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2023 Vol. 10, No. 2
Published: 2023-04-09
 
166 Radiation nutrition for tumors—research and thinking
Kuang Hao, Li Tao
The incidence of malnutrition in patients with radiotherapy for tumors is high and the core concept of radiation nutrition for tumors is to prevent diagnose treat evaluate and detect malnutrition in patients with radiation for tumors so as to reduce the toxic side effects of radiotherapy and increase the efficacy of radiotherapy. Radiotherapy is a 􀆵 double - edged sword for nutrition with positive and negative effects. Improving malnutrition is of great significance for tumor radiation therapy which can significantly improve the efficacy of tumor treatment and improve overall survival. Radiation nutrition requires the establishment of an multidisciplinary team and standardized diagnosis of radiation nutrition should be combined with patient -generated subjective global assessment score and Radiation Therapy Oncology Group criteria. The selection of enteral nutrition access follows the 􀆵four-step model and the influence of the irradiation field should be considered when selecting the parenteral nutrition pathway. Nutritional regimens for patients undergoing radiotherapy for tumors should be considered in a combination of 􀆵energy glycolipid-to-energy ratio protein vitamins and immunonutrients . Patients with radiotherapy for tumors need to manage the whole process of nutrition during the 􀆵 peri - radiotherapy period and do a good job in the detection and follow-up of radiation nutrition. The author believes that the development of tumor radiation nutrition should focus on basic research clinical criterion and translation research in order to help improve and standardize the level of clinical radiation nutrition and benefit the majority of tumor patients.
2023 Vol. 10 (2): 166-171 [Abstract] ( 297 ) HTML PDF (1149 KB)  ( 323 )
172 Nutrition impact symptoms
Feng Caiyun, Yu Kaiying, Shi Hanping
Nutrition impact symptoms NIS are a group of symptoms caused by the disease or its treatment and can affect a patient􀆳s nutritional status. These symptoms include pain dry mouth decreased appetite constipation satiety diarrhea oral ulcer nausea vomiting odor changes taste changes and difficulty swallowing. Different symptoms have different effects on nutrition. The number of symptoms that is symptom load is a more critical factor affecting nutritional status. Patient generated subjective global assessment PG- SGA is the most commonly used scale to study NIS in cancer patients. The Head and Neck Patient Symptom Checklist HNSC is a special tool for patients with head and neck cancer especially those receiving radiotherapy. The Edmonton Symptom Assessment System ESAS is suitable for patients with benign and malignant diseases. The NIS is reflected by the assessment scales and varies dramatically among diseases tumors stages individuals and medical treatments. Overall NIS is more common in patients with malignant tumors patients with more advanced tumors male patients patients over 65 years old and patients who underwent radiotherapy. A higher number or score of NIS indicates a worse prognosis for the patient. The management of NIS including the management of the symptoms and nutrition requires efforts from a multidisciplinary team.
2023 Vol. 10 (2): 172-176 [Abstract] ( 308 ) HTML PDF (1307 KB)  ( 372 )
177 Progress in the study of the relationship between tumor metabolism reprogramming and radiosensitivity
1Kong Lingling，2Guan Hui，1Xing Ligang
Metabolic reprogramming is one of the important hallmark of cancer. To meet the anabolic demands of the proliferative potential of tumor cells malignant cells tend to rewire their metabolic pathways. Radiation therapy is an important means for the treatment of malignant tumors. Compared with normal cells tumor cells have a large amount of metabolic heterogeneity from the development of precancerous lesions to local invasion metastasis or treatment resistance the metabolic phenotype and metabolic dependence may change. Radiation resistance has always been the main reason for limiting the efficacy of radiation therapy and is also a difficult and hot spot in the research of anti - tumor therapy. Tumor radiotherapy resistance is closely related to metabolic reprogramming. The special aerobic glycolysis mode of tumor cells creates a high lactic acid microenvironment which is not conducive to the role of radiation The accumulation of antioxidant molecules during metabolism can protect tumor cells from radiation damage of free radicals Under irradiation tumor cells need more energy supply and the synthesis of biological macromolecules to promote DNA damage and repair and flexible metabolic mode conversion provides conditions for it. The difference of metabolic patterns between normal tissues and malignant cells provides an opportunity for targeted metabolic therapy. This article reviews the relationship between the main metabolic pathways of tumor and radiotherapy hoping to reverse the radiation resistance and improve the sensitivity of tumor radiotherapy through targeted metabolism.
