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2024 Vol. 11, No. 4
Published: 2024-08-09
 
443 The research progress of immunonutrients in the prevention and treatment of malignant tumors
Liu Xiangrong, Liu Yinghua
With the deepening research on the immune mechanisms of malignant tumors the study and clinical application of immunonutrients are continually advancing and innovating. A multitude of studies have shown that various immunonutrients can prevent the occurrence of malignant tumors reduce resistance to certain chemotherapeutic drugs alleviate postoperative complications shorten hospital stays and expedite recovery of immune function and nutritional status through mechanisms such as anti - inflammation enhancement of immune cell functions inhibition of malignant tumor cell proliferation and metastasis as well as induction of tumor cell apoptosis. However despite this extensive research there is currently no consensus on the preventive therapeutic and prognostic roles of immunonutrients like glutamine arginine ω-3 polyunsaturated fatty acids and vitamins in the context of malignant tumors due to the scarcity of large-scale high-quality evidence. This article aims to systematically review the mechanistic roles and clinical efficacies of protein-based immunonutrients glutamine and arginine fatty acid-based immunonutrients ω-3 polyunsaturated fatty acids micronutrients vitamins and selenium microecological immunonutrients synbiotics and plant extract - based immunonutrients ginsenosides in the context of malignant tumor prevention and management. The objective is to explore the distinct features and inherent limitations of these different categories of immunonutrients thereby providing a foundation and direction for further in-depth research on the use of immunonutrients against malignant tumors and their integration into clinical practice.
2024 Vol. 11 (4): 443-449 [Abstract] ( 68 ) HTML PDF (870 KB)  ( 32 )
450 Interpretation of ESPEN practice guideline home parenteral nutrition in 2023
1Yu Yuan,1Liu Miao,2Cong Minghua
Chronic inability or lack of oral food can lead to malnutrition requiring parenteral nutrition treatment. Patients who need long- term parenteral nutritional therapy can implement home parenteral nutritional therapy at home under the guidance of a professional nutritional support team in order to maintain and improve the nutritional status of the patient and avoid long - term hospitalization save medical costs and improve the quality of life. In 2023 the ESPEN guidelines on home parenteral nutrition. It builds on previously published guidance provides an update on the available evidence and expert opinion and visualizes the recommendations by presenting them as a flowchart. It unified 71 recommendations of home parenteral nutrition central venous access device CVAD including central venous catheter peripherally inserted central catheter and implantable venous access port and infusion pump infusion catheter and CVAD site care nutritional preparations program monitoring and management. These recommendations have great value in guiding home parenteral nutritional management of patients. We interpret the guidelines and reorganize the recommendations to improve the understanding and practicability.
2024 Vol. 11 (4): 450-460 [Abstract] ( 50 ) HTML PDF (3291 KB)  ( 20 )
461 Research progress of microbiome and its metabolites regulating brain glioma
Liu Li, Wang Ran, Zhang Qi
Gliomas are the most common brain tumors accounting for 80% of malignant brain tumors of which glioblastoma multiforme is the most aggressive type of glioma and is one of the refractory tumors in the world. At present the main treatment for glioblastoma is surgery which has great side effects easy recurrence and low survival rate. Therefore seeking more potential biomarkers and improving survival rate remain important challenges in glioma research. There is growing evidence that the intratumoral and gut microbiome play an important role in glioma progression and treatment response and that specific microbiome is associated with different stages of tumor progression. In the meantime the interactions and mechanisms between the metabolites and the central nervous system have received extensive attention. However the correlation between the microbiome metabolites and glioma remains unclear. This review focuses on the relationship between the glioma intratumoral microbiome intestinal microbiome and their metabolites such as amino acids including tryptophan arginine glutamate short-chain fatty acids neurotransmitters. And the improvement effect of probiotics on glioma was summarized so as to provide relevant basis for early prediction and treatment of glioma based on the microbiome.
2024 Vol. 11 (4): 461-466 [Abstract] ( 25 ) HTML PDF (859 KB)  ( 20 )
467 Current progress of immunotherapy in locally advanced nasopharyngeal carcinoma
Huang Ningxin, He Jiaqi, Luo Haiqing
Nasopharyngeal carcinoma NPC has an insidious onset and it exhibits a high degree of malignancy. More than 70% of the patients are in middle or advanced stage at the time of initial diagnosis. Currently neoadjuvant chemotherapy combined with concurrent chemoradiotherapy CCRT is used as the standard treatment for locally advanced NPC LA-NPC . Although it has a good remission rate the risk of distant metastasis still exists in some patients. With the rapid development of immunotherapy immune checkpoint inhibitors ICIs especially programmed death- 1 / programmed death ligand- 1 PD- 1 / PD-L1 blockade have made breakthroughs in China. PD-1 inhibitors combined with chemotherapy have been used as the first-line treatment for recurrence and / or metastatic NPC R/ M NPC . Meanwhile immunotherapy has made new breakthroughs in the treatment of LA - NPC and many prospective clinical studies are underway. In this review we provide a comprehensive overview of the fundamentals of immunotherapy for LA-NPC patients and important research findings in immunotherapy in LA-NPC based on published clinical data and ongoing trials with the aim of providing insights for clinical practice and future clinical studies.
