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| Nutrition screening methods and evaluation tools for Three-level diagnosis of malnutrition in primary liver cancer |
| Hepatology Digestive Ward, The Second Hospital of Hohhot, Hohhot 010031, Inner Mongolia, China |
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Abstract The aim of this paper is to rationally select nutritional screening methods and evaluation tools and accurately determine the nutritional status of patients with PLC. This paper is based on the three-level diagnosis of malnutrition established by the Chinese Anti-cancer Association. By reviewing domestic and abroad literature , the methods and evaluation tools of the first-level diagnosis (nutritional screening), the second-level diagnosis (nutritional assessment) and the third-level diagnosis (comprehensive evaluation) for PLC patients were summarized and analyzed. The first-level diagnosis methods include NRS 2002, MUST and BMI. NRS-2002 is suitable for nutritional screening of PLC patients while the sensitivity of MUST is poor. BMI is the most direct and simplest nutritional screening method. It is not suitable to be used as an independent screening method for PLC patients because it is easily affected by body weight. The second-level diagnosis methods include SGA, PG-SGA and MNA. PG-SGA is a sensitive assessment tool for malnutrition among PLC patients. The sensitivity of SGA and MNA is poor. In addition to medical history collection, physical aptitude and physical examination, three-level diagnosis includes anthropological measurements of MAC, TSF and HGS, which has a higher accuracy in the determination of malnutrition in PLC patients because its directness and objectivity. Laboratory examination of TLC, ALB, PA, which has a poor sensibility, BIA and L3-SMI, which is able to accurately reflect the nutritional status of PLC patients and is not suitable for large-scale clinical use because it is easily affected by equipment and conditions. The results showed that NRS 2002 and PG-SGA are the preferred nutritional screening method and evaluation tools for PLC patients. Combined with MAC, TSF, HGS, BIA and L3-SMI, the nutritional status of PLC patients are able to be accurately evaluated.
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2019, Vol. 6 
