇，杜红珍，李娜，安永辉，李增宁. 321例恶性肿瘤患者人体成分分析研究[J]. 肿瘤代谢与营养电子杂志, 2020, 7(3): 307-311.
Zhang Lingling Wang Lijiao, Du Hongzhen, Li Na, An Yonghui, Li Zengning. 321 cases of patients with malignant tumor body composition analysis. Electron J Metab Nutr Cancer, 2020, 7(3): 307-311.
1.PRADO C M M, LIEFFERS J R, MCCARGAR L J, et al. Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study［J］. Lancet Oncol, 2008, 9(7):605-607.
2.PRADO C M M, BARACOS V E, MCCARGAR L J, et al. Body composition as an independent determinant of 5-fluorouracil-based chemotherapy toxicity［J］. Clin Cancer Res, 2007, 13(11):3264-3268.
3.LIEFFERS J R, BATHE O F, FASSABENDER K, et al. Sarcopenia is associated with postoperative infection and delayed recovery from colorectal cancer resection surgery［J］. Br J Cancer, 2012, 107(6):931-936.
4.CECCHINI S, CAVAZZINI E, MARCHESI F, et al. Computed tomography volumetric fat parameters versus body mass index for predicting short-term outcomes of colon surgery［J］. World J Surg, 2011, 35(2):415-423.
5.BLUETHMANN S M, MARIOTTO A B, ROWLAND J H. Anticipating the “Silver Tsunami”: Prevalence trajectories and comorbidity burden among older cancer survivors in the United States［J］. Cancer Epidemiol Biomarkers Prev, 2016, 25(7):1029-1036.
6.DEMARK-WAHNEFRIED W, PETERSON B L, WINER E P, et al. Changes in weight, body composition, and factors influencing energy balance among premenopausal breast cancer patients receiving adjuvant chemotherapy［J］. J Clin Oncol, 2001, 19(9):2381-2389.
7.LIM S L, ONG K C, CHAN Y H, et al. Malnutrition and its impact on cost of hospitalization, length of stay, readmission and 3-year mortality［J］. Clin Nutr, 2012, 31(3):345-350.
8.MURPHY K T, LYNCH G S. Editorial update on emerging drugs for cancer cachexia［J］. Expert Opin Emerg Drugs, 2012, 17(1):5-9.
9.KUMAR N B, KAZI A, SMITH T, et al. Cancer cachexia: traditional therapies and novel molecular mechanism-based approaches to treatment［J］. Curr Treat Options Oncol, 2010,11(3-4):107-117.
10.GRUNDMANN O, YOON S L, WILLIAMS J J. The value of bioelectrical impedance analysis and phase angle in the evaluation of malnutrition and quality of life in cancer patients—a comprehensive review［J］. Eur J Clin Nutr, 2015, 69(12):1290-1297.
11.崔久嵬, 刘雪莲, 李薇. 人体成分分析在抗肿瘤药物药动学及毒性预测中的研究进展［J］. 肿瘤代谢与营养电子杂志, 2018, 5(1):19-25.
12.YAMADA S, FUJII T, YABUSAKI N, et al. Clinical implication of inflammation-based prognostic score in pancreatic cancer［J］. Medicine, 2016, 95(18):e3582.
13.WEN-CHI CHOU, CHEN-YI KAO, PO-NAN WANG,et al.The application of the palliative prognostic index, charlson comorbidity index, and Glasgow prognostic score in predicting the life expectancy of patients with hematologic malignancies under palliative care［J］. BMC Palliat Care, 2015, 14(1):18.
14.李金海,朱明辉,蔡宇,等. 改良型格拉斯哥预后评分对肝门部胆管癌患者手术治疗预后评估的价值研究［J］. 浙江医学, 2018, 40(5):468-470.
15.宋旭敏, 任青, 程忠平. 格拉斯哥预后评分预测肿瘤的临床价值［J］. 医学综述, 2017(12):2354-2358.
16.HOPKINS J J, SAWYER M B. A review of body composition and pharmacokinetics in oncology［J］. Expert Rev Clin Pharmacol, 2017, 10(9):947-956.
17.SHACHAR S S, WILLIAMS G R, MUSS H B, et al. Prognostic value of sarcopenia in adults with solid tumours: A meta-analysis and systematic review［J］. Eur J Cancer (Oxford, England:1990), 2016, 57:58-67.
18.SIMONSEN C, DE HEER P, BJERRE E D, et al. Sarcopenia and postoperative complication risk in gastrointestinal surgical oncology［J］. Ann Surg, 2018, 268(1):58-69.
19.STRULOV S S, DEAL A M, WEINBERG M, et al. Skeletal muscle measures as predictors of toxicity, hospitalization, and survival in patients with metastatic breast cancer receiving taxane based chemotherapy［J］. Clin Cancer Res, 2017, 23(3):658-665.
20.RICHARDS C H, ROXBURGH C S D, MACMILLAN M T, et al. The relationships between body composition and the systemic inflammatory response in patients with primary operable colorectal cancer［J］. PLoS One, 2012, 7(8):e41883.
21.KIM E Y, KIM Y S, SEO J Y, et al. The relationship between sarcopenia and systemic inflammatory response for cancer cachexia in small cell lung cancer［J］. PLoS One, 2016, 11(8):e0161125.
22.LAIRD B J, FALLON M, HJERMSTAD M J, et al. Quality of life in patients with advanced cancer: Differential association with performance status and systemic inflammatory response［J］. J Clin Oncol, 2016, 34(23):2769-2775.
23.MCSORLEY S T, BLACK D H, HORGAN P G, et al. The relationship between tumour stage, systemic inflammation, body composition and survival in patients with colorectal cancer［J］.Clin Nutr, 2018, 37(4):1279-1285.
24.TANG P L, WANG H H, LIN H S, et al. Body composition early identifies cancer patients with radiotherapy at risk for malnutrition［J］. J Pain Symptom Manage, 2018, 55(3):864-871.
25.RYAN A M, POWER D G, DALY L, et al. Cancer-associated malnutrition, cachexia and sarcopenia: the skeleton in the hospital closet 40 years later［J］.Proc Nutr Soc, 2016, 75(2):199-211.
26.CAROLINA P, VELHO SONIA, LISA A, et al. Body composition as a prognostic factor of neoadjuvant chemotherapy toxicity and outcome in patients with locally advanced gastric cancer［J］.J Gastric Cancer, 2017, 17(1):74-87.
27.MARTIN L, BIRDSELL L, MACDONALD N, et al. Cancer cachexia in the age of obesity: skeletal muscle depletion is a powerful prognostic factor, independent of body mass index［J］. J Clin Oncol, 2013, 31(12):1539-1547.
28.SARHILL N. Assessment of nutritional status and fluid deficits in advanced cancer［J］. Am J Hosp Palliat Care, 2003, 20(6):465-473.