2024 Vol. 11 (4): 467-472 [Abstract] ( 20 ) HTML PDF (846 KB)  ( 33 )
473 Research on the role of fatty acids in cancer prevention and treatment
1He Yannan,2Zhao Feng,3Liu Yinghua
The correlation between dietary intake and fatty acid profile within the human body significantly impacts tumor development. Carbohydrates proteins and fats influence fatty acid metabolism. Adjusting dietary fatty acid including palmitic acid intake and unsaturated fatty acid consumption may improve the gastrointestinal anti - inflammatory milieu and overall health. An increased intake of leafy greens supplies alpha-linolenic acid and enriches dietary fiber thereby supporting the diversity and balance of the gut microbiota. Elevating ω-3 fatty acid levels has been shown to optimize gut flora reduce inflammation and decrease tumor risk. Conversely a high dietary proportion of ω - 6 fatty acids may exacerbate intestinal inflammation and potentially facilitate tumorigenesis. ω- 3 PUFAs inhibit tumor cell proliferation and promote apoptosis mitigating tumor risk by antagonizing the pro - inflammatory effects of ω-6 PUFAs. Managing the ratios of ω-6 ∶ ω-3 and arachidonic acid ∶ EPA helps reducing the incidence of chronic diseases and tumors. The effects of trans fats and saturated fats are linked to increased tumor risks whereas the influence of monounsaturated fats remains variable necessitating further investigation. In summary strategic management of dietary fatty acids regulate intestinal health mitigate inflammatory responses and positively influence tumor prevention and treatment offering new avenues for cancer management strategies.
2024 Vol. 11 (4): 473-479 [Abstract] ( 28 ) HTML PDF (887 KB)  ( 10 )
480 Discussion on the role of albumin preparations in tumor nutritional therapy
1Lyu Dapeng,2Mu Ying,3Cao Bingqing
Patients with malignant tumors often suffer from malnutrition due to chronic energy-protein depletion insufficient intake of other nutrients in the body and malabsorption resulting in energy and protein deficiency. Serum albumin level is an important indicator to reflect the nutritional status of patients. Clinically albumin preparations are often mistakenly used as nutrients in clinical practice. In fact the nutritional supply of cancer patients should be based on amino acids and energy supplementation. This article analyzes the basic points of human nutritional requirements metabolic changes nutritional status classification and nutrient supply of cancer patients. And we discussed the principles methods and classification of human nutrients and specific calculation methods of dosage supply A variety of amino acid formulation types that can be provided clinically. The synthesis and distribution of albumin in vivo were analyzed in detail. The main role of serum albumin in the human body is to expand blood volume and maintain plasma osmolality and it also has the biological function of non-osmotic pressure. The application history of albumin preparations and the clinical guidelines for albumin preparations in China and abroad are reviewed. The significance of albumin preparations in the application of various diseases is mainly used in shock caused by trauma and burns edema and ascites caused by liver cirrhosis or kidney disease cerebral edema neonatal hyperbilirubinemia. The misunderstandings of the clinical application of human albumin preparations were analyzed. This article provides a theoretical basis for how to correctly provide nutrition for cancer patients and how to use albumin preparations correctly and rationally.
2024 Vol. 11 (4): 480-484 [Abstract] ( 35 ) HTML PDF (811 KB)  ( 14 )
485 Expert consensus on nutritional therapy for cancer cachexia
Chinese Society of Nutritional Oncology, Chinese Society for Parenteral and Enteral Nutrition
The incidence rate of cachexia in malignant tumors is high and about 20% of patients with malignant tumors die of cachexia. Persistent skeletal muscle depletion is a core manifestation of cachexia leading to a serious decline in the quality of life of patients an increase in the incidence of complications and mortality. Clear diagnosis staging and grading are necessary for patients with malignant tumors which is beneficial for their anti-tumor and nutritional treatments. Patients with malignant tumors exhibit low intake and metabolic abnormalities both of which can lead to a negative balance of protein and energy. It is necessary to increase energy and nutrient intake to correct the negative balance of energy and protein. Close nutritional follow-up nutritional counseling and patient nutrition education are important measures for preventing and treating tumor cachexia. Simply choosing different foods and understanding their intake can help patients consume more energy and nutrients which may help improve their nutritional status.
2024 Vol. 11 (4): 485-492 [Abstract] ( 81 ) HTML PDF (918 KB)  ( 36 )
493 Expert consensus on nutritional therapy for home cancer patients
Chinese Society of Nutritional Oncology, Chinese Society for Parenteral and Enteral Nutrition
Cancer patients are more prone to malnutrition and the proportion of malnutrition is higher. During hospitalization medical staff can provide reasonable nutritional treatment based on the patient′s condition to improve their condition. However most cancer patients spend more time at home rather than in the hospital. Therefore nutritional treatment for home cancer patients is equally important. All home cancer patients need to undergo nutritional risk screening and assessment by professional healthcare professionals or nutritionists to determine whether home nutrition treatment is necessary. When it is not possible to meet the needs of home cancer patients through food and oral nutrition supplementation the implementation of home enteral and / or parenteral nutrition should be considered. Home parenteral nutrition requires the establishment of a parenteral nutrition preparation room strictly following sterile operating techniques and preparation processes and preparing parenteral nutrition preparations under the guidance of professionals. Fat emulsion can reduce the inflammatory response of long - term parenteral nutrition treatment and improve the prognosis of patients. Patients who receive long-term home parenteral nutrition treatment should supplement with glutamine in moderation.