2023 Vol. 10 (2): 177-182 [Abstract] ( 415 ) HTML PDF (3660 KB)  ( 687 )
183 Application of palliative care concept in nutritional management of cancer patients receiving radiotherapy
Liang Lanqing, Liu Fang, Qu Baolin
Radiotherapy is one of the main treatment methods for patients with malignant tumors. The continuous progress of radiotherapy technology has greatly improved the survival rate of cancer patients and reduced the side effects of treatment. However the incidence of malnutrition is still high in cancer patients during radiotherapy especially in patients with head and neck cancer and gastrointestinal cancer. Therefore the implementation of whole-course nutritional management is particularly important for patients undergoing radiotherapy. In recent years nutritional intervention for cancer patients has attracted more and more attention. Many nutritional guidelines and Consensus for cancer patients have been published at home and abroad. In particular the nutritional norms and guiding principles for radiotherapy patients have been formulated which provide a solid theoretical basis for clinical implementation of nutritional screening assessment and treatment. This requires the guidance of a whole-process concept so as to effectively combine theory with practice to realize the whole-process nutrition management of tumor radiotherapy patients. Modern palliative care is an interdisciplinary subject that integrates medicine psychology ethics and sociology. It is also a people - oriented care system that improves the quality of life of patients. It is applicable to the entire course of any health-threatening disease especially in patients with tumors not just in the terminal stage. The application of palliative care in the whole nutritional management of radiotherapy patients will help to reduce the incidence of malnutrition and improve the quality of life of patients and the efficacy of radiotherapy.
2023 Vol. 10 (2): 183-187 [Abstract] ( 185 ) HTML PDF (1294 KB)  ( 371 )
188 Research advance of nutritional intervention to improve cancer-related cognitive impairment
Jiang Shirui Jiang Jiwei Xu Jun
With the continuous improvement of diagnosis and treatment technology the life expectancy of cancer patients is gradually increasing which makes the complications caused by cancer itself and its treatment become increasingly prominent. Cancer related cognitive impairment CRCI is a type of cancer with functional impairment of memory attention and execution during the course of the disease which affects patients􀆶 daily life and severely reduces the quality of life of patients. So far there is still no effective treatment for this cognitive impairment which is directly or indirectly caused by cancer. In recent years the progress of nutrition intervention in the field of cancer and cognitive disorders has gradually attracted attention. It can be seen that nutrition intervention can improve the prognosis and quality of life of cancer patients and improve cognitive function. In view of this nutritional interventions may provide an opportunity to ameliorate cancer related cognitive impairment. However at present the understanding of nutrition intervention in CRCI is still limited and the potential mechanism of its influence on CRCI is still unknown. Therefore this review intends to summarize the relevant research evidence in recent 10 years and try to explore the potential mechanism of nutrition intervention on CRCI from four aspects aging and frailty neuroinflammatory response metabolic process and epigenetics. It provides new ideas for elucidating the potential application value of nutrition intervention in cancer-related cognitive impairment.
2023 Vol. 10 (2): 188-193 [Abstract] ( 293 ) HTML PDF (1580 KB)  ( 385 )
194 Research progress on sarcopenia and tumor prognosis
Lu Zijian, Guo Ling
Sarcopenia is a progressive generalized syndrome characterized by decreased skeletal muscle content and decreased function which is common in the elderly. It not only causes dysfunction but also increases the risk of fractures falls complications and even death. However more and more studies have found that sarcopenia is more common in patients with tumors and that sarcopenia associated with malignant tumors is called tumor - associated sarcopenia. In a variety of tumors such as gastrointestinal tumors head and neck tumors breast cancer and lung cancer the high incidence of tumor-related sarcopenia is not only related to the toxic side effects of chemotherapy and radiotherapy and postoperative complications but also seriously affects the long-term survival of patients. At present the research on tumor - related sarcopenia is in the exploratory stage and multi - center large - sample prospective evidence-based research is still needed to further reduce the occurrence of related adverse reactions and improve the quality of life of patients. This article reviews the definition evaluation and diagnostic criteria of tumor-associated sarcopenia as well as the correlation between tumor-related sarcopenia and the treatment of toxic side effects postoperative complications and survival prognosis in tumor patients in different tumors aiming to clarify the important clinical value of sarcopenia in the prognosis of tumor patients and provide a basis for further large-scale clinical research.
2023 Vol. 10 (2): 194-198 [Abstract] ( 262 ) HTML PDF (1646 KB)  ( 386 )
199 Guidelines for nutritional treatment of cancer patients receiving radiotherapy （2022）
Chinese Society of Nutritional Oncology China Society for Radiation Oncology Radiation Oncology Physicians Branch of Chinese
Malnutrition is a common clinical manifestation of cancer patients and one of the most common complications of radiotherapy patients. Malnutrition will adversely affect the toxicity and side effects of cancer patients and the efficacy of radiotherapy. Therefore the nutritional treatment of cancer patients receiving radiotherapy is of great significance. Based on this Chinese Society of Nutritional Oncology China Society for Radiation Oncology Radiation Oncology Physicians Branch of Chinese Medical Doctor Association experts to formulate this guideline which contents mainly based on the current Chinese nutritional treatment status of radiotherapy patients evidence published at home and abroad combined with the experience and opinions of experts in the fields of clinical pharmaceutical nutrition nursing etc. used the European Society of Cardiology ESC evidence grading and recommendation intensity standards and focused on the screening evaluation education treatment of malignant cancer receiving radiotherapy for analysis discussion and summary. Finally the clinical diagnosis and nutritional treatment guidelines for cancer patients with radiotherapy were formulated for clinicians to provide a reference basis for standardized diagnosis and treatment.
