BMJ:牛津大学研究,体重突然减轻可能是癌?伴发这些症状要警惕!

2020-08-19 佚名 e药环球

调整饮食和增加运动,是很多人减重、瘦身时会选择的途径。但如果一个人生活方式没有发生重大变化,既没有改变饮食习惯,也没有多运动,体重却突然减轻了,而且还找不到原因,可能是身体出现了潜在的疾病,比如癌症。

调整饮食和增加运动,是很多人减重、瘦身时会选择的途径。但如果一个人生活方式没有发生重大变化,既没有改变饮食习惯,也没有多运动,体重却突然减轻了,而且还找不到原因,这时候就应该注意了,可能是身体出现了潜在的疾病,比如癌症。

体重突然减轻虽然是癌症的一个信号,但糖尿病、胃溃疡以及精神疾病等也会导致这种情况。因此,从中识别出哪些体重突然减轻的人应及时进行癌症筛查,就尤为重要。

近日,一项在线发表于《英国医学杂志》(BMJ)的研究,分析了体重突然减轻并伴有哪些临床特征,包括症状、体征以及血液检查结果等,会进一步增加患癌风险。

研究作者之一、牛津大学Paul Aveyard教授指出:“医生面临进退两难的境地,他们面对的体重突然减轻的患者可能患有癌症,但其症状不足以立即证明进一步检查的合理性,也不能指向特定类型的癌症,这项研究让我们定义了一些关键的体征和症状,以帮助医生更快地采取正确的行动,这可以改善患者的预后。”

英国牛津大学领衔的研究团队对临床实践研究数据链(CPRD,一个英国电子健康记录数据库)中的数据进行了分析,共涉及6.4万名受试者,其中58.2%为女性,41.8%为男性;51.8%的受试者年龄在60岁以上。

研究人员统计了受试者出现体重突然减轻后,进行诊疗时的临床特征。此外,还收集了受试者吸烟、饮酒等生活方式信息,以及疾病史和诊疗后3-6个月内癌症发病情况。

在体重突然减轻诊疗后的6个月内,共有908名受试者罹患癌症,最常见是肺癌,其次是结直肠癌胃癌、食管癌、胰腺癌淋巴瘤;体重突然减轻的受试者最常见的临床特征包括咳嗽、腹痛、背痛、胸部感染和疲乏。

在调整了吸烟、饮酒等因素影响后,进一步分析发现,体重突然减轻的受试者在6个月内,患癌症的可能性大幅增加,尤其是在男性中。总体来看,体重突然减轻受试者的患癌可能性,是体重没有突然减轻受试者的2倍;在男性中,是3倍;在女性中则相差不大。

在男性受试者中,体重突然减轻并伴有这10种临床症状和体征,使患癌症的可能性增加了198%-510%,包括腹痛(118%)、食欲不振(196%)、吞咽困难(246%)、咯血(326%)、非心源性胸痛(86%)、腹部肿块(510%)、胸部症状(441%)、缺铁性贫血(396%)、黄疸(467%)和淋巴结疾病(162%)。

在女性受试者中,体重突然减轻并伴有11种临床症状和体征,使患癌症的可能性增加了86%-1990%,腹痛(130%)、食欲不振(157%)、背痛(62%)、排便习惯改变(254%)、消化不良(155%)、腹部肿块(448%)、胸部症状(1080%)、缺铁性贫血(270%)、黄疸(1990%)、淋巴结病(138%)和静脉血栓栓塞(540%)。

此外,多项血液检查结果也与患癌可能性增加有关,包括低白蛋白(367%)、碱性磷酸酶升高(54%)、低血红蛋白(205%)、白细胞总数增加(276%)和C反应蛋白升高(259%)。

研究人员分析受试者的临床特征与癌症类型发现,通常一些临床特征常被认为与单个部位的癌症相关,但一些临床特征与体重突然减轻同时出现时,与多个部位的癌症可能性增加有关。例如患有消化不良和体重突然减轻的女性,患胃或食管、肠、胰腺、肺、骨结缔组织或软组织、淋巴瘤、乳腺、中枢神经系统和白血病等类型或部位的癌症可能性会增加。

埃克塞特大学Willie Hamilton教授,也是该研究作者之一,补充指出:“这项研究对改善癌症诊断很重要,我们都知道体重突然减轻可能是癌症。现在我们知道还应该询问患者哪些事项,以及寻找哪些癌症。体重突然减轻的患者,在他们的癌症被发现之前,经常会去不同的专家那里进行诊疗,我们的研究应该改善这个过程,以期在更早的阶段检测出更多的癌症。”

对于体重突然减轻的人而言,除了要及时进行诊疗外,还应将自己的体征或症状详细告知医疗人员,进行相关检查,排除癌症可能,或者及时发现癌症,尽早治疗,以提高生存率。

原始出处:

Brian D Nicholson, Paul Aveyard,Sarah J Price, et al.Prioritising primary care patients with unexpected weight loss for cancer investigation: diagnostic accuracy study.BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2651 (Published 13 August 2020)1

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    2020-10-05 gaoxiaoe
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    2020-08-19 ms5000000741733160

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    2020-08-19 ms5000000741733160

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    2020-08-19 liangying

    额 好害怕

    0

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众所周知,化疗、手术等传统的治疗方法,主要利用外力来消灭肿瘤。而免疫治疗,则是通过增强患者自身的免疫应答来抑制肿瘤生长。疾病的发生和免疫力有关,普遍认为免疫力越强,治疗癌症的效果就越好。