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2024 Vol. 11, No. 6
Published: 2024-12-09
 
747 Effect of different dietary patterns on the cancer development
Zhang Gege, Song Chunhua
Globally tumor is the second most common cause of death. Cancer accounted for around one in six fatalities globally in 2020. The most prevalent malignancies are those of the breast lungs colon rectal and prostate. An estimated one - third of tumor-related deaths are thought to be related to smoking drinking being obese eating a poor diet and not exercising. The World Health Organization estimates that 30%-50% of tumor cases could be prevented through measures such as healthy eating habits and avoidance of key risk factors. Certain components of food have an important impact on the multiple pathways of tumor development and progression. Thus research is being done on the relationship between diet and a range of tumors as well as how diet can both prevent tumor and enhance the prognosis of tumor patients. At the same time diets are combinations of multiple components and dietary patterns allow for a holistic assessment of diet quality that better takes into account the cumulative effects and complex interactions between dietary components. In addition to reviewing recent cohort studies on the impact of different dietary patterns on tumor this article also examines research on the metabolomics of different dietary components and offers insights into the possible connections between different dietary patterns and tumor. Among the more widely advised healthy eating patterns are the Mediterranean diet dietary approaches to stop hypertension and a healthful plant-based diet. Dietary components and quality are crucial for good health. The impact of various dietary patterns on tumor in Asian populations requires more research. In order to provide guidance for the prevention and treatment of tumor this article reviews the effects of various dietary patterns on the development of tumor and their potential mechanisms such as the Mediterranean diet the western diet the plant-based diet dietary approaches to stop hypertension and the low-carb diet.
2024 Vol. 11 (6): 747-749 [Abstract] ( 38 ) HTML PDF (2438 KB)  ( 15 )
750 Dietary education is the optimal method for nutritional therapy of cancer patients
1Qin Jin,2Cong Minghua
Nutrition is the foundation of cancer therapy and diet is the foundation of nutritional therapy. In the five-step nutrition therapy diet occupies the first and second steps and is the optimal method which characterized by high frequency variety affordability and universality. A reasonable diet can provide patient with sufficient and balanced nutrients which can improve the immunological function promoting the tolerance and continuity of cancer therapy. Food choices are a part of the elaborate behavior pattern which gradually formed under the influence of lifestyle habits culture society economy and environment. Dietary education needs to employ behavioral intervention strategies to help cancer patients master dietary knowledge change dietary behaviors and promote well-being. Cancer patients experience a significantly metabolic changes during different disease stages and treatment periods resulting in varying nutritional needs. Comprehensive and accurate dietary education can enable cancer patients to follow dietary plans that align with their metabolic characteristics and pathological changes solidifying the foundation of nutritional therapy in cancer. This article reviews the relevant theories implementation processes and specific content of dietary education for cancer patients providing reference and guidance for medical staff to conduct dietary education.
2024 Vol. 11 (6): 750-755 [Abstract] ( 22 ) HTML PDF (937 KB)  ( 15 )
756 Research progress on amino acid metabolism in tumor microenvironment
1Xue Yaqi,2Qin Liqiang,3Zhang Jianwei
The tumor microenvironment is a complex system composed of non-tumor host cells around tumor cells non-cellular components vascular system and soluble products which plays an important role in the initiation and progression of tumor. Components in the tumor microenvironment as therapeutic targets for tumors have attracted extensive research interest. Amino acids are the substrates for protein synthesis and are a vital source of energy and nutrients. More and more evidence indicates that amino acid metabolism affects tumor growth metastasis and other biological processes through the regulation of tumor microenvironment and is closely related to tumor immunity and drug resistance. At present dietary therapies targeting amino acid metabolism including inhibition of amino acids transporter activity regulation of amino acids biosynthesis and amino acids modified dietary have had remarkable achievements however there are still many problems to be solved. In this paper the effects of amino acid metabolism on immune cells tumor - associated fibroblasts and other components in tumor microenvironment were reviewed and studies about targeting amino acid metabolism for tumor therapy in recent years were summarized. We are aimed at providing research basis for better therapy increased therapeutic effect and less drug resistance.
2024 Vol. 11 (6): 756-762 [Abstract] ( 37 ) HTML PDF (987 KB)  ( 10 )
763 Advances in epidemiologic research on dietary patterns and risk of esophageal cancer
1Zhang Xiaorui,1 2Wang Yijie,1Liu Fen
Esophageal cancer is one of the most common malignant tumors of digestive tract with high malignant degree poor prognosis and serious disease burden. Dietary factors play an important role in the occurrence and development of esophageal cancer. Current research has extensively explored the relationship between individual food groups or nutrients and the risk of esophageal cancer. However there may be synergistic or antagonistic effects among various food groups or nutrients during physiological metabolism. Therefore considering dietary factors from the perspective of dietary patterns can better reflect the overall effect and is more easily translated into guideline recommendations. This approach holds greater practical significance for the primary prevention of esophageal cancer. This paper provided an overview of the methods used to construct dietary patterns in research on the risk of esophageal cancer including a priori a posteriori and hybrid approaches. It also summarized the recent findings on the association between dietary patterns and esophageal cancer and elucidated the potential underlying mechanisms. Healthy dietary patterns characterized by vegetables fruits whole grains and legumes such as plant-based dietary pattern Mediterranean diet and healthy diet index were found to be associated with reduced risk of esophageal squamous cell carcinoma. Dietary patterns characterized by red meat processed meat refined grains or inflammatory dietary patterns may increase the risk of esophageal squamous cell carcinoma and esophageal adenocarcinoma. This review may provide scientific references for future research in this field.