2023 Vol. 10 (2): 199-207 [Abstract] ( 568 ) HTML PDF (2726 KB)  ( 962 )
208 Expert consensus on nutritional treatment for patients with gastric cancer
Chinese Society of Nutritional Oncology, Chinese Society for Parenteral and Enteral Nutrition
In recent years the incidence rate of gastric cancer has gradually declined in the world but it is still a high incidence of cancer in China. Once malnutrition occurs in patients with gastric cancer due to the decline of skeletal muscle quality and function in the perioperative period the incidence of postoperative complications hospital infection and mortality have increased the length of hospital stay has been prolonged the quality of life has declined and medical costs have increased In patients with advanced gastric cancer malnutrition will lead to an increase in the incidence of adverse reactions a decline in treatment tolerance and completion and affect the efficacy and quality of life also ultimately lead to a shortened survival period. Inadequate intake weight loss and anti-tumor treatment including surgery radiotherapy and chemotherapy are the main factors considered in selecting the indications for nutritional intervention. At this stage the primary goal of nutritional support for patients with gastric cancer is to maintain lean tissue reduce the incidence of complications during peri-operation and peri-radiotherapy ensure the safe and smooth completion of radical surgery for gastric cancer ensure the completion of full dose and treatment of radiotherapy and chemotherapy and ultimately improve the efficacy and prognosis and realize benefits from the perspective of health economics.
2023 Vol. 10 (2): 208-212 [Abstract] ( 601 ) HTML PDF (815 KB)  ( 894 )
213 Screening and functional analysis of genes related to necrotizing apoptosis in patients with lower-grade glioma
1Lyu Ying,2Yuan Pengrui，1Xu Jingxuan
Objective To determine the expression and prognostic significance of necrotic apoptosis-related genes in patients with lower grade gliomas. Method The clinical practice data and sequencing data of lower grade gliomas were integrated from the TCGA database and the necrosis-related genes retrieved from the database were compared and analyzed. First univariate Cox regression was used to screen the genes of necrotic apoptosis related to the prognosis of patients with lower grade glioma and then multivariate Cox regression was used to screen the genes that have the effect of regulating the prognosis. Through GO enrichment of prognostication-related genes in high and low risk groups the factors that may affect the risk difference were summarized and then the immune function status of high and low risk groups was investigated using ssGSEA analysis data. Result Seven genes were identified by Lasso regression and lower grade glioma prognosis using univariate Cox regression and the high-risk and low-risk groups could be distinguished by the prognostic risk scoring model of these seven genes. Kaplan-Meier data survival analysis showed that the overall survival rate of the low-risk group was much higher than that of the high-risk group. The GO enrichment data analysis showed that there was a significant difference in the immunity of the high - risk group compared with the low - risk group while the ssGSEA enrichment analysis showed that the scores of most immune cells in the high - risk group were also significantly different from the low-risk group and the scores of the low-risk group were lower. Conclusion The seven genes of FADD FAS MLKL RIPK1 RIPK3 TLR3 and TNF are significantly associated with necrotic apoptosis in patients with lower grade gliomas and can be used as the next target for the treatment of lower grade gliomas.
2023 Vol. 10 (2): 213-218 [Abstract] ( 135 ) HTML PDF (3961 KB)  ( 154 )
219 Expression of Foxp3 p62 and nuclear factor-κB in patients with colon cancer and their correlation with the formation of adjacent tumor deposits
Hu Xiaofeng, Wu Xueliang, Yang Dongdong, Wang Yifei
Objective To explore the expression of Foxp3 p62 and NF-κB in patients with colon cancer and their correlation with the formation of adjacent tumor deposits. Method The research samples were collected from 80 colon cancer patients admitted to Department of General Surgery The First Affiliated Hospital of Hebei North University from January 2019 to January 2022 and were divided into control group 36 cases and deposition group 44 cases according to whether they had adjacent tumor deposits. The expression of Foxp3 p62 and NF-κB mRNA in patients was detected by qRT-PCR the expression of Foxp3 p62 and NF - κB positive cells in patients was detected by immunohistochemistry and Foxp3 p62 NF-κB in the lesion organizers of the two groups of patients were detected by western blotting experiment. NF-κB mRNA relative protein expression. Logistic multivariate regression was used to analyze the correlation between the above indicators and the formation of paracancerous tumor deposits in patients. Result The mRNA expressions of Foxp3 p62 and NF-κB in the deposition group were significantly higher than those in the control group and the difference was statistically significant P < 0. 05 . The difference was statistically significant in the control group P < 0. 05 the relative expressions of Foxp3 p62 and NF-κB proteins in the deposition group were significantly higher than those in the control group and the difference was statistically significant P<0. 05 Logistic multivariate regression analysis showed that Foxp3 p62 NF-κB mRNA the proportion of Foxp3 p62 NF-κB positive cells and the relative expression of Foxp3 p62 NF-κB protein were all significantly correlated with the occurrence of adjacent tumor deposits in patients. The independent risk factors in patients with adjacent tumor deposits P<0. 05 . Conclusion The Foxp3 p62 NF-κB mRNA the proportion of Foxp3 p62 NF-κB positive cells and the proportion of Foxp3 p62 and NF-κB positive cells in colon cancer patients with adjacent tumor deposits The relative expressions of p62 and NF-κB proteins were both increased and their high levels of expression were independent risk factors for the formation of paracancerous tumor deposits in patients with colorectal cancer. disease progression.