2024 Vol. 11 (4): 493-498 [Abstract] ( 42 ) HTML PDF (829 KB)  ( 49 )
499 Clinical effect of high-dose vitamin C combined with FOLFOX6 for colorectal cancer
1Sun Longfeng,1Wang Zhichao,1Dai Meng,2Fan Yueping,3Rao Benqiang
Objective To investigate the clinical effect of high-dose vitamin C combined with FOLFOX6 chemotherapy for colorectal cancer. Method The clinical data of 58 patients with colorectal cancer admitted to Aviation General Hospital from April 2016 to September 2017 were retrospectively analyzed. According to the treatment methods they were divided into experimental group treated with high - dose vitamin C combined with FOLFOX6 chemotherapy n = 29 cases and control group treated with FOLFOX6 chemotherapy alone n = 29 cases . The effects of treatment adverse reactions and improvements in patients′ quality of life were compared between the two groups. Result The effective rate was 58. 6% in the experimental group and 44. 8% in the control group with statistically significant differences P<0. 05 . After treatment tumor marker carcinoembryonic antigen and tumor marker carbohydrate antigen 19-9 concentrations in 2 groups were significantly decreased after treatment P<0. 05 and the decrease in experimental group was more obvious than control group P<0. 05 . The adverse reactions of digestive tract reaction and bone marrow suppression were significantly reduced in the experimental group and the differences between the two adverse reactions were statistically significant P< 0. 05 . The improvement rate of experimental group was 62. 06% which was significantly higher than that of control group 48. 27% and the difference was statistically significant P< 0. 05 . Conclusion Compared with FOLFOX6 chemotherapy alone high - dose vitamin C combined with FOLFOX6 chemotherapy in the treatment of colorectal cancer can achieve significant clinical efficacy reduce the adverse reactions of chemotherapy and improve the quality of life of patients which has high clinical value.
2024 Vol. 11 (4): 499-504 [Abstract] ( 21 ) HTML PDF (1440 KB)  ( 6 )
505 A study of blood lipid levels with clinical characteristics and survival prognosis of patients with middle - to late - stage nasopharyngeal carcinoma
1Kou Liyong,2Wu Ping,2Sun Jing,1Chen Wei,3Ge Xiaosong
Objective To explore the correlation between serum lipid levels and clinical characteristics and survival prognosis of patients with middle- to late-stage nasopharyngeal carcinoma NPC . Method To retrospectively analyze 285 patients with NPC stage Ⅲ-Ⅳ in Affiliated Hospital of Jiangnan University and collect serum lipid-related indexes of high-density lipoprotein cholesterol HDL-C low-density lipoprotein cholesterol LDL-C apolipoprotein A1 ApoA1 apolipoprotein B ApoB apolipoprotein E ApoE cholesterol CHOL and triglyceride TG . Statistical analysis and clinical prognostic evaluation were performed using univariate and multivariate Cox regression Kaplan-Meier survival curves and ROC curves. Result ApoA1 was significantly higher in NPC patients aged ≥55 years than in NPC patients aged <55 years P= 0. 013 . Further grouped by gender the results showed that HDL-C was significantly higher in the female group than in the male group P= 0. 001 . The results of Cox one-way analysis showed that the difference in OS between high CHOL level and NPC patients was statistically significant HR = 1. 626 95% CI = 1. 065 - 2. 482 P= 0. 024 . Further ApoB ApoE and CHOL with P<0. 1 were included in a multifactorial Cox proportional risk analysis which showed that CHOL was a risk factor for NPC prognosis HR = 1. 613 95% CI = 1. 058-2. 460 P = 0. 026 . The differences in HDL-C P= 0. 024 LDL-C P = 0. 001 and ApoB P = 0. 001 were statistically significant at different baseline CHOL levels. Survival time was longer in the low CHOL group than in the high CHOL group and the low CHOL group had a higher overall survival time P= 0. 025 . ROC curve analysis showed that the area under the curve of CHOL predicting NPC prognosis AUC = 0. 581 95% CI = 0. 505-0. 656 P= 0. 037 . Conclusion Significant differences in serum lipids were found between the different clinical features of patients with middle and advanced NPC Serum CHOL emerged as an independent predictor of prognosis in patients with middle and advanced NPC and High cholesterol level is a risk factor for nasopharyngeal carcinoma patients and is associated with poor prognosis.
