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2023 Vol. 10, No. 5
Published: 2023-10-09
 
573 Focus on tumour-associated sarcopenia
Li Zengning, Chang Yaping
In oncology patients disease - induced hypophagia and hypermetabolism which in turn causes accelerated protein breakdown and insufficient protein synthesis in skeletal muscle is known as tumour - associated sarcopenia. Sarcopenia has the potential to reduce clinical outcomes affect mental status and increase hospitalisation costs. The core of the focus on tumour - associated sarcopenia is to screen diagnose and intervene in oncology patients with sarcopenia thereby improving clinical outcomes and shortening hospital stays. The SARC - F can be used as a screening tool in combination with diagnostic techniques such as computed tomography CT magnetic resonance imaging MRI or dual energy x-ray absorptiometry DXA . Diagnostic techniques such as MRI or DXA facilitate early detection of sarcopenia in tumour patients. Interventions mainly include nutritional interventions exercise interventions and comprehensive interventions. Among them nutritional interventions mainly include supplementation of protein ω-3 polyunsaturated fatty acids ω- 3 PUFAs vitamin D and so on. It is hoped that more oncology - related medical personnel and patients will improve their understanding of tumour-related sarcopenia conduct in-depth basic research and improve precise nutritional interventions so as to reduce the risk of sarcopenia in oncology patients and thus help more oncology patients.
2023 Vol. 10 (5): 573-578 [Abstract] ( 266 ) HTML PDF (1439 KB)  ( 334 )
579 Progress in the pathogenesis diagnosis and treatment of sarcopenic obesity
Sarcopenic obesity is a clinical state in which the co - existence of obesity and sarcopenia. In the co - existence of sarcopenia and obesity the lean body mass is unbalanced with the fat content. Which is associated with adverse clinical outcomes. Both sarcopenia and obesity have independent adverse effects on health and the synergistic effect of both leads to increased metabolic disorders making the health problems brought by sarcopenia obesity far more serious than that of sarcopenia or obesity alone. Early and effective intervention measures can prevent treat and delay the progression of sarcopenic obesity. Therefore early screening diagnosis and treatment are particularly important. The treatment measures for sarcopenic obesity mainly include nutrition and exercise intervention and new drug therapy or intestinal flora therapy also have a certain effect on sarcopenic obesity. In recent years research on sarcopenic obesity has made certain progress. The European Society for Clinical Nutrition and Metabolism and the European Association for Obesity Research have published diagnostic criteria to clarify their diagnosis for the first time the pathogenesis of sarcopenic obesity and the complex interaction between metabolic disorders and inflammation have been further revealed but there is still no specific treatment for sarcopenic obesity. This paper reviews the diagnostic criteria molecular mechanisms and treatment progress of sarcopenic obesity providing reference for the prevention treatment and clinical research of sarcopenic obesity.
2023 Vol. 10 (5): 579-584 [Abstract] ( 301 ) HTML PDF (834 KB)  ( 450 )
585 Research progress of the relationship of irisin with sarcopenia
Lu Yufan, Yang Xuefeng
Sarcopenia is an age-related progressive disease associated with decline in muscle mass strength and function which severely reduces the quality of life of sufferers and increases the social and economic burden. With the acceleration of the process of global population aging sarcopenia has become one of the major public health problems that impair the health of the elderly people in our country and even the in the world but there are lack of effective prevention and control measures. Irisin as an active protein factor secreted by skeletal muscle regulates muscle and bone metabolism as well as glucose and lipid metabolism through mitogen-activated protein kinase and other cell signaling pathways affects biological processes such as myoblast differentiation and myoblast fusion promotes the growth and proliferation of skeletal muscle cells and maintains muscle mass and function. Irisin deficiency can lead to the decline of skeletal muscle mass and muscle strength which is closely related to the occurrence and development of sarcopenia. Blood irisin levels have the potential to be a therapeutic target and an early monitoring biomarker for metabolically related diseases such as sarcopenia. However the evidence from current studies on the association between irisin and the risk of sarcopenia is limited and the relevant mechanism has not been clarified. This article reviews the research progress of irisin and sarcopenia aiming to provide new ideas for early screening diagnosis and intervention treatment of senile sarcopenia.