2024 Vol. 11 (6): 763-770 [Abstract] ( 33 ) HTML PDF (3224 KB)  ( 3 )
771 Challenges and strategies of chimeric antigen receptor T-cell therapy in solid tumors
Li Xingning Qu Chunfeng
Adoptive cell therapy is the process of regulating patients ' own immune system through the administration of tumor-reactive immune cells to achieve the goal of eliminating tumor cells. CAR-T cell is genetically modified T cell and the CAR-T cell therapy is a kind of adoptive T-cell therapy. Compared with generally adoptive cell therapy for tumors CAR-T cell therapy offers the advantages of higher specificity and stronger cytotoxicity on tumor cells and prolonged curative efficacy. In the treatment of hematological malignancies CAR - T cell therapy proves effective. An increasing number of preclinical studies and corresponding clinical studies have been carried out to extend CAR - T cell therapy to the treatment of some solid tumors such as metastatic melanoma non-small cell lung cancer breast cancer and colorectal cancer. However it has not achieved good curative efficacy. Owing to the differences in properties between solid solid tumors and hematological malignancies CAR-T cell therapy is challenged for the treatment of the solid tumors such as on - target off - tumor toxicity immune escape caused by tumor antigen heterogeneity CAR- T cell exhaustion due to the immunosuppressive tumor microenvironment resulting in the limited therapeutic efficacy and immune toxicity. To improve the clinical efficacy and safety of CAR-T cell therapy in the treatment of the solid tumors many different strategies are developing currently based on the unique characteristics of solid tumors such as overexpressing chemokine receptors and cytokines dual CAR-T cells improving T cell metabolism adjusting the affinity of CAR. To provide a reference for future CAR-T cell therapy for solid tumors the development of CAR-T cells current challenges and associated optimization strategies for CAR-T cells in solid tumor treatment are reviewed in this paper.
2024 Vol. 11 (6): 771-776 [Abstract] ( 23 ) HTML PDF (2415 KB)  ( 16 )
777 Nutrition improvement of ω-3 PUFAs in tumor therapy and its potential mechanism
Zhang Xiaona, Zhang Jian
ω-3 polyunsaturated fatty acids ω-3 PUFAs can help reduce symptoms of cachexia and reduce weight loss in patients with advanced malignant tumors. As an immune nutrient it can improve the perioperative immune function of patients with malignant tumors and reduce the levels of inflammatory markers improvement of the sensitivity and tolerance of treatment and reduce the therapeutic drug or radiation dose. The potential mechanisms of ω-3 PUFAs are ① increase the content of corresponding fatty acids in the phospholipids of the cell membrane involved in the inflammatory response thereby enhancing the fluidity of the cell membrane and reducing the activation of pro-inflammatory transcription factors such as nuclear factor-κB NF-κB specialized pro-resolving mediators SPMs including resolvins protectins and maresins regulating the inflammatory process. ② Eicosapentaenyl ethanolamide EPEA and DHEA derived from EPA and DHA were converted into EEQ-EA and EDP-EA isomers under the action of Cytochrome P450 CYP monooxygenases which inhibited the activation of JNK signaling pathway and alleviated the macrophage inflammatory response triggered by palmitic acid attenuating LTB4 - induced neutrophil mobility and activation. In addition EDPs inhibits angiogenesis induced by vascular endothelial generating factor VEGF and fibroblast growth factor 2 in vivo. ③ ω - 3 PUFA can selectively induce ferroptosis in cancer cells under environmental acidosis and produce toxic effects on tumor cells. Although ω- 3 PUFAs has been widely used in clinical practice its effects in the treatment and nutrition improvement of cancer patients are still inconsistent. More high-quality clinical trials and in-depth mechanism studies are needed.
