Alterations in inflammatory biomarkers and energy intake in cancer cachexia: a prospective study in patients with inoperable pancreatic cancer
Alterations in inflammatory biomarkers and energy intake in cancer cachexia: a prospective study in patients with inoperable pancreatic cancer
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DOI：
10.1007/s12032-016-0768-2
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发表时间：
2016-06-01
期刊：
影响因子：
3.4
通讯作者：
Hjermstad, Marianne J.
中科院分区：
文献类型：
--
作者：
Bye, Asta;Wesseltoft-Rao, Nima;Hjermstad, Marianne J.
慢性全身炎症反应被认为是癌症恶病质形成的潜在机制。我们进行了一项前瞻性研究，以研究不能手术的胰腺癌患者在疾病过程中炎症生物标志物的变化以及炎症生物标志物与恶病质之间的关系。20例患者，中位（范围）年龄67.5（35-79）岁，5例女性，中位随访时间为5.5（1-12）个月。恶病质的诊断是根据2011年共识的分类系统（过去6个月体重减轻5%，BMI < 20 kg/m(2)，体重减轻2%，或肌肉减少症）和改良的格拉斯哥预后评分（mGPS），该评分结合了CRP和白蛋白水平。采用酶免疫法测定炎症生物标志物。在研究开始时和接近死亡时，患者的大多数炎症生物标志物水平都有所增加，尽管并非全部具有统计学意义，这表明持续的炎症。根据基于共识的分类系统，11例（55%）患者在纳入时被分类为恶病质。他们在炎症生物标志物或能量摄入方面与非恶病质患者没有差异。根据mGPS， 7例（35%）被定义为恶病质，其IL-6水平高于非恶病质患者（p < 0.001）。他们的生存时间也比非恶病质患者稍长，但不显著（p = 0.08）。mGPS应被视为鉴别癌症恶病质的附加框架。
Chronic systemic inflammatory response is proposed as an underlying mechanism for development of cancer cachexia. We conducted a prospective study to examine changes in inflammatory biomarkers during the disease course and the relationship between inflammatory biomarkers and cachexia in patients with inoperable pancreatic cancer. Twenty patients, median (range) age 67.5 (35-79) years, 5 females, were followed for median 5.5 (1-12) months. Cachexia was diagnosed according to the 2011 consensus-based classification system (weight loss >5 % past six months, BMI < 20 kg/m(2) and weight loss >2 %, or sarcopenia) and the modified Glasgow Prognostic score (mGPS) that combines CRP and albumin levels. Inflammatory biomarkers were measured by enzyme immunoassays. The patients had increased levels of most inflammatory biomarkers, albeit not all statistically significant, both at study entry and close to death, indicating ongoing inflammation. According to the consensus-based classification system, eleven (55 %) patients were classified as cachectic upon inclusion. They did not differ from non-cachectic patients with regard to inflammatory biomarkers or energy intake. According to the mGPS, seven (35 %) were defined as cachectic and had a higher IL-6 (p < 0.001) than the non-cachectic patients. They also had a slightly, but insignificantly longer survival than noncachectic patients (p = 0.08). The mGPS should be considered as an additional framework for identification of cancer cachexia.