2023 Vol. 10 (5): 585-589 [Abstract] ( 130 ) HTML PDF (814 KB)  ( 197 )
590 Immunomodulation and tumor-associated muscle loss
Ji Wei,Cui Jiuwei
The incidence of malnutrition is high in patients with malignant tumors while muscle loss is an important feature of malignancy related malnutrition. Inflammation is thought to be a key cause of tumor-associated muscle loss including the involvement of inflammatory factors and immune cells. The activation of inflammatory factors and their mediated signaling pathways leads to the increase of catabolism in muscle tissue. However most drugs targeting inflammatory factors have not shown a good effect on tumor-related muscle loss suggesting that other mechanisms are involved. In recent years it has been found that innate immune cells and adaptive immune cells participate in tumor-related muscle loss through modulating feeding behavior metabolic reprogramming and regulation of muscle tissue stem cells but the specific mechanism has not been clarified. The interaction of immune and metabolic factors jointly leads to muscle loss. The metabolic changes in systemic circulation and the local microenvironment caused by muscle loss also affect the activation and signal transduction of immune cells. Therefore the analysis of the interaction of immune factors with muscle tissue should pay attention to the unity and variability of the systemic circulation and the local microenvironment in order to identify targets on which interventions can be exerted and to provide direction for the treatment of tumor-related muscle loss thereby to improve treatment response as well as clinical benefit in patients with malignant tumor.
2023 Vol. 10 (5): 590-593 [Abstract] ( 212 ) HTML PDF (810 KB)  ( 173 )
594 Gut flora intervention on sarcopenia in cancer patients
1Luo Xiaoqin,1Yang Hexiang,2Zhao Qingchuan
Tumors are identified as key factors in secondary sarcopenia. Despite the ambiguity surrounding the precise mechanism of sarcopenia in cancer patients an increasing array of research indicates that an imbalance in the gut microbiota may play a critical role in this context. These microorganisms which influence energy metabolism and intestinal mucosal protection via the nervous immune and endocrine systems may provide potential targets for sarcopenia's prevention and treatment in cancer patients. Current interventions include fecal bacteria transplantation the introduction of probiotics prebiotics symbiotics or postbiotics and modifications in diet. Despite some research limitations gut microbiota intervention is emerging as a new strategy to maintain muscle mass and function by enhancing immunity regulating metabolism and reducing treatment side effects. This paper analyzes existing studies reviews the relationship between intestinal microbiota intervention and sarcopenia in cancer patients outlines intervention effects and provides directions for future research and treatment options. The available evidence strongly supports the potential role of gut microbiota in treating and caring for cancer patients.
2023 Vol. 10 (5): 594-600 [Abstract] ( 188 ) HTML PDF (852 KB)  ( 305 )
601 The function and mechanism of lactic acid in tumor microenvironment
1Zhao Ming,1Zhang Yajuan,2Yang Weiwei
Metabolic reprogramming is a major hallmark of tumor cells. It is vital for tumor tumorigenesis growth metastasis and survival in adverse condition. Tumor cells abundantly produce lactic acid via 􀆵 aerobic glycolysis and released to extracellular microenvironment. This causes lactic acid to accumulate in the tumor microenvironment and makes it in low pH value. Recent studies revealed that lactic acid can not only be utilized as energy resources by tumor cells but also play regulated roles in tumor cells immune cells and stroma cells. In general lactic acid plays different roles in different components of tumor microenvironment. On the one hand lactic acid directly enhances the survival proliferation or migration of tumor cells by mediating metabolic reprogramming signal transduction or epigenetic modification. On the other hand lactic acid promotes tumor formation growth or metastasis indirectly by mediating angiogenesis or immune escape. In addition lactic acid - related metabolic enzymes transporters and its downstream targets significantly correlates with tumor progression which have the potential to be targeted drugs in cancer therapy. This review summarizes the recent advances in the function and mechanism of lactic acid in tumor microenvironment and discusses the future research orientation and its prospect as tumour therapeutic targets.