2024 Vol. 11 (6): 777-781 [Abstract] ( 31 ) HTML PDF (922 KB)  ( 9 )
782 Establishment of standardized screening diagnosis and treatment criteria for sarcopenia and expert recommendations
Shanghai Anticancer Association Oncology Nutrition and Supportive Therapy Professional Committee
Sarcopenia is a progressive skeletal muscle disease characterized by a decline in muscle strength quantity quality and function. It is commonly observed in elderly individuals cancer patients and those with chronic diseases. Sarcopenia significantly increases the risk of falls surgical complications and mortality rates among high-risk populations imposing a substantial burden on both healthcare systems and society. However there is currently no unified screening and diagnostic criteria for sarcopenia and there is a lack of systematic and individualized diagnostic criteria and standardized treatment measures suitable for the Chinese population. This article aims to summarize published research and guidelines related to sarcopenia to establish standardized screening criteria diagnostic and treatment processes and systems with Chinese characteristics. These can be applied in healthcare institutions at all levels in China for screening assessment diagnosis treatment and monitoring of sarcopenia providing a reference for clinical practitioners and researchers.
2024 Vol. 11 (6): 782-787 [Abstract] ( 36 ) HTML PDF (1011 KB)  ( 12 )
790 Exploration of the clinical relationship between tumor heterogeneity and evaluation of radiotherapy and chemotherapy efficacy in rectal cancer by magnetic resonance functional imaging analysis
Duan Yanhua, Yu Yudong, Deng Xiaoyan
Objective Overall tumor assessment such as histogram analysis was a common means to obtain tumor heterogeneity information that may affect the treatment response. The purpose of this study was to evaluate the role of functional magnetic resonance imaging MRI in analyzing tumor heterogeneity in evaluating the efficacy of radiotherapy and chemotherapy CRT for rectal cancer. Methods From January 2020 to November 2021 60 patients with locally advanced rectal cancer LARC who underwent MRI examination before CRT in our hospital were selected as the research subjects. The apparent diffusion coefficient ADC intra-voxel incoherent motion Dslow Dfast and F and stretch index model DDC and α were obtained from the histogram of the whole tumor. Histogram indexes and prognostic factors before CRT were compared between patients with complete pathological remission pCR and those without pCR. The receiver operating characteristic curve ROC curve was constructed to evaluate the diagnostic performance of these parameters. Results After CRT treatment 13 patients 21. 7% were classified as pCR group while the other 47 patients were classified as non-pCR group 78. 3% . Compared with the pCR group the non-pCR group had significant differences in tumor volume TRG and pT stages P < 0. 05 . The mean standard deviation and the 10th 25th 50th 75th 90th and 95th percentile of ADC in pCR group were significantly lower than those in non-pCR group P<0. 05 . The mean skewness kurtosis and 25th 50th 75th 90th and 95th percentile of DDC in pCR group were lower than those in non-pCR group P<0. 05 . In ADC its average value AUC = 0. 890 P<0. 001 95%CI = 0. 806-0. 974 had the highest diagnostic performance. In DDC its average AUC = 0. 866 P<0. 001 95%CI = 0. 771-0. 960 has the highest AUC value. Average ADC combined with tumor volume had the highest diagnostic performance in predicting pCR with AUC of 0. 932 sensitivity of 100% and specificity of 81%. Conclusion The whole-tumor ADC mean combined with the tumor volume can effectively predict the response of LARC to CRT.
2024 Vol. 11 (6): 790-796 [Abstract] ( 17 ) HTML PDF (5759 KB)  ( 5 )
797 Correlation between the expression and prognosis of unsaturated fatty acid-related enzymes CBR1 ALOX15 and FADS1 in epithelial ovarian cancer
1Lei Yuchen,1Li Ting,1Wang Rixin,2Lyu Haixu,1Jin Xiaoming,3Kong Dan,1Liu Yu
Objective Exploring the correlation between the expression and prognosis of monounsaturated fatty acid related enzyme CBR1 polyunsaturated fatty acid related enzymes ALOX15 and FADS1 in epithelial cancer tissues. Method The expression levels of CBR1 ALOX15 and FADS1 were analyzed by immunohistochemistry and Western blot analysis from 65 epithelial ovarian cancer samples collected from the Department of Gynecology Affiliated Cancer Hospital of Harbin Medical University from April 2020 to December 2023. Analyze the expression of these three unsaturated fatty acid-related enzymes tumor cell proliferation correlation with overall patient survival and immune cell infiltration through GEPIA2 database Kaplan-Meier survival curve and TIMER2. 0 database. Result Study found that CBR1 was correlated with serum CA125 levels ALOX15 was correlated with epithelial ovarian cancer staging and P53 expression and FADS1 was correlated with differentiation degree all P<0. 05 . GEPIA2 database showed that FADS1 was statistically significant with tumor stage and CBR1 and FADS1 were positively correlated with tumor cell proliferation. Kaplan-Meier survival analysis showed that high expression of FADS1 predicted shorter survival while high expression of ALOX15 predicted longer survival. Western blot analysis of the expressions of three UFA-related enzymes in EOC tumor tissues and adjacent tissues showed that the expressions of CBR1 and ALOX15 were consistent with GEPIA2 database while the expressions of FADS1 were opposite. The expression of these three unsaturated fatty acid - related enzymes was correlated with immune cell infiltration macrophages and CD8 + T cells . Conclusion This study validated the correlation between the expression of CBR1 ALOX15 and FADS1 in epithelial ovarian cancer and the clinical prognosis of patients However the relationship between monounsaturated fatty acids or polyunsaturated fatty acids and tumor occurrence development and prognosis still requires a large amount of experimental data for verification.