2023 Vol. 10 (2): 219-224 [Abstract] ( 148 ) HTML PDF (8944 KB)  ( 25 )
225 Effects of probiotics combined with enteral nutrition on postoperative inflammatory factors cellular immune function and nutritional indexes in patients with gastric cancer undergoing radical operation
1Li Zhou,1Ma Yong,1Fang Shixu,2Xu Lin
Objective To observe the effect of probiotics combined with enteral nutrition support on postoperative inflammatory factors cellular immune function and nutritional indicators in patients with gastric cancer after radical operation. Method 134 patients with gastric cancer who underwent laparoscopic assisted radical gastrectomy in general surgery department of Department of General Surgery Zigong First People's Hospital from January 2020 to July 2022 were selected and randomly divided into control group n = 67 and observation group n = 67 The control group received early enteral nutrition support EENS group and the observation group received probiotics combined with early enteral nutrition support PEENS group. The levels of inflammatory factors IL-2 IL-6 TNF - α cellular immune function CD4 + CD8 + CD4 + / CD8 + and nutritional indexes albumin and total protein levels in peripheral blood measured by protein analyzer and complications were compared between the two groups before and after treatment. Result After the intervention the levels of IL-2 IL-6 and TNF - α in the observation group were significantly lower than those in the control group and before the intervention P<0. 05 + / CD8 + levels were significantly higher than those in the control group and before intervention P<0. 05 CD8 + levels in the observation group after intervention were significantly lower than those in the control group and before intervention P < 0. 05 albumin and total protein levels in the observation group after intervention were significantly higher than those in the control group and before intervention P < 0. 05 there was no significant difference in the incidence of complications between the two groups P>0. 05 . Conclusion Probiotics can effectively reduce the level of inflammatory response protect cellular immune function and improve nutritional status in patients with early gastric cancer after operation.
2023 Vol. 10 (2): 225-229 [Abstract] ( 184 ) HTML PDF (834 KB)  ( 324 )
230 Diagnostic study of systemic inflammatory indicators on sarcopenia in patients with colorectal cancer
1Chen Li,1Zhang Zeyu,1Wu You,1Ni Peiping,2Lyu Muhan,1Wang Min
Objective To investigate the diagnostic value of inflammatory indicators for sarcopenia in patients with colorectal cancer. Method A cross-sectional study of 410 patients with colorectal cancer who were admitted to the Department of Gastrointestinal Surgery Affiliated Hospital of Southwest Medical University from December 2019 to December 2021 was conducted. The patients were divided into sarcopenia group and non-sarcopenia group by the skeletal muscle index SMI of the third lumbar vertebrae. Platelet to lymphocyte ratio PLR neutrophil to lymphocyte ratio NLR and systemic immune inflammatory index SII were used to evaluate systemic inflammation. Multivariate logistic regression analysis was used to analyze the influence of systemic inflammatory indicators on the risk of sarcopenia in colorectal cancer patients. The receiver's operating characteristic ROC curve is used to determine the best cut-off value of inflammatory indicators and to judge its sensitivity and specificity. Result Among 410 patients with colorectal cancer 232 56. 60% were in the sarcopenia group and 178 43. 40% were in the non - sarcopenia group. Compared with the non - sarcopenia group the sarcopenia group had higher NLR PLR and SII lower body mass index and albumin levels longer hospitalization time and higher total costs and complication rates P<0. 05 . Regression analysis showed that PLR≥172. 00 OR = 1. 78 95%CI = 1. 17-2. 72 P= 0. 007 was an independent risk factor for sarcopenia in colorectal cancer patients. The ROC curve showed that the best cut -off value of PLR in predicting the risk of sarcopenia was 185. 12 the sensitivity was 52. 20% and the specificity was 66. 90% . Conclusion In colorectal cancer patients high PLR increases the risk of sarcopenia which has certain diagnostic value for sarcopenia.