2024 Vol. 11 (4): 505-511 [Abstract] ( 34 ) HTML PDF (1652 KB)  ( 10 )
512 Changes of symptom groups in patients with esophageal cancer during chemotherapy and its implications
1Xu Chunming,2Jiang Jing,3Mao Xiaoping
Objective To explore the symptom group composition and dynamic change track of patients with esophageal cancer during chemotherapy and provide evidence for symptom management of patients with esophageal cancer during chemotherapy. Method A total of 168 patients with esophageal cancer treated by chemotherapy in Nantong Cancer Hospital from June 2021 to December 2022 were selected as the study objects. General data questionnaire Anderson symptom assessment scale and symptom supplement questionnaire were used at the first admission T1 first chemotherapy T2 second chemotherapy T3 and last chemotherapy T4 . Symptom cluster were extracted by exploratory factor analysis. Result There were 12 20 22 and 18 symptoms with an incidence greater than 20% at each time node from T1 to T4 respectively. The incidence ranged from 12. 50% to 94. 12%. Exploratory factor analysis revealed Three five six and six symptom cluster were extracted from T1 T2 T3 and T4 respectively during chemotherapy for patients with esophageal cancer. Among them sleep disorder symptom group cognitive-related symptom group and psychoneurotic symptom group persisted from T1 to T4 pain symptom group digestive tract symptom group existed from T2 -T4 . Activity tolerance symptom group existed in T3 - T4 . Conclusion Patients with esophageal cancer have multiple symptoms and high incidence during chemotherapy and the composition of T3 and T4 symptom cluster is relatively stable. Nurses should pay attention to the symptom cluster of postoperative patients with esophageal cancer during chemotherapy and take appropriate measures to actively intervene to alleviate various symptoms so as to reduce the impact on patients.
2024 Vol. 11 (4): 512-518 [Abstract] ( 25 ) HTML PDF (1261 KB)  ( 11 )
519 Prognostic association and prediction model construction of malnutrition and NPC patients based on GLIM criteria
1Xu Ting,2Lin Jiajia,2Lai Jianyue,2Cheng Mei,1Zhao Huiling
Objective To explore the prognostic association of malnutrition and NPC patients based on GLIM criteria and the prediction model construction. Method A total of 185 NPC patients were collected from January 2022 to January 2023 and were divided into two groups based on GLIM criteria namely malnutrition group n = 72 and no malnutrition group n = 113 . Compared with general data malnutrition factors were affected by binary Logistic regression analysis. After another 12-month follow-up association with nutritional status by Cox proportional risk Kaplan-Meier survival analysis and ROC curve analysis of malnutrition based on GLIM criteria. Result After binary Logistic regression analysis age ≥ 60 years OR = 2. 393 TNM stage Ⅲ ~ Ⅳ OR = 2. 053 ≥3 gastrointestinal symptoms OR = 2. 288 and chemoradiotherapy OR = 2. 097 were independent risk factors for malnutrition in NPC patients P <0. 05 . After a 12-month follow-up visit 66 progression-free survival in the malnutrition group 112 control subjects with progression-free survival according to the Kaplan-Meier survival analysis statistical difference in death / recurrence rate and survival time between the two groups P <0. 05 After the Cox proportional risk analysis Malnutrition was an independent factor affecting the prognosis of NPC patients P <0. 05 After the ROC curve analysis Assessment of malnutrition based on GLIM criteria in predicting NPC prognosis AUC = 0. 743 S. E. = 0. 083 P = 0. 029 95% CI = 0. 580 - 0. 907 sensitivity of 85. 7% specificity of 62. 9% the Youden index is set at 0. 486 indicating a high predictive efficacy of malnutrition assessment based on the GLIM criteria. Conclusion The nutritional status of nasopharyngeal cancer patients will be affected by age tumor TNM digestive tract symptoms and radiotherapy and chemotherapy. For high-risk factors precise prevention and rehabilitation should be required to reduce the malnutrition rate. At the same time it is necessary to focus on monitoring the malnutrition status based on GLIM standards timely detect malnutrition and guide clinical intervention to improve the prognosis.
2024 Vol. 11 (4): 519-524 [Abstract] ( 24 ) HTML PDF (1282 KB)  ( 6 )
525 Effect of pre -treatment nutritional status on outcome in elderly patients with locally advanced esophageal squamous cell carcinoma undergoing radical radiotherapy
Cai Huicui, Wang Yan, Ye Jinjun, Chen Yan
Objective To explore the impact of pre -treatment nutritional status on the outcome of elderly patients with locally advanced esophageal squamous cell carcinoma undergoing radical radiotherapy. Method A total of 96 elderly patients with locally advanced esophageal squamous cell carcinoma who received treatment at Jiangsu Cancer Hospital from May 2021 to January 2023 were selected. Prior to treatment levels of prealbumin PAB hemoglobin Hb serum albumin ALB and NRS 2002 score were tested and binary logistic regression analysis was performed to determine the prognostic factors affecting the patients. According to the patient′s prognosis they were further divided into two groups namely the poor prognosis group death n = 32 and the good prognosis group survival n = 64 . The levels of PAB Hb ALB and NRS 2002 scores were compared between the two groups. Analyze the predictive value of PAB Hb ALB levels and NRS 2002 score values through ROC curve analysis. Result 96 patients underwent serum tests before treatment with ALB 43. 86 ± 9. 86 g / L PAB 178. 95 ± 18. 53 mg / L Hb 129. 84 ± 15. 43 g / L and NRS 2002 3. 49 ± 1. 86 points. According to binary logistic regression analysis pre-treatment ALB ≤ 44g / L pre-treatment PAB ≤ 179 mg / L pre-treatment Hb ≤ 126 g / L and pre-treatment NRS 2002 score>3 points are prognostic factors affecting elderly patients with locally advanced esophageal squamous cell carcinoma P<0. 05 . The regression model was validated using Bootstrap method with an AUC of 0. 866 and 95%CI = 0. 795-0. 938. Meanwhile the ALB 52. 65 ± 8. 91 g / L PAB 189. 63 ± 19. 12 mg / L and Hb 141. 58 ± 17. 21 g / L in the group with good prognosis were higher than those in the group with poor prognosis and the NRS 2002 score 1. 55 ± 0. 75 was lower than that in the group with poor prognosis P<0. 05 . Through ROC analysis the ALB PAB Hb and NRS 2002 scores predicted the prognosis of elderly patients with locally advanced esophageal squamous cell carcinoma to be 0. 836 0. 898 0. 877 and 0. 914 respectively. Conclusion PAB Hb ALB levels and NRS 2002 score value can predict the survival prognosis of elderly patients with locally advanced esophageal squamous cell carcinoma. By testing their nutritional status before treatment it can play an important role in the recent efficacy and survival prognosis which is conducive to reducing mortality and improving prognosis.