2024 Vol. 11 (6): 797-804 [Abstract] ( 17 ) HTML PDF (19466 KB)  ( 2 )
805 Relationship between feeding intolerance and inflammatory factors in patients with gastric cancer and analysis of influencing factor
Huang Xiaoyu, Wu Lihong, Wang Yonglei
Objective To analyze the influencing factors of early enteral nutrition feeding intolerance in postoperative patients with gastric cancer and to explore the correlation between inflammatory factors and enteral nutrition feeding intolerance in postoperative patients with gastric cancer. Method A total of 200 patients with gastric cancer who underwent radical gastrectomy and early enteral nutrition at the Jiangsu Province Hospital of Traditional Chinese Medicine from June 2022 to April 2024 were selected and their clinical data were retrospectively analyzed. Result In the feeding intolerance group the age was 65. 65 ± 15. 11 years old the nutritional risk screening NRS 2002 score was 3. 31±1. 34 the intraoperative blood loss was 92. 74±48. 36 ml the operation time was 212. 53±48. 51 min and the first time to get out of bed after operation was 4. 58±2. 06 days. The level of prealbumin in the feeding intolerance group was 126. 61±52. 15 g / L which was lower than that in the TEN tolerance group P < 0. 05 . Patients with malnutrition assessed by GLIM were more likely to develop feeding intolerance P < 0. 05 . The levels of TNF-α IL-6 IL-8 IL-1β and CRP in feeding intolerance group were 6. 17±2. 73 pg / ml 48. 29±18. 49 pg / ml 41. 64±16. 34 pg / ml 21. 6±12. 69 pg / ml 70. 42±38. 09 mg / L respectively. They were higher than the enteral nutrition tolerance group P < 0. 05 . Multivariate Logistic regression analysis showed that age NRS 2002 score GLIM score of malnutrition and intraoperative blood loss were risk factors for enteral nutrition intolerance. IL- 6 IL- 8 and IL- 1β are positively correlated with feeding intolerance in postoperative patients with gastric cancer. Conclusion Age NRS 2002 score GLIM score of malnutrition and intraoperative blood loss are the risk factors of feeding intolerance in postoperative patients with gastric cancer. The expression of inflammatory factors is significantly correlated with feeding tolerance.
2024 Vol. 11 (6): 805-810 [Abstract] ( 16 ) HTML PDF (935 KB)  ( 11 )
811 Longitudinal study on the changes in nutritional literacy among postoperative breast cancer patients
Wang Lina, Liu Xiaoqing
Objective To explore the trajectory of postoperative nutritional literacy changes in breast cancer patients and analyses the influencing factors of different trajectories. Method 450 breast cancer patients admitted to Yuncheng Central Hospital Shanxi Medical University from April 2022 to January 2024 were selected as the study subjects and the basic information questionnaire and the nutritional literacy questionnaire were used to conduct questionnaire surveys in the postoperative period T1 one month after operation T2 three months after operation T3 and six months after operation T4 respectively. The latent category growth model and one-way analysis of variance were used for data analysis and testing. Result In this study 450 questionnaires were initially distributed and 412 valid consecutive questionnaires were completed for the four time points with a recovery rate of 91. 56%. The scores of surgical nutrition literacy in breast cancer patients were 19. 31±5. 33 21. 67±5. 26 23. 07±5. 49 23. 22±5. 21 respectively. There were three different tracks of nutritional literacy and the average probabilities were 0. 962 0. 958 and 0. 960 respectively. The 3 trajectory categories were medium literacy increase group 47. 1% higher literacy smooth group 29. 1% and lower literacy smooth group 23. 8% . Different trajectory categories were found in age χ 2 = 8. 870 P = 0. 012 marital status χ 2 = 8. 210 P = 0. 016 educational level χ 2 = 26. 061 P < 0. 001 mode of residence χ 2 = 8. 886 P = 0. 012 BMI index χ 2 = 24. 959 P < 0. 001 preoperative radiotherapy χ 2 = 10. 298 P = 0. 006 were significantly different. Logistic regression showed that <60 years old married educational level secondary school and above and BMI > 18. 5 kg / m 2 became protective factors for nutritional literacy in breast cancer patients and living alone and preoperative radiotherapy became risk factors P < 0. 05 . Conclusion In this study three types of trajectories of nutrient literacy were identified by investigating the changing characteristics of postoperative nutrient literacy in breast cancer patients. Patients in different nutrient literacy groups and are affected by a combination of age marriage education level mode of residence BMI and preoperative radiotherapy etc. It is important to pay attention to the assessment of the level of postoperative nutrient literacy of breast cancer patients especially those in the lower literacy smoother group and timely nutritional knowledge education and necessary nutritional interventions and support to improve their nutritional status in the later stage of the disease.