2023 Vol. 10 (5): 601-608 [Abstract] ( 157 ) HTML PDF (4535 KB)  ( 364 )
609 Nutritional management guideline for late sequelae of radiotherapy
Chinese Society of Nutritional Oncology, China Society for Radiation Oncology, Radiation Oncology Physicians Branch of Chinese
Radiation-induced sequelae include early and late sequelae. Late sequelae of radiotherapy result in reduced nutritional status and quality of life which further adversely affects tumor control and survival of oncology patients. Therefore providing appropriate and standardized nutritional management for patients who develop radiotherapy-induced late sequelae is important. Chinese Society of Nutritional Oncology China Society for Radiation Oncology and Radiation Oncology Physicians Branch of Chinese Medical Doctor Association had organized multidisciplinary experts to develop this evidence-based guideline using the Delphi method to form a consensus of expert recommendations and grading the quality of evidence according to the GRADE method. This guideline provides evidence-based advice on the systematic nutritional management of common radiotherapy-induced late sequela for relevant clinical staffs.
2023 Vol. 10 (5): 609-615 [Abstract] ( 271 ) HTML PDF (1266 KB)  ( 584 )
616 Expert consensus on refeeding syndrome in cancer patients
Chinese Society of Nutritional Oncology, Chinese Society for Parenteral and Enteral Nutrition
Refeeding syndrome generally refers to the electrolyte metabolism disorder characterized by hypophosphatemia after the body re-ingestion of nutrients after a long period of hunger or malnutrition which adversely affects the heart liver respiratory system nervous system and muscular system leading to clinical complications and even death. For severely malnourished patients refeeding syndrome is a potentially fatal complication. The incidence of refeeding syndrome among hospitalized patients in different hospitals ranges from 0. 43% to 34% and among tumor patients receiving nutritional treatment the incidence of refeeding syndrome can be as high as about 25%. The pathogenesis pathological and physiological changes of refeeding syndrome are related to insulin resistance electrolyte transfer to cells and enhanced synthetic metabolism. Based on existing research and evidence combined with clinical experience this article summarizes and recommends the diagnosis and treatment of tumor patients with refeeding syndrome.
2023 Vol. 10 (5): 616-618 [Abstract] ( 506 ) HTML PDF (754 KB)  ( 552 )
619 Application study of cancer prehabilitation in overweight and obese patients with breast cancer undergoing radiotherapy
1Tao Wei,2Wang Shu'an,1Jiang Chunyu,1Zhang Jianyu,1Qiao Xue,1Yu Jingyi,2Chen Xiaotian
Objective To explore the cancer prehabilitation CP concept for overweight or obese breast cancer BC auxiliary during radiotherapy in patients with nutritional status the influence of the blood lipid metabolism and complications. Method A retrospective study was conducted on 118 patients with BC who received adjuvant radiotherapy in the department of radiotherapy of Nanjing Pukou People's Hospital from January 2020 to March 2022. They were divided into prehabilitation group n = 63 and control group n = 55 . The indexes of HB ALB TG TC HDL - C LDL - C FACIT - F score JSEQ score radiation dermatitis and VAS score were compared between the two groups. Result During radiotherapy the hemoglobin level of the two groups decreased without significant difference P > 0. 05 . The serum albumin level of the prehabilitation group was better than the control group P < 0. 05 . In terms of lipid metabolism the increase of TG in the prehabilitation group was lower than the control group P < 0. 05 while there was no significant difference in TC HDL-C and LDL-C P > 0. 05 . FACIT-F score JSEQ score degree of radiation dermatitis and VAS score of pain in the prehabilitation group were better P < 0. 05 . Conclusion In the adjuvant radiotherapy of overweight or obese BC patients CP may not only help to maintain nutritional status and to improve lipid metabolism but also help to improve the related complications.