2024 Vol. 11 (4): 525-531 [Abstract] ( 28 ) HTML PDF (1494 KB)  ( 5 )
532 The value of neutrophil - lymphocyte ratio and geriatric nutritional risk index in predicting prognosis in patients with colorectal cancer
Li Wei, Deng Hao, Li Wei, Liu Xiaowei
Objective To investigate the value of neutrophil-lymphocyte ratio NLR and geriatric Nutritional risk index GNRI in predicting the prognosis of patients with colorectal cancer. Method A total of 103 patients with colorectal cancer who were diagnosed and treated in Wuhan Red Cross Hospital from May 2019 to January 2021 and followed up to December 2023 were selected as the study objects and set as the colorectal cancer group and 52 healthy subjects were selected as the control group during the same period. Compare the changes of NLR and GNRI. The changes of NLR and GNRI in colorectal cancer patients with different pathological characteristics were compared. Kendall′ s tau - b method was used to analyze the correlation between NLR GNRI and clinical features. Cox regression risk model was used to analyze the effects of NLR and GNRI on the prognosis of colorectal cancer patients. The combined parameters of NLR and GNRI were constructed by Logistic regression and receiver operating characteristic ROC curves were drawn to analyze the efficacy of NLR GNRI and the combined prediction of prognosis. Result The NLR and GNRI in colorectal cancer group were lower than those in control group P<0. 05 . The progression-free survival of 103 patients with colorectal cancer was 30. 98±8. 27 the overall survival was 32. 91±6. 09 months the 3-year progression-free survival rate was 71. 84% 74 / 103 and the 3-year overall survival rate was 77. 67% 80 / 103 . There were statistically significant differences in NLR and GNRI among colorectal cancer patients with different age differentiation degree clinical stage lymph node metastasis and albumin P< 0. 05 . Kendall′s tau-b correlation analysis showed that NLR was positively correlated with age differentiation clinical stage and lymph node metastasis of colorectal cancer patients and negatively correlated with albumin P<0. 05 . GNRI was negatively correlated with age differentiation and clinical stage of colorectal cancer patients and positively correlated with albumin P<0. 05 . Cox regression risk model analysis showed that the increase of NLR and the decrease of GNRI were independent influencing factors for 3-year disease-free survival and overall survival of colorectal cancer patients P<0. 05 . ROC curve analysis showed that the AUC values of NLR GNR and the combination of NLR and GNR were 0. 732 0. 693 and 0. 808 respectively P<0. 05. Sensitivity was 69. 60% 60. 90% 65. 20%. The specificity was 93. 70% 96. 20% and 98. 80% . Conclusion The increase of NLR and the decrease of GNRI have adverse effects on the prognosis of colorectal cancer patients and dynamic observation of their changes is conducive to providing guidance for clinical treatment and prognosis assessment.
2024 Vol. 11 (4): 532-539 [Abstract] ( 19 ) HTML PDF (1638 KB)  ( 4 )
540 Construction the GLIM criteria - based predictive model for nutritional deterioration in patients with malignant tumors undergoing radiotherapy
Chen Qiao, Gao Mingyue, Yuan Meirui, Zhang Xiaodan, Liu Chen
Objective To investigate the nutritional status of cancer patients undergoing radiotherapy using the Global Leadership Initiative on Malnutrition GLIM criteria and establish a predictive model for post-radiotherapy nutritional deterioration. Method A total of 97 hospitalized cancer patients who received radiotherapy at the Fourth Military Medical University of the Chinese People′s Liberation Army from January 2022 to December 2022 were selected. The GLIM criteria for malnutrition were applied before radiotherapy and patients were categorized into stable nutrition n = 57 or deteriorated nutrition groups n = 40 based on whether they experienced more than a 5% body weight loss after radiotherapy. Univariate and multivariate Logistic regression analysis was conducted to identify factors influencing nutritional deterioration during hospitalization and a nomogram prediction model was developed based on these factors. Discrimination AUC Hosmer-Lemeshow test and decision curve analysis DCA were used to assess the model′s accuracy and clinical utility. Result Among the 97 patients 38 39. 1% had nutritional risk or malnutrition while 40 41. 2% experienced nutritional deterioration following radiotherapy. There were no significant differences in age gender education level tumor location underlying diseases distant metastasis or BMI at admission between the two groups. Univariate and multivariate logistic regression analyses revealed that GLIM malnutrition status radiotherapy frequency and prealbumin levels independently predicted nutritional deterioration after radiotherapy P < 0. 05 . The nomogram model demonstrated an AUC value of 0. 723 95% CI = 0. 622-0. 825 with good calibration curves observed for both validation data sets as well as ideal curves in terms of discrimination ability. Conclusion The GLIM criteria is an effective tool for predicting the deterioration of nutritional status in tumor patients after radiotherapy. The nomogram model constructed based on the GLIM evaluation radiotherapy frequency and prealbumin levels can effectively predict the risk of nutritional deterioration in patients after radiotherapy. This provides valuable guidance and reference for medical staff in the radiotherapy department to implement proactive preventive nursing interventions.