2024 Vol. 11 (6): 811-817 [Abstract] ( 14 ) HTML PDF (955 KB)  ( 4 )
818 The predictive value of controlling nutritional status combined with inflammatory markers for immune response in esophageal cancer
1Wei Shuang,2Zhang Yuhong,3Sun Hongfu
Objective To explore the controlling nutritional status CONUT and systemic immune - inflammatory index SII neutrophil-lymphocyte ratio NLR and platelet-lymphocyte ratio ratio PLR in predicting the efficacy of immunotherapy in patients with locally advanced or metastatic esophageal squamous cell carcinoma and the predictive efficacy of combining the above four indicators. Method Patients with esophageal squamous cell carcinoma treated with immune combined chemotherapy or chemoradiotherapy in Cancer Hospital of Shandong First Medical University and Gaomi People 's Hospital from January 2018 to December 2021 were retrospectively analyzed. The hematological examination results of the patients within 1 week before treatment were collected and the CONUT score SII NLR and PLR values of the patients were calculated. The dependent receiver operating characteristic curve ROC curve was drawn based on one-year overall survival and the best cut-off values of CONUT SII NLR and PLR were calculated. The primary end point was overall survival OS and the secondary end points were progression-free survival PFS and objective response rate ORR . Result A total of 335 patients were enrolled. According to the ROC curve the cut-off values of CONUT SII NLR and PLR were 2. 5 749. 69 2. 795 and 202. 975 respectively. The median OS was 27. 3 22. 9-31. 7 months in the low COUNT group and 23. 3 16. 29-30. 25 months in the high COUNT group P < 0. 001 . The median PFS was 10. 9 9. 96-11. 84 months in the low count group and 7. 6 6. 51-8. 63 months in the high count group P = 0. 001 . The median OS of the low SII group and the high SII group were 27. 9 25. 12 - 30. 68 months and 17. 9 16. 99 - 18. 81 months P < 0. 001 respectively. The median PFS of the low SII group and the high SII group were 11. 6 10. 69-12. 51 months and 7. 5 (6. 56-8. 44) months P < 0. 001 respectively. The median OS of the low NLR group and the high NLR group were 28. 37 25. 25-31. 49 months and 18. 6 16. 20-21. 0 months respectively P = 0. 016 . The PFS was 10. 93 9. 96-11. 90 months and 7. 53 6. 80-8. 26 months respectively P < 0. 001 . The median OS of the low PLR group and the high PLR group were 27. 5 23. 7-31. 3 and 21. 0 14. 3-27. 7 months respectively P = 0. 007 and the median PFS were 10. 9 9. 9 - 11. 9 and 8. 3 7. 5 - 9. 2 months respectively P < 0. 001 . The combined prediction efficiency of the four indicators was higher than that of the single CONUT score. Conclusion For patients with locally advanced or metastatic esophageal squamous cell carcinoma treated with immunotherapy patients with low CONUT score before treatment have better OS and PFS than those with high CONUT score and the predictive value of combined inflammation indicators is better.
2024 Vol. 11 (6): 818-826 [Abstract] ( 27 ) HTML PDF (3730 KB)  ( 55 )
827 Analysis of adherence and influencing factors of electronic patient-reported outcome tools in colorectal cancer patients
1Wang Huilin,2Yang Min,3Wang Xinyi,4Zhai Jingbo,1Li Jiang,2Cong Minghua
Objective To evaluate the adherence and influencing factors of colorectal cancer CRC patients using electronic patient-reported outcome ePRO tool for symptom management during anti -tumor therapy. Method A retrospective analysis was conducted on data of 326 CRC patients recruited from 36 hospitals nationwide from January to November 2023. Adherence to ePRO tool during anti-tumor therapy was assessed using overall response rate ORR average response rate ARR single response rate SRR and patient-level response rate PRR . The generalized linear mixed model was used to analyze factors influencing the use of ePRO tool. Result During anti-tumor therapy ORR of CRC patients ranging from 31. 98% to 60. 36% and ARR from 31. 49% to 62. 09% across different ePRO tool modules. The mean PRR of CRC patients varied between 27. 33% and 51. 15% depending on the total number of treatment cycles. Higher adherence was observed in younger patients those with stage Ⅱ and Ⅲ CRC patients residing in rural areas and those receiving immunotherapy. Conclusion Adherence to ePRO tools during anti-tumor therapy in CRC patients in clinical settings is relatively low. To enhance the adherence of CRC patients to ePRO tools and thereby maximize their clinical utility in symptom management efforts should be directed towards strengthening patient education optimizing the design of ePRO tools and reinforcing the feedback mechanisms between healthcare providers and patients.