2023 Vol. 10 (2): 230-235 [Abstract] ( 146 ) HTML PDF (1704 KB)  ( 171 )
236 Body composition and nutritional status of inpatients in oncology department
1Meng Weifen,1Yue Jingyan,2Zang Ting,1Jiang Hua,1Zhang Yunyan,2Wang Mengjie
Objective To investigate the nutritional status and body composition of hospitalized cancer patients analyze the differences and correlations in nutritional status of inpatients in oncology department of different genders and different ages and provide an evidence for the implementation of nutritional therapy for cancer patients. Method Retrospectively analyze the nutritional status and body composition of 411 inpatients who were in the oncology department Cancer Center Changzhou Second People's Hospital Affiliated to Nanjing Medical University from July 2020 to April 2021 who applied the clinical nutrition analyzer for nutritional diagnosis and treatment. The patients were divided into non - elderly group < 65 years old and elderly group ≥ 65 years old . The body composition nutritional status of cancer patients of different genders and different ages and the correlation between phase angle and nutritional risk screening and nutritional assessment were analyzed. Result The incidence of nutritional risk was 44. 77% NRS 2002≥ 3 points the incidence of moderate malnutrition and severe malnutrition were 37. 23% PG-SGA was 4 - 8 points and 37. 47% PG-SGA≥9 points respectively among all patients. Among male patients compared to non-elderly group the body weight muscle mass total water content and skeletal muscle indexes of the elderly group were significantly decreased which was statistically significant 64. 88± 10. 26 kg vs 59. 42 ± 10. 75 kg 49. 1 ± 6. 86 kg vs 44. 95 ± 5. 93 kg 38. 32 ± 5. 27 kg vs 35. 15 ± 4. 58 kg 28. 64±4. 56 kg vs 25. 84± 3. 91 kg P< 0. 05 the incidence of nutritional risk and severe malnutrition increased significantly 24. 18% vs 56. 25% 20. 88% vs 46. 53% P<0. 05 . Among female patients compared to non-elderly group there was no significant difference in body composition indexes of elderly patients P > 0. 05 but the incidence of severe malnutrition increased significantly 32. 39% vs 42. 86% P<0. 05 . Phase angle was negative correlated with nutritional risk and malnutrition in cancer patients of different sexes and ages significantly. Conclusion The incidence of severe malnutrition in elderly cancer patients in oncology department has increased significantly and the body composition indicators of male patients have decreased significantly. Clinically body composition and nutritional status of elderly male cancer patients should be given more attention.
2023 Vol. 10 (2): 236-242 [Abstract] ( 167 ) HTML PDF (1493 KB)  ( 270 )
243 Application of middle and upper arm circumference and triceps skinfold thickness in nutritional evaluation of children with tumor
1Huang Fan,1Zheng Lan,1Dong Qian,2Cheng Shengbao
Objective To explore the application value of mid-upper arm circumference MUAC and triceps skinfold thickness TSFT in nutritional evaluation of children with tumor. Method From January 2020 to December 2021 162 children with tumor in Department of Pediatrics Union East West Lake Hospital and The Second Department of Pediatrics Huangpi District People's Hospital were selected as the research objects. According to the dual-energy X-ray absorption method the nutritional status of children was evaluated and they were divided into malnutrition group and normal group according to their nutritional status. The levels of MUAC TSFT body mass index albumin and prealbumin in all children were measured. Spearman correlation coefficient was used to analyze the correlation between MUAC and TSFT levels and body mass index albumin level and prealbumin level. The value of MUAC and TSFT levels in diagnosis of malnutrition in children with tumor alone and jointly was analyzed and compared and the diagnostic value was expressed by Kappa value. Result The levels of MUAC TSFT BMI albumin and prealbumin in children with tumor were lower than the reference values. Spearman analysis showed that MUAC and TSFT had correlation with body mass index albumin and prealbumin P< 0. 05 . moreover MUAC had a stronger correlation with albumin in the normal group and the malnutrition group. TSFT had a stronger correlation with albumin in the malnutrition group and with prealbumin in the normal group. Kappa values of MUAC and TSFT were 0. 886 and 0. 897 respectively which were higher than 0. 860 of BMI and 0. 885 of albumin combined with prealbumin but lower than 0. 949 of MUAC combined with TSFT P < 0. 05 . Conclusion Both MUAC and TSFT can be used in the diagnosis of malnutrition in children with clinical tumors but their combined diagnosis has higher clinical value.