2023 Vol. 10 (5): 619-625 [Abstract] ( 123 ) HTML PDF (850 KB)  ( 78 )
626 Relationship between malnutrition diagnosed by GLIM criteria and the prognosis of nasopharyngeal carcinoma patients
1Zhao Jun,1Xia Bing,1Xu Wanggen,2Feng Jian,3Dong Weida
Objective To evaluate the pre-treatment nutritional status of nasopharyngeal carcinoma NPC patients who received chemoradiotherapy and explore the relationship between malnutrition diagnosed by the Global Leadership Initiative on Malnutrition GLIM and survival outcome. Method This retrospective study was conducted in a series of 175 NPC patients treated with chemoradiotherapy at our hospitals from January 2017 to December 2021. Using a two-step method the prevalence of malnutrition in this population was investigated by GLIM criteria. Kaplan-Meier curves with Log-rank test were used to compare progress-free survival PFS and overall survival OS of malnourished and non-malnourished patients. The independent prognostic factors for NPC patients were determined by the univariate and multivariate Cox regression analysis. Result A total of 17. 1% 30 / 175 of patients had malnutrition risk according to the Nutrition Risk Screening 2002. According to GLIM criteria the prevalence of malnutrition was 25. 7% 45 / 175 in NPC patients of which 8. 6% 15 / 175 had unintentional weight loss 9. 7% 17 / 175 had low body mass index BMI and 20. 6% 36 / 175 had a decrease in muscle mass. The survival analysis indicated that the 3-year PFS rates of malnourished and non-malnourished patients were 74. 6% and 95. 3% respectively χ 2 = 15. 871 P<0. 001 . The 3-year OS rates of malnourished and non-malnourished patients were 73. 1% and 90. 5% respectively χ 2 = 7. 384 P= 0. 007 . There were significant survival differences between the two groups for PFS and OS. Malnutrition diagnosed by GLIM criteria was an independent predictor of PFS HR = 2. 335 95%CI = 1. 072-5. 084 P= 0. 031 and OS HR= 4. 810 95%CI = 1. 763-13. 127 P = 0. 002 for NPC patients. Conclusion GLIM criteria was an effective tool for nutritional assessment and survival prediction of NPC patients and it might be helpful for early detection of malnutrition and guidance of clinical intervention.
2023 Vol. 10 (5): 626-632 [Abstract] ( 146 ) HTML PDF (1401 KB)  ( 102 )
633 The value of bone turnover biomarkers and tumor marker in the diagnosis of bone metastasis in breast cancer
Xiong Bingjun,Huang Jing,Yuan Keyu,Lyu Shuzhen,Li Yanping
Objective To explore the diagnostic value of ICTP Tracp 5b and CA15-3 in bone metastasis of breast cancer. Method A retrospective review was performed in 87 breast cancer and 25 breast benign diseases the breast cancer patients were divided into 3 groups 32 patients with bone metastasis 35 patients with no metastasis and 20 patients with extraosseous metastasis. The serum levels of serum ICTP Tracp 5b and CA15 - 3 in 87 patients with breast cancer and 25 patients with benign tumor were measured by enzyme-linked immunosorbent assay ELISA and chemiluminescence immunoassay CLISA . Result The serum levels of ICTP Tracp 5b and CA15-3 were significantly increased in the bone metastasis group P < 0. 05 . The sensitivity specificity positive predictive value and negative predictive value of the parallel combined detection of serum ICTP Tracp 5b and CA15-3 in the diagnosis of bone metastasis of breast cancer were 96. 88% 76. 36% 70. 45% and 97. 67% respectively. The sensitivity of parallel combined detection is significantly greater than ICTP Tracp 5b and CA15-3 P<0. 05 . The sensitivity specificity positive predictive value and negative predictive value of the parallel combined detection were 37. 50% 98. 18% 92. 31% and 72. 97% respectively. The specificity of parallel combined detection is significantly greater than ICTP Tracp 5b and CA15-3 P<0. 05 . Joint diagnosis is more effective than independent diagnosis of the three. Conclusion The detection of serum ICTP Tracp 5b and CA15-3 can significantly improve the diagnostic efficiency of bone metastasis in breast cancer and can be used as an effective laboratory index to assist imaging diagnosis of bone metastasis in breast cancer.