2024 Vol. 11 (6): 827-833 [Abstract] ( 15 ) HTML PDF (951 KB)  ( 6 )
834 Clinical study on the correlation between body fluid distribution and radiation oral mucositis in patients with head and neck cancer undergoing radiotherapy based on bioelectrical impedance analysis
1Liu Jie,1Zhao Di,2Zhao Yuexin,1Lu Hong,1Bian Xinyu,1Wang Pei
Objective Bioelectrical impedance analysis BIA was used to observe the fluid distribution of patients with head and neck cancer who were undergoing radiotherapy including intracellular water extracellular water total body water ECW/ ICW % ECW/ TBW % changes. At the same time by observing the occurrence time and degree of radiation oral mucositis ROM during radiotherapy the correlation between the fluid distribution and the occurrence and degree of ROM was analyzed. Method A total of 60 patients with head and neck caner who were undergoing radiotherapy in the Radiotherapy Department of Jiangsu Province Hospital of Chinese Medicine from September 2022 to March 2024 were prospectively included. fluid distribution indicators such as ICW ECW TBW ECW/ ICW % and ECW/ TBW % were collected and recorded before at the 2nd 4th and 6th week and finished day of radiotherapy respectively. To observe the occurrence time and severity of oral mucositis during radiotherapy RTOG radiation damage grading standard and explore the correlation between them. Result The values of ICW ECW and TBW varied with the degree of ROM at the 4th week of radiotherapy. ICW values in patients with OM grade 3 or higher were significantly lower than those with OM grade 2 or lower P < 0. 05 while ECW ECW/ ICW % and ECW/ TBW % values were increased significantly P < 0. 05 . No correlations were found between fluid distribution and ROM occurrence in other time. Conclusion The fluid distribution of patients with head and neck cancer during radiotherapy was significantly related to the occurrence and degree of radiation oral mucositis. The characteristics of human fluid distribution based on BIA measurement may be used as a potential predictor of radiation-induced oral mucositis which has great clinical significance for screening patients with high risk of ROM and prior intervention before symptoms occur.
2024 Vol. 11 (6): 834-839 [Abstract] ( 12 ) HTML PDF (1599 KB)  ( 10 )
840 Construction and verification of frailty risk prediction model in elderly lung cancer patients
1Xu Mengmeng,1Wang Xiaolan,2Chen Roudi
Objective To investigate the occurrence and influencing factors of frailty in elderly lung cancer patients establish a frailty prediction model and verify it. Method In this study 500 patients with lung cancer admitted to our hospital during the period from January 2022 to March 2024 were selected as research objects. The frailty status and influencing factors were analyzed statistically. Regression analysis was used to construct frailty risk prediction model and the model was displayed and verified by column graph. Result In the modeling group of this study 350 elderly lung cancer patients aged 61-79 years old with an average age of 68. 22 ± 7. 25 years old including 121 females 34. 57% and 229 males 65. 43% participated. Among 350 elderly patients with lung cancer 123 had frailty 35. 14% . Univariate analysis showed that age Charson comorbidity index nutritional status duration of disease body mass index BMI hemoglobin D - dimer albumin depression and cancer fatigue were the independent risk factors for fadility in elderly lung cancer patients P < 0. 05 . Result of multi - factor analysis Age Charson comorbidity index duration of disease D-dimer depression and cancer fatigue were the risk factors for frailty in elderly lung cancer patients P < 0. 05 hemoglobin albumin BMI nutritional status were the protective factors for frailty in elderly lung cancer patients P < 0. 05 . In the verification group AUC was 0. 842 95%CI = 0. 802-0. 886 sensitivity was 83. 5% and specificity was 73. 8%. Conclusion This study established a risk prediction model for frailty in elderly lung cancer patients. Frailty in elderly lung cancer patients is affected by age Charson comorbidity index nutritional status duration of disease D-dimer albumin depression and cancerous fatigue. In the future trajectory studies should be carried out to optimize the prediction model and establish a dynamic nomogram model to provide a reliable tool for clinical nurses to dynamically predict the frailty of elderly patients with lung cancer with a view to reducing frailty.