2023 Vol. 10 (2): 243-248 [Abstract] ( 120 ) HTML PDF (953 KB)  ( 309 )
249 Correlation analysis of preoperative nutritional risk status perioperative period and prognosis in patients with lung cancer
Zhang Haifeng, Maokai, Ding Hairu, Zhou Xiaoqi
Rugao Hospital affiliated to Nantong University Department of Thoracic Surgery Rugao People's Hospital Nantong 226500 Jiangsu China
2023 Vol. 10 (2): 249-254 [Abstract] ( 158 ) HTML PDF (1045 KB)  ( 146 )
255 Fear of progression and its correlation with social support and post-traumatic growth among postoperative patients with lung cancer
1Zhang Wenhui,2Zhang Yuting,3Qin Yi,1Shi Jiahai
Objective To investigate fear of progression and analyze its correlation with social support and post-traumatic growth in postoperative patients with lung cancer. Method Using the convenient sampling method a total of 250 postoperative patients with lung cancer who were treated in the Department of Thoracic Surgery of the Affiliated Hospital of Nantong University from May 2021 to January 2022 were selected. The general information questionnaire Fear of Progression Questionnaire FoP-Q-SF Social Support Rating Scale SSRS and Post - Traumatic Growth Scale PTGI - SF were used to investigate the general characteristics fear of progression social support and posttraumatic growth of patients. Result The score of fear of progression was 26. 75±8. 57 the score of social support was 38. 88± 7. 40 34. 68± 9. 54 was the score of post-traumatic growth. Fear of progression was negatively correlated with social support and post-traumatic growth and social support was positively correlated with post-traumatic growth. Sex education level family monthly income disease awareness clinical stage and post-traumatic growth were the influencing factors of fear of progression. Conclusion Fear of progression in postoperative patients with lung cancer was at a middle level. Clinicians should formulate targeted measures alleviate fear of progression and improve the quality of life.
2023 Vol. 10 (2): 255-261 [Abstract] ( 225 ) HTML PDF (851 KB)  ( 397 )
262 Prognostic nutritional index LMR and NLR in the treatment of non-small cell lung cancer
Yuan Yanling, Tang Wubing, Tong Lihua, Liu Mindong, Yang Wen
Objective To investigate the effect of prognostic nutritional index PNI neutrophil - lymphocyte ratio NLR and lymphocyte-monocyte ratio LMR on the efficacy of PD-1/ PD-L1 inhibitors in the treatment of non-small cell lung cancer NSCLC . Evaluation and analysis of prognostic factors. Method According to the inclusion and exclusion criteria the clinical data of 78 patients with NSCLC who were admitted to The Sixth Affiliated Hospital of South China University of Technology / Tumor District 1 from January 2018 to May 2022 were selected for retrospective study. All patients were treated with PD-1/ PD-L1 inhibitor and baseline data were collected and followed up. The differences of NLR LMR and PNI in NSCLC patients with different curative effects were analyzed and NLR LMR and PNI were divided into high and low groups by the median and the differences in curative effect grades of NSCLC patients with different preoperative NLR LMR and PNI were analyzed. According to the follow-up waterlogging the patients were divided into survival group and death group and the univariate differences between the two groups were compared. The prognostic factors were analyzed by binary Logistic regression and the ROC curve was used to analyze the prognostic value of NLR LMR and PNI in NSCLC patients. Result There were significant differences in preoperative NLR LMR and PNI in NSCLC patients with different curative effects P<0. 05 The comparison of NLR values in CR group PR group >SD group >PD group P<0. 05 . The effective rate and disease control rate of PD-1/ PD-L1 inhibitor in low NLR group high LMR group and high PNI group were higher than those in NLR group low LMR group and low PNI group P< 0. 05 . Binary Logistic regression analysis showed that high NLR low LMR and low PNI were prognostic risk factors and treatment intervention time less than third-line and ECOG score 0-1 were prognostic protective factors P<0. 05 . ROC curve analysis showed that the AUCs of NLR LMR and PNI for predicting the prognosis of NSCLC patients were 0. 880 0. 823 and 0. 907 respectively all with good accuracy. The three combined data predicted 0. 934 respectively with higher accuracy. The Z values between NLR LMR PNI and the three combined AUC were 0. 811 2. 061 and 1. 1248 respectively. Conclusion PNI NLR and LMR have good value in evaluating the efficacy of PD-1/ PD-L1 inhibitors in the treatment of NSCLC. High NLR low LMR and low PNI are prognostic risk factors. The treatment intervention time is less than the third-line and the ECOG score is 0-1. Prognostic protective factors and NLR LMR and PNI can be used as prognostic indicators for patients with NSCLC And the combined prediction effect is better.