2023 Vol. 10 (5): 633-638 [Abstract] ( 116 ) HTML PDF (1567 KB)  ( 76 )
639 The effect of progressive nutritional support on survival and soluble CD44 levels in oral cancer patients
1Zhan Yujing,2Yao Jinhui
Objective To explore the effects of progressive nutritional support on soluble CD44 level and quality of life in patients with oral cancer. Method 65 patients diagnosed with oral cancer surgery at the Affiliated Oncology Hospital of Shandong First Medical University from December 2018 to December 2020 were randomly divided into a control group 32 cases and an experimental group 33 cases using a random number table method The control group received routine nutritional intervention while the observation group received progressive nutritional support. Patients in the control group received conventional nutritional intervention and patients in the observation group received progressive nutritional support. After continuous intervention for 7 days the levels of nutrition-related indicators body weight hemoglobin total protein prealbumin gastrointestinal symptoms abdominal pain abdominal distension diarrhea nausea vomiting and soluble CD44 standard CD44 CD44s and variant CD44 CD44v were compared between the two groups. After the intervention all patients were followed up for 4 weeks to compare the quality of life and its influencing factors. Result Compared with the control group the total protein 66. 72±3. 45 g / L vs 62. 45±3. 07 g / L and prealbumin 209. 41±23. 44 g / L vs 181. 41±20. 07 g / L levels in the observation group were significantly higher after 7 days of intervention P<0. 05 . The levels of CD44s 421. 75±32. 41 g / L vs 481. 43±30. 01 g / L and CD44v 60. 14±10. 12 g / L vs 67. 81±10. 01 g / L in the observation group were lower than those in the control group P< 0. 05 . Compared with the control group the incidence of abdominal pain abdominal distension diarrhea nausea and vomiting in the observation group was significantly lower 21. 2% vs 53. 1% P<0. 05 . The quality of life in the observation group was higher than that in the control group 83. 39±8. 44 vs 75. 69±6. 98 points P< 0. 05 . From the distribution of patients with different quality of life grades the difference between the observation group and the control group was statistically significant Z = - 2. 481 P < 0. 05 . Conclusion Progressive nutritional support can improve the nutritional status of patients reduce the level of soluble CD44 alleviate adverse reactions and improve the overall quality of life.
2023 Vol. 10 (5): 639-644 [Abstract] ( 104 ) HTML PDF (822 KB)  ( 156 )
645 Application of molecular markers of endothelial cell injury in patients with malignant tumor organ failure
Zhou Kun,Suo Bing,Li Yanli,Gao Qingfeng,Wu Caiyu
Objective To evaluate the application value of quick sequential organ failure score qSOFA soluble thrombomodulin sTM tissue plasminogen activator- inhibitor complex t-PAIC in patients with malignant multiple organ failure MOF . Method A retrospective analysis was performed on 240 patients diagnosed with malignant tumor in our hospital including 125 patients without organ failure and 115 patients with multiple organ failure MOF . Mann-Whitney U test was used to compare the two groups and binary Logistics regression was used to analyze the relationship between sTM t-PAIC and MOF in malignant tumor patients. The receiver operating characteristic curve ROC determines the diagnostic efficiency of each index and the maximum Youden index is taken as the best cutoff value. Survival curve was plotted by Kaplan-Meier method to analyze the difference of survival rate among different groups. Result The 60-day mortality qSOFA score SOFA score sTM t-PAIC of malignant tumor patients with MOF were significantly higher than those without organ failure group the difference was statistically significant P < 0. 001 . Binary Logistic regression analysis showed that sTM and t - PAIC were significantly correlated with MOF in patients with malignant tumors OR = 1. 750 1. 185 P<0. 001 P = 0. 003 . ROC curve analysis results showed that the cutoff values of qSOFA sTM and t-PAIC for predicting MOF in malignant tumor patients were 2 27. 40 kU/ L and 18. 65 μg / L respectively and the area under curve AUC were 0. 815 0. 848 and 0. 824 respectively. The combined diagnosis efficiency of sTM + t-PAIC was the highest and the AUC was 0. 881. Patients with qSOFA≥2 sTM≥27. 40 kU/ L t-PAIC≥18. 65 μg / L were taken as the high level group and those with less than cutoff value were taken as the low level group. Kaplan-Meier analysis results showed that the overall survival rate of patients with high level qSOFA sTM t-PAIC was significantly reduced. The difference was statistically significant P = 0. 021 P< 0. 001 P<0. 001 . Conclusion In malignant tumor patients with MOF plasma sTM and t-PAIC levels were significantly increased and were significantly correlated with the prognosis of patients. It is suggested that sTM and t-PAIC should be included in the scoring criteria of SOFA or qSOFA or used as auxiliary diagnosis of SOFA or qSOFA. Early intervention of malignant tumor patients with MOF can improve the short-term prognosis of tumor patients through non-invasive and rapid laboratory detection.