2024 Vol. 11 (6): 840-846 [Abstract] ( 29 ) HTML PDF (1526 KB)  ( 8 )
847 Risk factor analysis of malnourished patients with esophageal cancer based on multidimensional assessment
Hong Hong, Dai Lijun, Zhong Qiaoling, Jiang Jing
Objective To explore the risk factors of malnutrition in patients with esophageal cancer based on multidimensional nutritional status assessment. Method Clinical data of 106 patients with esophageal cancer admitted to the Oncology Department of Hai'an Hospital of Traditional Chinese Medicine from March 2019 to March 2023 were retrospectively analyzed. Through the global leadership initiative on malnutrition the Global Leadership Initiative on Malnutrition GLIM European Society for Clinical Nutrition and Metabolism 2015 ESPEN 2015 and patient-generated subjective global assessment PG-SGA were used to evaluate the nutritional status of 106 patients with esophageal cancer and the influencing factors of malnutrition were analyzed by binary Logistic regression. Result There were 21 cases of malnutrition assessed by GLIM 18 cases of malnutrition assessed by ESPEN 2015 19 cases of malnutrition assessed by PG-SGA and 27 cases of malnutrition assessed by multidimensional comprehensive assessment. Binary Logistic regression analysis showed that age > 60 years old comorbidities family history pathological stage Ⅲ-Ⅳ course of disease ≥ 12 months gastrointestinal symptoms ≥2 items poor diet behavior and Kanofsky performance score KPS < 70 points were all risk factors for malnutrition in patients with esophageal cancer P < 0. 05 . Conclusion Evaluating the nutritional status of esophageal cancer patients based on multidimensional nutritional status has good clinical value age > 60 years comorbidities family history pathological stage Ⅲ - Ⅳ duration of the disease >12 months gastrointestinal symptoms ≥2 poor dietary behaviors and KPS < 70 are risk factors for malnutrition in patients with esophageal cancer which need to be emphasized more in the clinic.
2024 Vol. 11 (6): 847-853 [Abstract] ( 24 ) HTML PDF (934 KB)  ( 8 )
854 Analysis of the epidemiological characteristics of vitamin deficiency in patients with digestive system tumors based on clinical data from 13 463 patients
Li Jiawei, Xu Wenwen, Xie Yin, Yu Xiang, Wang Chen, Zheng Xuan
Objective This study aims to investigate the levels of various serum vitamins in patients with digestive system tumors analyze the differences in vitamin deficiencies among different categories of tumor patients and further explore the correlation between serum vitamin levels protein indicators and inflammation indicators. This research aims to provide a scientific basis for vitamin supplementation in clinical patients with digestive system tumors. Methods We collected the results of serum vitamin tests for 13 463 in-patients with digestive system tumors in Changhai Hospital from January 2018 to June 2023. Statistical software SPSS 21. 0 was used for variance analysis to compare serum vitamin levels and chi-square tests were conducted to analyze the differences in deficiency rates of various vitamins in different types of digestive system tumors. Additionally Spearman correlation analysis was employed to investigate the correlation between serum vitamins and protein and inflammation indicators Results Digestive system tumor patients significantly lack water-soluble vitamins vitamin B1 vitamin C and vitamin B6 with an overall deficiency rate of 67. 75% 61. 51% and 32. 17% respectively. The significant deficiency of fat-soluble vitamin vitamin D is observed with an overall deficiency rate of 63. 60%. The deficiency rates of vitamin B1 in esophageal cancer gastric cancer colorectal cancer and pancreatic cancer are significantly higher than those in liver cancer patients 69. 11% 69. 03% 72. 62% 74. 14% vs. 18. 41% P < 0. 001 . The serum folate deficiency rate in liver cancer patients is much higher than in the above four types of digestive system tumor patients 46. 44% vs. 9. 02% 13. 13% 12. 82% 5. 70% P < 0. 001 . Spearman correlation analysis demonstrates that the levels of serum vitamin C and vitamin B6 in digestive system tumor patients are positively correlated with serum albumin vitamin C r = 0. 207 P < 0. 001 vitamin B6 r = 0. 255 P < 0. 001 . vitamin A is negatively correlated with IL-1β r = -0. 306 P < 0. 01 vitamin B6 is negatively correlated with IL-6 r = -0. 265 P < 0. 01 and vitamin C is negatively correlated with TNF-α r = - 0. 203 P < 0. 05 . Conclusion Different types of digestive system tumors exhibit distinct patterns of vitamin deficiencies. Clinically it is essential to develop corresponding nutritional supplementation plans based on their metabolic characteristics and to pay attention to the impact of inflammation on vitamin consumption.
2024 Vol. 11 (6): 854-863 [Abstract] ( 19 ) HTML PDF (5824 KB)  ( 18 )
864 The effect and potential mechanism of exercise on the efficacy of immune checkpoint inhibitors in cancer patients
Xia Ruiyang Du Cheng
The introduction of immune checkpoint inhibitors has brought new hope to cancer patients. However some patients do not respond to or develop resistance to immune checkpoint inhibitors so how to improve the efficacy of immune checkpoint inhibitors is imminent. It is well known that exercise can reduce the risk of cancer improve the survival rate of cancer patients and even enhance the efficacy of cancer treatment. However the mechanism of immune changes during exercise is very complex so how exercise affects the efficacy of immune checkpoint inhibitors is still uncertain. To date studies have been conducted to investigate the impact of exercise on hormonal mice or cancer patients treated with immune checkpoint inhibitors. These studies have sought to elucidate the potential mechanisms underlying alterations in the anti-tumor immune system and the tumor microenvironment. The findings from these preclinical and clinical trials indicate that exercise may enhance the anti-tumor immune system and the tumor microenvironment in cancer patients. The objective of exercise is to induce mobilization and redistribution of immune cells the release of immunostimulatory myokines alterations in immune cell metabolism and the amelioration of immune senescence in order to exert antitumor effects. The presence of hot tumors may enhance the efficacy of immune checkpoint inhibitor therapy in patients improve their survival prognosis and facilitate the response rate of cold tumors to immune checkpoint inhibitors. The generation of hot tumors or reprogramming of cold tumors is primarily facilitated by exercise through effector T-cell infiltration myeloid-derived suppressor cell depletion anti-tumor myofactor secretion and normalization of the tumor vasculature system. However further advancement of clinical studies on this topic is necessary. This review aims to discuss the development and potential mechanistic aspects of combination therapy of exercise and immune checkpoint inhibitors.
