Clinical Nutrition: 胰十二指肠切除术早期胰腺癌患者的营养和免疫功能障碍及其对预后的影响

2020-11-18 MedSci原创 MedSci原创

即使在胰腺癌早期阶段,营养不良也很常见,对临床结局也有重大影响。本项研究的目的是探究因怀疑患有胰腺癌而计划行胰十二指肠切除术的患者队列中的免疫和营养障碍与预后的影响。

背景与目标

即使在胰腺癌早期阶段,营养不良也很常见,对临床结局也有重大影响。本项研究的目的是探究因怀疑患有胰腺癌而计划行胰十二指肠切除术的患者队列中的免疫和营养障碍与预后的影响。

 

 

方法

研究人员对2016年1月至2018年11月间在维尔纽斯大学医院进行胰十二指肠切除术的患者进行了分析。将患者随机分为免疫营养与对照组的营养干预组,对于肿瘤的分类则分为胰腺导管腺癌(PDAC)与其他胰腺肿瘤的组。营养评估包括筛查(NRS 2002),人体测量,生物电阻抗分析和腰椎骨骼肌指数(LSMI)。在手术前后测量炎症指标。术后30天使用综合并发症指数(CCI)评估手术结局。

 

 

结果

尽管在22.4%的患者中发现营养风险增加,但最终诊断出恶病质的比例为41.4%。虽然肥胖症患者主要诊断为恶病质,但在所有BMI类别中均发现了肌肉减少症,而肥胖患者中有11.7%患有肌肉减少症。在52.5%的患者中发现LSMI降低。回归模型表明营养指标对CCI有很大影响(R2系数为71.1%)。与其他胰腺肿瘤患者相比,PDAC患者的特征是手术前全身炎症增加,术后炎症降低(p = 0.02)。

 

 

 

结论

本项研究发现在早期胰腺癌患者队列中发现了很高的营养障碍率,包括异常的身体成分组成,它们对术后结果产生了负面影响。

 

 

原始出处:

Jaroslav Tumas. Et al. Nutritional and immune impairments and their effects on outcomes in early pancreatic cancer patients undergoing pancreatoduodenectomy. Clinical Nutrition.2020.

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topicName=null, topicId=null, topicList=[TopicDto(id=32947, encryptionId=09d33294eb8, topicName=功能障碍)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b3493649807, createdName=naiwu78, createdTime=Tue Nov 17 05:56:03 CST 2020, time=2020-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1507736, encodeId=bec0150e73665, content=<a href='/topic/show?id=8764484014' target=_blank style='color:#2F92EE;'>#clinical#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4840, encryptionId=8764484014, topicName=clinical)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1ee59933733, createdName=zll0628, createdTime=Tue Nov 17 05:56:03 CST 2020, time=2020-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1513551, encodeId=c2f91513551df, content=<a href='/topic/show?id=9293289e30d' target=_blank style='color:#2F92EE;'>#免疫功能#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28973, encryptionId=9293289e30d, topicName=免疫功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Nov 17 05:56:03 CST 2020, time=2020-11-17, status=1, ipAttribution=)]
    2020-11-19 Oranhyg

    营养重要性

    0

  5. 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style='color:#2F92EE;'>#免疫功能#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28973, encryptionId=9293289e30d, topicName=免疫功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Nov 17 05:56:03 CST 2020, time=2020-11-17, status=1, ipAttribution=)]
    2020-11-19 莉莉安 Lillian C.

    优质蛋白对癌症患者的重要性

    0

  6. 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style='color:#2F92EE;'>#免疫功能#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28973, encryptionId=9293289e30d, topicName=免疫功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Nov 17 05:56:03 CST 2020, time=2020-11-17, status=1, ipAttribution=)]
    2020-11-19 titiwangsunny

    谢谢

    0

  7. 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    2020-11-18 sayme13

    角度不错

    0

  8. 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  9. 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style='color:#2F92EE;'>#免疫功能#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28973, encryptionId=9293289e30d, topicName=免疫功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Nov 17 05:56:03 CST 2020, time=2020-11-17, status=1, ipAttribution=)]
    2020-11-17 zll0628
  10. 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