2023 Vol. 10 (5): 645-651 [Abstract] ( 90 ) HTML PDF (2032 KB)  ( 100 )
652 Analysis of risk factors of sarcopenia in lung cancer patients and the application value of nomograph prediction model
Zhou Yin,Zhuang Caili,Ni Hao,Li Shuangru,Zhao Xue
Objective To explore the risk factors of sarcopenia in patients with lung cancer and construct its nomograph prediction model. Method From September 2020 to September 2022 96 patients with lung cancer admitted to Huai 'an Second People's Hospital special needs ward were regarded as the study subjects the clinical data and laboratory indicators of patients were recorded bioelectrical impedance test was applied to detect human body composition according to the criteria established by AWGSOP the patients were grouped into two groups myopenia group 52 cases in the concurrent group and no myopenia group 44 cases in the non-concurrent group logistic regression analysis was applied to analyze the factors affecting sarcopenia in patients with lung cancer a nomograph model was constructed for predicting sarcopenia in patients with lung cancer the differentiation and consistency of the nomograph model for predicting sarcopenia in patients with lung cancer were evaluated with ROC and calibration curve. Result A total of 96 patients with lung cancer were included in this study and there were 52 patients with sarcopenia the incidence of sarcopenia was 54. 17% 52 / 96 long-term smoking history NRS 2002 score body mass index BMI fat-free body mass FFM muscle mass SLM appendicular skeletal muscle mass ASM body fat BFM were obviously different between the concurrent group and the non-concurrent group P<0. 05 multivariate Logistic regression analysis showed that long-term smoking history NRS2002 score and BMI were the factors affecting sarcopenia in lung cancer patients P<0. 05 the nomograph model shows that the weight of long-term smoking history was increased by 21. 8 points the weight of NRS2002 score was increased by 25 points for every 1 point increase and the weight of BMI was increased by 12. 5 points for every 2 kg / m 2 decrease H-L fit test showed that χ 2 = 3. 891 P = 0. 867 the slope of the calibration curve approached 1 the area under the ROC curve was 0. 917 and the sensitivity and specificity were 92. 31% and 75. 00% respectively. Conclusion Long-term smoking history NRS2002 score and low level BMI are all the factors that influence the occurrence of sarcopenia in lung cancer patients. The nomograph model constructed in this study has high clinical value in the individualized prediction of sarcopenia in lung cancer patients.
2023 Vol. 10 (5): 652-657 [Abstract] ( 121 ) HTML PDF (1260 KB)  ( 208 )
658 The investigation and analysis of construction actuality of cancer nutrition therapy demonstration ward
1Li Zengning,1Song Shiming,1Xue Hongmei,1Duan Yuhao,1Du Hongzhen,2Song Chunhua,3Shi Hanping
Objective Investigating and analyzing the construction actuality of cancer nutrition therapy demonstration ward and then offering recommendations and guidance for future construction and development of the demonstration ward. Method Information about the development of each demonstration ward was gathered via a questionnaire survey. The fundamental facts about the unit clinical and nutritional treatment nutrition team makeup and bed-to-member ratio and nutrition science education activities were the primary topics covered in the survey. Each demonstration ward ' s overall structure was categorized and summarized and the improvement in nutrition screening assessment consultation and treatment work between before and after the demonstration ward's establishment were compared and evaluated among other things. Result 94 units totaled including 2 secondary hospitals were included in the survey. The number of inpatient beds in each unit was mostly concentrated in the range of 1000 – 2000 and the number of beds in the demonstration ward were mainly concentrated in the range of 50. When compared to before the demonstration ward were established the average number of people conducting nutritional risk screening assessment and consultation and treatment per year increased while the typical number of patient hospitalization days and medical expenses decreased. In the majority of units there are no more than 10 clinicians including dietitians and dietetic technicians as well as no more than five dietetic nurses the physician-to-bed ratio is below 1 20 and the ratio of dietitians dietetic technicians and dietetic nurses to beds is equal to or below 1 20. The majority of the annual events for nutrition science education don't exceed 20. Conclusion Hospital levels and regions are distributed unevenly in the Chinese present development of nutrition demonstration ward. The standard of nutrition screening and treatment in each unit has increased since the demonstration ward were established and the typical length of stay and medical expenses have reduced. Most units require more physicians and nurses and the effort to improve nutrition teaching needs to be enhanced.