2024 Vol. 11 (6): 864-871 [Abstract] ( 26 ) HTML PDF (1011 KB)  ( 9 )
872 Application and research progress of CT and MRI in the assessment of cancer cachexia
Liu Shanling, Wang Yingjuan, Wang Chuanlin, Zhou Lan
Cancer cachexia is a kind of major complication of various malignant tumors and is characterized by skeletal muscle atrophy adipose tissue degeneration systemic inflammation and various metabolic abnormalities contribute to functional impairment. CT and MRI are capable of qualitatively and quantitatively measuring muscle area muscle density and muscle fat content. Utilizing advanced imaging techniques we assessed skeletal muscle area skeletal muscle index lateral and axial psoas major muscle thickness indices along with other relevant parameters in patients. This comprehensive evaluation aims to provide a more precise and objective assessment of sarcopenia and related conditions facilitating the identification of malignant fluid occurrence and progression stages thereby enabling the formulation of tailored nutritional treatment plans for specific phases. In this paper we review the application and research progress of CT and MRI in the assessment of nutritional status and diagnosis of cancer cachexia in patients with tumors and actively carry out nutritional therapy in patients with nutritional risk or early stage of cancer cachexia to delay the development and improve the clinical outcome of patients.
2024 Vol. 11 (6): 872-877 [Abstract] ( 15 ) HTML PDF (1377 KB)  ( 7 )
878 A scoping review of the application of global leadership initiative on malnutrition diagnostic criteria for malnutrition in surgical patients
Shi Jiawei, Li lingyu, Shi Chenghao, Liu Xinyi, Zou Haiou
This paper aims to conduct a comprehensive review of the relevant literature on the application of GLIM standard in surgical inpatients understand the actual application status and effect of GLIM standard in surgical patients promote the continuous improvement and optimization of the standard and provide reference for the subsequent application and verification of GLIM standard. According to the Australian Joanna Briggs Institute scoping Review guidelines Computer searches were conducted on PubMed CINAHL Scopus Embase The Cochrane Library Web of Science CNKI Wanfang Data Knowledge Service Platform and Chinese biomedical literature database etc. and the extracted data of the included literatures were sorted out and analyzed. A total of 34 literatures met the study criteria. Patients undergoing surgery for gastrointestinal tumors during surgery were the key population for GLIM standard application and the more common types of study design were cohort studies and cross - sectional studies. The most commonly used phenotype indicators are involuntary weight loss and low body mass index and the most commonly used etiological type indicators are disease or inflammatory status. GLIM criteria have good clinical applicability in the diagnosis of malnutrition in some surgical inpatients. There is still a need to use the complete GLIM diagnostic criteria for malnutrition in different surgical patient populations and disease Settings in strict accordance with the guidelines to identify and address possible problems or deficiencies in the GLIM criteria and to promote continuous improvement and optimization of the criteria to meet the needs of different contexts.
2024 Vol. 11 (6): 878-887 [Abstract] ( 26 ) HTML PDF (3019 KB)  ( 10 )
888 Health issues and nutrition management in long-term survivors of childhood cancer
Zhao Wenli, Yan Jie, Yang Wenli, Li Dongdan, Huang Hongmei
With the continuous improvement and development of childhood cancer treatment the number of long-term survivors is also increasing. Meanwhile childhood cancer survivors CCSs may face long-term adverse effects of cancer treatment this review delves into the health challenges faced by CCSs and proposes targeted nutritional management strategies to reduce their risk of disease and improve overall quality of life. By analyzing existing literature and research data this paper reveals the health problems of CCSs in endocrine secondary tumors and cardiovascular diseases clinicians and patients need to raise awareness of these complications and it is suggested to form a multidisciplinary team consisting of doctors nurses nutritionists psychologists and other healthcare professionals to provide comprehensive care and support for CCSs.
2024 Vol. 11 (6): 888-892 [Abstract] ( 23 ) HTML PDF (937 KB)  ( 17 )
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