2024 Vol. 11 (4): 540-546 [Abstract] ( 25 ) HTML PDF (2106 KB)  ( 6 )
547 Study on the relationship between phenotype of tumor-infiltrating lymphocytes and clinicopathological characteristics and gut microbiota in patients with colon cancer
Huang Chao, Fang Xinggang, Chen Lu
Objective To explore the relationship between the phenotype of tumor - infiltrating lymphocytes TIL and clinicopathological characteristics and gut microbiota in patients with colon cancer. Method From June 2017 to February 2023 76 colon cancer patients admitted to Taihe Hospital were collected as the colon cancer group and 76 healthy individuals who underwent physical examinations during the same period were collected as the control group. The TIL phenotype expression levels of two groups were detected fluorescent quantitative PCR was applied to detect gut microbiota and the clinical and pathological data of colon cancer patients were collected. Spearman was applied to analyze the correlation between TIL phenotype and gut microbiota. Result Compared with the control group the level of CD4 + T cell in the colon cancer group was obviously increased 28. 05± 5. 48 % vs 32. 49± 6. 13 % while the levels of CD3 + T cell and CD8 + T cell were obviously reduced 60. 47 ± 6. 53 % vs 53. 17 ± 6. 37 % 30. 69±6. 38 % vs 24. 85 ± 6. 42 % P < 0. 05 . According to the median values of CD3 + T cell 52. 62% CD8 + T cell 25. 87% and CD4 + T cell 31. 94% colon cancer patients were divided into 38 cases with high expression of CD3 + T cell 38 cases with low expression of CD3 + T cell 38 cases with high expression of CD8 + T cell 38 cases with low expression of CD8 + T cell 38 cases with high expression of CD4 + T cell and 38 cases with low expression of CD4 + T cell. There were lymph node metastasis the higher the degree of tumor differentiation the higher the TNM stage and the difference between high and low expression of CD3 + T cell CD8 + T cell and CD4 + T cell was statistically significant χ 2 = 5. 330 4. 659 6. 786 χ 2 = 7. 962 10. 483 4. 343 χ 2 = 11. 120 7. 280 13. 300 P<0. 05 . Compared with the control group the numbers of Bacteroides fragilis Escherichia coli and Enterococcus in the colon cancer group increased obviously 6. 58 ± 0. 83 lgN/ g vs 8. 59 ± 1. 36 lgN/ g 7. 36 ± 1. 04 lgN/ g vs 9. 73 ± 1. 25 lgN/ g 7. 21±1. 08 lgN/ g vs 9. 28±1. 74 lgN/ g while the numbers of Lactobacillus and Bifidobacterium decreased obviously 8. 85±1. 46 lgN/ g vs 6. 34± 1. 22 lgN/ g 8. 94± 1. 09 lgN/ g vs 6. 17± 1. 32 lgN/ g P< 0. 05 . Spearman correlation analysis showed that Bacteroides fragilis Escherichia coli and Enterococcus were negatively correlated with the proportion of CD3 + T cell and CD8 + T cell in colon cancer patients r = - 0. 482 - 0. 459 - 0. 532 r = - 0. 438 - 0. 472 - 0. 508 P < 0. 05 Lactobacillus and Bifidobacterium were positively correlated with the proportion of CD3 + T cell and CD8 + T cell r = 0. 581 0. 507 r = 0. 536 0. 467 P<0. 05 Bacteroides flimsii Escherichia coli and Enterococcus were positively correlated with the proportion of CD4 + T cell r = 0. 483 0. 495 0. 461 P<0. 05 and Lactobacillus and Bifidobacterium were negatively correlated with the proportion of CD4 + T cell r = -0. 563 -0. 579 P<0. 05 . Conclusion The phenotypes of CD3 + T cell CD8 + T cell and CD4 + T cell in TIL of colon cancer patients have certain relationship to the clinicopathological characteristics and gut microbiota.