2023 Vol. 10 (5): 658-666 [Abstract] ( 137 ) HTML PDF (7062 KB)  ( 142 )
667 Effects of nutritional index and controlled nutritional status score on chemotherapy response and survival of patients with ovarian cancer
Han Huimin, Qin Tingting, Zhang Yuanyuan, Xu Yang
Objective Exploring the effects of prognostic nutritional index PNI and control nutritional score CONUT on chemotherapy response and survival in ovarian cancer patients undergoing chemotherapy. Method A prospective study was conducted on 160 ovarian cancer patients who were treated at Wuhan Third Hospital from January 2017 to December 2017 and followed up until December 2022. Based on the cut-off value of moderate to severe malnutrition of CONUT and PNI patients were divided into low CONUT group CONUT<5 n = 74 and high CONUT group CONUT ≥ 5 n = 86 according to the CONUT score. Patients were divided into a low PNI group PNI<40 n = 78 and a high PNI group PNI ≥40 n = 82 based on PNI. Collect the overall survival OS of patients in different groups evaluate the overall survival of patients using Kaplan Meier curve based on their prognosis and analyze the relationship between CONUT PNI and OS. Compare the adverse reactions of different CONUT and PNI chemotherapy. Result The median follow - up time of 160 ovarian cancer chemotherapy patients was 33 months the 95% CI was 33. 694 36. 694 with a total of 99 patients 61. 88% reaching the follow-up endpoint. The median OS of patients in the low CONUT vs. high CONUT group was 45 months versus 27 months χ 2 = 50. 283 P<0. 05 respectively median OS for PNI <40 and PNI 40 was 27 months and 44 months respectively χ 2 = 9. 286 P<0. 05 . Patients with CONUT 5 or PNI <40 had lower overall survival than those with CONUT <5 and PNI 40. Cox regression showed that clinical stage CA125 NLR PLR and LMR were all independent factors affecting OS in ovarian cancer patients with different CONUT and PNI levels P < 0. 05 . The incidence of leukopenia thrombocytopenia nausea vomiting and diarrhea was higher in patients with low CONUT P<0. 05 . The incidence of nausea vomiting and diarrhea was higher in the low PNI group than in the PNI group P<0. 05 . Conclusion CONUT and PNI affect the OS of ovarian cancer patients with chemotherapy and the adverse effects of CONUT and PNI patients are inconsistent it can be seen that the association between nutritional status and the short-term and long-term prognosis of ovarian cancer chemotherapy patients is significant which can be used as an effective indicator to predict the chemotherapy response and prognosis of patients.
2023 Vol. 10 (5): 667-673 [Abstract] ( 135 ) HTML PDF (1407 KB)  ( 118 )
674 Research progress on metabolically unhealthy normal weight
Deng Xiujuan,Zhang Zhenyi
Obesity and insulin resistance are central part of metabolic syndrome . However some people with normal weight also exist glucose and lipid metabolism disorder including hypertension hyperlipidemia hyperglycemia subclinical inflammation etc. These people are called metabolically unhealthy normal weight. As the current diagnostic criteria for metabolic syndrome and obesity are inconsistent the definition of metabolically unhealthy normal weight is also inconsistent in different studies. Health hazards of metabolically normal weight including increased risk of cardiovascular disease tumor kidney damage cholelithiasis and low testosterone were found in recent studies. Metabolic unhealthy normal weight may be related to body weight body composition intestinal flora dietary patterns and age but the specific mechanism remains unclear. Compared with obese patients the metabolically abnormalities in these people are easy to be ignored or missed. And intervention studies of large sample population in metabolic unhealthy normal weight are lacking. We reviewed the population distribution risks and possible influencing factors of metabolic unhealthy in patients with normal weight aiming to improve the attention to these patients.
2023 Vol. 10 (5): 674-678 [Abstract] ( 108 ) HTML PDF (830 KB)  ( 198 )
679 The influence of sarcopenia on the prognosis of lung cancer patients
1Wei Xinxin,2Xue Wei,3Li Liting
Lung cancer is one of the most common malignant tumors. In China the mortality rate of lung cancer ranks first among malignant tumors seriously endangering the health of Chinese people. Faced with this current situation how to timely and quickly improve the quality of life of patients and extend their lifespan is an urgent problem to be solved. Sarcopenia refers to age -related muscle mass loss accompanied by decreased muscle strength or physical dysfunction. Sarcopenia can be caused by many factors such as chronic diseases lack of exercise malnutrition and drug side effects. At the same time more and more studies have also proved that sarcopenia has a high incidence rate in lung cancer gastric cancer liver cancer esophageal cancer and other types of tumors and it is also an independent risk factor affecting the prognosis of tumors. At present although sarcopenia is common in lung cancer patients the pathophysiology is still unclear. Therefore this article reviews the definition and diagnosis of sarcopenia the pathogenesis of lung cancer-related sarcopenia and the impact of sarcopenia on the prognosis of lung cancer patients with different treatment methods so as to provide a theoretical basis for the prevention of lung cancer related sarcopenia.