2023 Vol. 10 (2): 262-269 [Abstract] ( 205 ) HTML PDF (1471 KB)  ( 236 )
270 Prognostic nutritional index predicts prognosis and efficacy of first-line chemotherapy for metastatic pancreatic cancer
Yang Lei, Su Jing, Wang Wenbo, Zhou Fuxiang
Objective We aim to investigate the clinical value of prognostic nutritional index PNI in evaluating the prognosis of patients with metastatic pancreatic cancer. Method Clinical data and follow-up data of 83 patients with metastatic pancreatic cancer undergoing first-line chemotherapy from April 2017 to February 2022 in Zhongnan Hospital of Wuhan University were retrospectively collected and analyzed. PNI value was calculated and the optimal cut-off point of PNI was determined using the receiver operation characteristics ROC curve. Cox univariate and multivariate regression analysis and Kaplan-Meier curve were performed to evaluate the prognostic value of PNI for metastatic pancreatic cancer patients. Result According to the ROC curve analysis the optimal cut-off point of PNI was 43. 10. PNI was significantly correlated with objective response rate ORR progression free survival PFS and overall survival OS of patients with metastatic pancreatic cancer receiving first-line chemotherapy. The median PFS and median OS were 4. 61 95%CI = 3. 92-5. 30 and 9. 05 95%CI = 8. 20-9. 89 months respectively. The ORR in low PNI group and high PNI group was 5. 9% and 32. 7% respectively P<0. 05 . The median progression free survival time mPFS of patients in low PNI group and high PNI group were 2. 96 months 95%CI = 2. 53-3. 47 and 5. 67 months 95%CI = 4. 43-6. 21 respectively. There was a significant difference between the two groups P<0. 01 . Meanwhile the median overall survival time mOS of patients in the low PNI group and the high PNI group was 5. 92 months 95% CI = 5. 30 - 6. 55 and 11. 84 months 95% CI = 9. 10 - 14. 59 respectively. There was also a significant difference between the two groups P<0. 01 . Multivariate Cox regression analysis showed that PNI HR = 0. 123 95% CI = 0. 061- 0. 248 P< 0. 01 was an independent prognostic factor of OS in patients with metastatic pancreatic cancer. Conclusion PNI can be used as a prognostic factor for patients with metastatic pancreatic cancer.
2023 Vol. 10 (2): 270-276 [Abstract] ( 207 ) HTML PDF (1695 KB)  ( 134 )
277 Progress of ICIs combination therapy in MSS colorectal cancer
Ning Chengong, Sun Yanbo, Sun Feng
Colorectal cancer is the most common malignant tumor of digestive system ranking the third in incidence and the second in mortality which poses a serious threat to the survival and quality of life of patients. Immune checkpoint inhibitors have become an important component of the first -line and late -line treatment regimens for MSI -H/ dMMR colorectal cancer. However MSI-H/ dMMR colorectal cancer accounts for only 4% ~ 5% of all metastatic colorectal cancers and for MSS / pMMR colorectal cancer patients due to tumor heterogeneity and complex immunologically heterogeneous tumor microenvironment immune checkpoint inhibitors alone often cannot overcome these factors and have low response rate or secondary drug resistance so the use of single ICIs is basically ineffective. At present combination therapy strategies such as anti-PD-1 and CTLA-4 ICIs combined with radiotherapy ICIs combined with MEK inhibitor and VEGF inhibitor ICIs combined with oncolytic virus double immunotherapy combined with targeted therapy are adopted to improve the response rate of MSS / pMMR colorectal cancer patients. Although the above -mentioned combination therapy strategy has achieved good short-term efficacy and has great prospects in the treatment of mCRC patients most of them are single - arm small - sample exploratory studies and the data are not completely stable and consistent. The safety and effectiveness need to be verified by more large-sample prospective clinical trials and also need to be confirmed and confirmed by phase Ⅲ clinical studies. This article aims to review the progress of ICIs combination therapy for MSS colorectal cancer.
2023 Vol. 10 (2): 277-282 [Abstract] ( 184 ) HTML PDF (898 KB)  ( 448 )
283 Relationships between ketogenic diet and metabolic associated fatty liver disease
1Hu Yanfang,1Wang Jian,2Meng Qinghua
With lifestyle changes metabolism-related fatty liver disease MAFLD accounts for a gradual increase in chronic liver disease affecting 25% of adults worldwide and being thought to be co-present with other chronic liver diseases. MAFLD is not only closely related to the occurrence and development of chronic hepatitis cirrhosis hepatocellular carcinoma but also considered as a cause and effect with obesity and type 2 diabetes. Besides it also promotes the onset of hypothyroidism metabolic syndrome cardiovascular disease and malignant tumors. Given the fact that there is currently no specific drug for treatment adopting a healthy lifestyle and weight loss are key to the prevention and treatment of MAFLD and its comorbidities. The ketogenic diet is a therapeutic diet with low carbohydrate high fat and appropriate protein that converts the body's energy supply from glucose to fat mobilization which in turn produces the energy supply mode of ketone bodies. Based on this theoretical basis ketogenic diet is considered to have the potential to reduce body mass improve insulin resistance regulate glycolipid metabolism. And the effect of it as the adjuvant treatment for diabetes mellitus type 2 and obesity has been verified in many animal models and clinical trials. Still the clinical application of ketogenic diet in MAFLD is mostly short-term research and the relationship between the two is still in the exploration stage. This article reviews the research reports on how ketogenic diets reduce body mass and improve insulin resistance in patients with MAFLD.