2024 Vol. 11 (4): 547-552 [Abstract] ( 26 ) HTML PDF (832 KB)  ( 6 )
553 Effects of enteral feeding through nasogastric tube on nutritional status and body status of patients with esophageal cancer during radiotherapy and chemotherapy
1Cheng Yanli,2Wang Miaomiao,3Zhong Huijuan,1Chen Yingge,3Yuan Gaofeng
Objective To investigate the effects of intranasal feeding NGT through nasogastric tube on nutritional status and body status of patients with esophageal cancer during radiotherapy and chemotherapy. Method Retrospective analysis was performed on 100 patients with esophageal cancer who underwent concurrent chemoradiation and chemotherapy treated in the First People's Hospital of Suqian Affiliated to Nanjing Medical University from January 2020 to December 2023. They were divided into 2 groups according to different nutritional therapy methods. The nutritional therapy methods were NGT enteral feeding n = 50 and oral nutritional supplements ONS n = 50 . The nutritional status NRS 2002 and patient-generated subjective global assessment PG-SGA of the two groups were compared before and after 8 weeks of intervention assessment PG-SGA body mass index BMI and related serum nutritional indices body status Karnofsky performance status KPS and incidence of toxic side effects of chemoradiotherapy . Result There was no significant difference in the scores of NRS 2002 PG-SGA and KPS between the two groups before intervention P>0. 05 . After 8 weeks of intervention the scores of NRS 2002 and PG-SGA in NGT group were significantly lower than those in ONS group while the scores of KPS in NGT group were significantly higher than those in ONS group P<0. 05 . Before intervention there was no significant difference in serum nutritional indexes between the two groups P>0. 05 . After 8 weeks of intervention serum ALb Hb Fer and prealbumin levels in NGT group were significantly higher than those in ONS group P< 0. 05 . There was no significant difference in the incidence of toxicity and side effects between 2 groups P> 0. 05 . Conclusion Early NGT nutritional support can effectively improve the nutritional status and physical status of patients with esophageal cancer receiving radiotherapy and chemotherapy and has good clinical application value.
2024 Vol. 11 (4): 553-558 [Abstract] ( 28 ) HTML PDF (828 KB)  ( 8 )
559 Social support and fear of cancer recurrence among postoperative patients with cervical cancer the mediation role of illness uncertainty
1Li Lin,2Chen Jingjing,1Wu Ting,3Li Honglin
Objective To investigate the fear of cancer recurrence FCR 、illness uncertainty and social support in postoperative patients with cervical cancer and to analyze illness uncertainty in FCR and social support. Method From September 2022 to July 2022 a cross sectional survey research a convenience sampling method was used to select 260 postoperative patients with cervical cancer in Hai′an People′s Hospital and Affiliated Hospital of Nantong University as the research objects. The general information questionnaire and the fear of progression questionnaire-short form FoP-Q-SF the disease uncertainty scale MUIS social support rating scale SSRS were used to investigate the patients. Result The majority of cervical cancer survivors have FCR 68. 85% . The scores of FoP -Q-SF、MUIS and SSRS in postoperative patients with cervical cancer were 37. 08± 6. 01 points 79. 86± 11. 21 points 40. 83 ± 10. 94 points. FCR and MUIS was significantly negatively associated with social support FCR was significantly positively associated with uncertainty in illness P< 0. 01 . Moreover uncertainty in illness was found to mediate the relationship between social support and FCR the indirect effect-0. 189 and the mediating effect accounted for 47. 97%. Conclusion The FCR level of postoperative patients with cervical cancer is high and good social support can directly mitigate FCR while illness uncertainty can play a mediation role between social support and FCR. Clinicians should conducted to explore effective interventions for social support and IU to ultimately mitigate FCR in cervical cancer survivors
2024 Vol. 11 (4): 559-565 [Abstract] ( 34 ) HTML PDF (845 KB)  ( 17 )
566 The relation of taste change nutritional status and cancer fatigue in lung cancer chemotherapy
1Huang Wenxia,1Bai Qianwen,1Qian Jing,2Zhu Jie
Objective To explore the correlation between taste change its nutritional status and cancer fatigue in lung cancer chemotherapy patients. Method Retrospective analysis of 137 patients with lung cancer chemotherapy collected in Suzhou Hospital of Traditional Chinese Medicine from February 2021 to February 2024 for chemotherapy-related taste change scale CiTAS nutritional risk screening NRS 2002 cancer fatigue CFS status assessment Pearson method and linear regression analysis of CiTAS score NRS 2002 score and CFS score. Result Basic taste change score 15. 52±2. 52 taste abnormalities and taste hallucinations 9. 12± 2. 63 eating distress 20. 15±2. 35 overall taste change 12. 35±2. 89 CiTAS score 57. 13±7. 78 NRS 2002 score 4. 89± 2. 22 physical fatigue 24. 86± 2. 84 emotional fatigue 12. 36± 2. 39 cognitive fatigue 11. 78± 2. 55 CFS score 49. 01± 6. 60 points. Analyzed by the Pearson method total score of CiTAS was positively correlated with NRS 2002 score physical fatigue emotional fatigue cognitive fatigue and CFS total score After a linear regression analysis NRS 2002 The score and the total CiTAS score will affect the total CFS score By the analysis of the mediation effect NRS 2002 Score β = 0. 469 P<0. 001 and total CiTAS score β = 1. 105 P<0. 001 can significantly and positively predict the total CFS score The CiTAS total score plays a partial mediating role in the influence of NRS 2002 score and CFS total score the mediation effect accounted for 21. 17% of the total effect proportion. Conclusion Lung cancer chemotherapy patients taste change symptoms moderate to severe level and will directly affect the nutrition and cancer fatigue taste change the more serious nutritional status cancer fatigue the more serious a positive correlation to actively develop nutrition support adjust food taste to meet the demand of patients to ensure enough nutrition intake improve physical and mental health.