2023 Vol. 10 (5): 679-683 [Abstract] ( 109 ) HTML PDF (811 KB)  ( 85 )
684 Advances on energy expenditure predictive equations for oncology patients
1Ruan Huijuan,1Feng Yi,2Liang Xiaoxiao,2Chen Dawei,2Huang Jiaoyan,2Huang Youyang,2Shi Hanping
The prevalence of malnutrition in oncology patients is around 40%-80% and its occurrence is associated with higher mortality and more medical expenditures. The nutritional status of oncology patients is an important factor affecting treatment outcome and prognosis. Accurate prediction of human energy requirements is a prerequisite for nutritional health counseling and clinical nutrition support. The indirect calorimetry IC method is often considered the gold standard for assessing resting energy expenditure REE . Due to substantial geographical differences differences in the level of medical development the IC method requires not only specialized equipment but also specialized personnel to perform it and therefore it is still not possible to perform IC measurements for all patients in accordance with the guidelines. It has been found that different cancer types stages and treatments have different effects on energy expenditure and conflicting findings exist. The estimation of energy expenditure and demand of cancer patients still remains to be studied. Therefore it is important to evaluate and select predictive equations for energy expenditure suitable for patients with different types of cancers. This study reviews the characteristics of energy metabolism of cancer patients common energy expenditure prediction formulas and focuses on sorting out the relevant research progress of energy expenditure and prediction formulas for patients with various tumor diseases. Finally this study also proposes the direction and outlook of future research.
2023 Vol. 10 (5): 684-689 [Abstract] ( 117 ) HTML PDF (1041 KB)  ( 97 )
690 Research progress on nutritional assessment and treatment of colorectal cancer patients undergoing chemotherapy
Yin Chunmei, Wang Jiwei, Zheng Xilan
Colorectal cancer is one of the common malignant tumors of digestive tract in China. 2020 China Cancer Statistical Report shows that the incidence rate and mortality rate of colorectal cancer in China rank 2nd and 5th among malignant tumors respectively with 555 000 new cases and 286 000 deaths. The main methods of treatment include surgical resection radiotherapy chemotherapy targeted therapy and immunotherapy. Chemotherapy as one of the important treatments may cause complications such as bone marrow suppression nausea and vomiting hand-foot syndrome and malnutrition while playing a positive role. Malnutrition is prevalent in patients undergoing chemotherapy for colorectal cancer and malnutrition can further lead to negative effects such as aggravation of chemotherapy side effects interruption or delay of chemotherapy and decrease in the effectiveness of chemotherapy. Early nutritional screening and assessment can help timely detect nutritional risk or malnutrition in colorectal cancer patients facilitate the implementation of nutritional support therapy improve nutritional status reduce chemotherapy-related adverse effects increase chemotherapy tolerance and improve the quality of life thus benefiting patients. In this paper the nutritional status of colorectal cancer chemotherapy patients nutritional screening and assessment methods and nutritional treatment strategies are reviewed in light of the progress of domestic and international research with a view to providing reference bases for the nutritional support treatment of colorectal cancer chemotherapy patients.
2023 Vol. 10 (5): 690-694 [Abstract] ( 191 ) HTML PDF (1325 KB)  ( 215 )
695 Training strategy of clinical nutrition talents under the background of "hunger-free hospital-free hospital" construction
Lu Yang
In order to strengthen the management of malnutrition in patients in October 2018 Beijing Shijitan Hospital Capital Medical University took the lead in initiating the construction of " hunger - free hospital" program in China which has played an important role in improving clinical outcomes shortening hospital stay reducing complications and saving medical costs. The construction of "hunger-free hospital" is a systematic project the most critical part of which is to do a good job in the training of clinical nutrition talents. This paper reviews the implementation process of the clinical nutrition talent management system jointly constructed by multi-functional departments of the hospital during the construction of "hunger-free hospital" and the implementation strategy of the clinical nutrition professional talent management system for the whole talent training cycle and analyzes the key role of the training of clinical nutrition talents for the construction of " hunger - free hospital " from the perspective of human resource management.
2023 Vol. 10 (5): 695-699 [Abstract] ( 112 ) HTML PDF (2757 KB)  ( 112 )
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