2023 Vol. 10 (2): 283-287 [Abstract] ( 223 ) HTML PDF (838 KB)  ( 402 )
288 Progress in Clinical Diagnosis and Treatment of Cancer-related Cardiac Atrophy
1Wang Shuan，2Zhu Jiayu，3Fang AiJuan，1Chen Xiaotian，4Xu Yan，3Chen Hui
In recent years the number of cancer patients in the world has risen sharply and the medical and economic burden caused by cancer cachexia and its related complications has also increased dramatically. Cancer cachexia is a complex multifactorial syndrome characterized by progressive loss of skeletal muscle and associated with multiple organ dysfunction which could not be completely reversed by conventional nutritional therapy. Cardiac complications associated with cancer cachexia include cardiac atrophy remodeling dysfunction and even heart failure. Cancer cachexia - induced cardiac atrophy is mainly as a result of interactions between cachexia mediators and the ubiquitin-proteasome pathway. Activation of the ubiquitin-proteasome system UPS decreases cardiac protein synthesis and inflammation accelerates the process of myocardial atrophy at the same time insulin resistance leads to the depletion of stored proteins and hinders the uptake and utilization of nutrients by tissues and cells. It is an early complication of the cardiovascular system in patients with cancer cachexia which is often ignored or confused with the primary heart disease. Failure to diagnosis and treatment cardiac atrophy in time will not only aggravate severe cachexia but also reduce the curative effect of anticancer treatment. Therefore scientific diagnosis and treatment of cancer related cardiac atrophy can help improve the curative effect of anti-cancer treatment and thus improve the survival rate of cancer patients. Therefore the early screening diagnosis and treatment of cancerous cachexia related cardiac atrophy is of great significance for tumor treatment.
2023 Vol. 10 (2): 288-293 [Abstract] ( 193 ) HTML PDF (2967 KB)  ( 141 )
294 Function of long-chain acyl-CoA synthetases family and the research progress in tumors
1Zhang Lin,2Wu Bo,3Wang Dongwen
Fatty acids are essential nutrients to maintain normal physiological functions in the body and need to be activated by relevant enzymes in the body before they enter the normal metabolic pathway. While dysregulation of fatty acid metabolism is closely associated with tumorigenesis. Long - chain acyl - CoA synthases ACSLs are responsible for the activation of long - chain fatty acids. The ACSLs family consists of five members ACSL1 ACSL3 ACSL4 ACSL5 and ACSL6 with different isoforms having different cellular localizations which can catalyze different lipids and influence their metabolic routes. ACSLs are extensively involved in endoplasmic reticulum stress iron death drug resistance and tumor inflammatory microenvironment by regulating fatty acid metabolism. And ACSLs are often deregulated in tumors and can affect fatty acid metabolism. However fatty acids can activate different ACSLs by activating multiple transcription factors in combination with gene response elements and tumor cells and protein ubiquitination can regulate the expression of ACSLs genes. This leads to the development of metabolic disorders in tumors and other metabolic diseases. Triacsin C an inhibitor of ACSLs has great potential for the development of antitumor drugs. This article reviews the expression and localization of ACSLs in cells physiological functions functions in tumors and molecular mechanisms. The results indicate that ACSLs are associated with inflammatory response lipid metabolism disorders tumor invasion and metastasis in tumors which are important for tumor development and may become valuable biomarkers and therapeutic targets for tumor therapy.
2023 Vol. 10 (2): 294-301 [Abstract] ( 266 ) HTML PDF (3773 KB)  ( 306 )
302 Research progress of nutrition management pattern of Patients with colorectal cancer undergoing chemotherapy
Yin Chunmei, Wang Jiwei, Zheng Xilan
As the third most common malignant tumor colorectal cancer is characterized by high incidence and high mortality rate. Chemotherapy is an important treatment in addition to surgery radiotherapy immunotherapy and targeted therapy which can produce a series of adverse effects while playing a therapeutic role affecting nutritional status and even leading to malnutrition which in turn will reduce the tolerance of chemotherapy and even seriously affect the quality of life and survival time of patients. In recent years nutrition therapy has become one of the important components of comprehensive cancer treatment which is closely related to patients' nutritional status treatment effect chemotherapy related adverse reactions and other survival prognosis. Clinical workers have actively explored nutritional management and various nutritional management patterns based on theory patient - led and medical staff-led have shown results which have a positive impact on the nutritional status and tumor prognosis of patients undergoing chemotherapy for colorectal cancer. This paper combines the recent progress of domestic and international research with the results of the study on the nutritional management of colorectal cancer patients. Therefore this paper reviews the nutritional management patterns for patients undergoing chemotherapy for colorectal cancer taking into account the research progress at home and abroad in recent years in order to provide a reference basis for clinical scientific research and management.
2023 Vol. 10 (2): 302-306 [Abstract] ( 215 ) HTML PDF (1708 KB)  ( 1163 )
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