2024 Vol. 11 (4): 566-570 [Abstract] ( 24 ) HTML PDF (818 KB)  ( 14 )
571 Research progress on the role of M2 type pyruvate kinase glycolipid metabolism key enzymes in metabolic reprogramming of malignant tumors
1Chen Yekai,1Li Hegen,2Zhao Tiancheng,1Zhu Lihua,1Zhou Lei
Metabolic reprogramming is one of the important features of tumors which provides essential macromolecules for adenosine triphosphate ATP and intracellular protein and nucleotide biosynthesis thereby promoting the proliferation and survival of tumor cells. The metabolism of tumor cells is significantly different from that of normal cells and the strong plasticity of tumors is an important reason for the slow progress of targeted tumor metabolic therapy research. Research has shown that key metabolic enzymes in glucose and lipid metabolism can alter their own activity and obtain non metabolic enzyme functions in various ways thereby driving metabolic reprogramming in tumor cells. These methods mainly include abnormal protein expression mutations post - translational modifications changes in oligomeric state and subcellular translocation. Pyruvate kinase is a key enzyme in the cellular glycolytic pathway which catalyzes the conversion of phosphoenolpyruvate to pyruvate and produces adenosine triphosphate. M2 type pyruvate kinase PKM2 can promote tumor cell proliferation and synthetic metabolism by enhancing the Warburg effect. It can also enter the nucleus as a co transcription factor and protein kinase to regulate gene transcription playing an important role in malignant tumor metabolic remodeling cell proliferation and metastasis. This article summarizes the abnormal expression of PKM2 in various types of tumors its role and mechanism in tumor metabolism regulation and its application and breakthroughs in the field of traditional Chinese medicine in order to provide new ideas for clinical tumor metabolism therapy.
2024 Vol. 11 (4): 571-575 [Abstract] ( 17 ) HTML PDF (822 KB)  ( 15 )
576 Research progress of purinergic receptors in tumors
Yang Xue, Deng Licong, Wan Shan
Purinergic signaling is involved in many biological processes. Adenosine 5′ - triphosphate and other extracellular nucleotides act as endogenous ligands to bind and activate purinergic receptors for signaling and indicate their potential. A variety of widely expressed purinergic receptors have been found in human tumor tissues and tumor cell lines which are activated by extracellular ATP in inflammatory and hypoxic tumor environments and play a key role in affecting tumor cell metabolism proliferation and metastasis. Specifically P2X receptors belong to ligand - gated ion channels while P2Y receptors belong to G protein - coupled receptors. Activation of these receptors affects key biological processes such as intracellular Ca 2+ concentration cell cycle apoptosis and cell migration. In different types of tumors different purinergic receptor subtypes show different expressions and effects. For example P2X7 promotes tumor cell proliferation in neuroblastoma while P2Y12 inhibits tumor cell clonogenicity and migration in glioblastoma. In addition the activation of purinergic receptors also affects the immune response and therapeutic effect in the tumor microenvironment. Drugs targeting different purinergic receptor subtypes can affect the growth and metastasis of tumor cells and even enhance the effect of immunotherapy. This article reviewed the functional research progress of a variety of purinergic receptors and discussed their roles in different cancers and further understand its potential as a target for anti-tumor drugs.
2024 Vol. 11 (4): 576-584 [Abstract] ( 24 ) HTML PDF (4254 KB)  ( 13 )
585 Application and selection of nutritional screening scales for pediatric cancer patients
1Wang Jiayu,2Li Wanqi,1 3Wu Yan,4Li Ruoyu,5Song Chunhua,6Du Zhenlan,1Tao Ling
Malnutrition significantly reduces the living quality of pediatric cancer patients and increases the risk of postoperative infections. Addressing this issue through early nutritional screening and intervention for children at risk of malnutrition is crucial to prevent malnutrition and its associated complications. In China the prevalence of malnutrition among pediatric cancer patients is relatively high and multiple factors such as tumor type stage and the individual variability of treatment regimens increase the complexity of determining whether a child with cancer is malnourished. Currently most studies use scales from other countries making it difficult to standardize and compare results across different scales. Therefore there is an urgent need to develop a set of targeted nutritional screening scales that are applicable to Chinese pediatric cancer patients. This paper compares the similarities and differences between the current domestic and international pediatric nutritional screening scales regarding their screening purpose populations content scoring criteria applications limitations and effectiveness. This paper further summarizes the advantages and disadvantages of each scale proposes improvements to existing scales and offers recommendations for developing a nutritional screening scale tailored for pediatric cancer patients in China aimed at advancing the establishment and application of nutritional screening scales for pediatric cancer patients in the country.
2024 Vol. 11 (4): 585-590 [Abstract] ( 28 ) HTML PDF (842 KB)  ( 5 )
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