Relationship between Pre-Treatment Nutritional Status, Serum Glutamine, Arginine Levels and Clinicopathological Features in Taiwan Colorectal Cancer Patients

台湾地区大肠直肠癌病人治疗前营养评估、血清麸酰胺酸与精胺酸值，和临床病理特征之间的关系

Yi-Ping Pan ； Pei-Hung Chang ； Chung-Wei Fan ； Wen-Ko Tseng ； Jen-Seng Huang ； Chih-Hung Chen ； Wen-Chi Chou ； Cheng-Hsu Wang ； Kun-Yun Yeh

《Asia Pacific Journal of Clinical Nutrition》 預刊文章 Pp. 1-13

https://doi.org/10.6133/apjcn.2015.24.4.23

摘要

目的：此研究是要探讨台湾地区大肠直肠癌病人治疗前营养不良情形、血清麸酰胺酸与精胺酸值，和临床病理特征之间的关系。方法：针对164位病人，运用三种营养不良诊断标准，包含六个月内体重下降百分之五、身体质量指数每平方尺小于18.5公斤及低白蛋白质血症，评估治疗前营养状况，同时也收集治疗前血清中麸酰胺酸与精胺酸浓度，来测试它们之间关系与临床病理参数的影响。结果：有32位（23.5%）病人体重下降、19位（11.9%）病人有较低身体质量指数及57位（35.8%）病人有低白蛋白质血症。单变量分析发现低白蛋白质血症与高肿瘤期数、低麸酰胺酸浓度、高CRP值和无疾病进展存活率有关。单变量分析也显示低麸酰胺酸浓度与高肿瘤期数相关，但是精胺酸浓度却没有发现与临床病理参数有关。在多变量分析中，无论是营养不良诊断标准或是血清中麸酰胺酸与精胺酸浓度都与住院时间和无疾病进展存活率有关没有相关。结论：台湾地区大肠直肠癌病人治疗前营养不良情形，会因为不同营养不良诊断标准而有所差异；治疗前营养不良及低血清中麸酰胺酸与精胺酸浓度与住院时间和无疾病进展存活率有关没有相关。

關鍵字

体重下降 ； 低身体质量指数 ； 低白蛋白质血症 ； 麸酰胺酸 ； 精胺酸

並列摘要

Objective: To examine the relationship between malnutrition criteria, serum glutamine and arginine concentrations, and clinicopathological features in Taiwan colorectal cancer patients. Methods: Three malnutrition criteria (body weight loss ＞5% over past 6 months, body mass index (BMI) ＜18.5kg/m^2, and hypoalbuminemia) and serum levels of glutamine and arginine were measured in 164 colorectal patients. Malnutrition status and serum glutamine and arginine concentrations were tested for their association with each other, as well as with the clinicopathological variables. Results: Of the 164 patients, 38 (23.5%) had body weight loss, 19 (11.9%) had low BMI, and 57 (35.8%) had hypoalbuminemia. The univariate analysis showed hypoalbuminemia was correlated with advanced tumor stage, lower concentrations of glutamine, higher C-reactive protein level, and progression-free survival rate. Univariate analysis also showed glutamine levels were lower in advanced tumor stage, but arginine levels were not associated with any clinicopathologic variables. Neither the nutrition criteria used in this study nor glutamine and arginine levels were correlated with hospital stay or progression-free survival rate in multivariate analysis. Conclusions: Different nutrition assessment criteria produced different malnutrition rates in colorectal cancer patients; however, pre-treatment malnourished status and low serum glutamine and arginine concentrations were not correlated with hospital stay and progression-free survival rate.

並列關鍵字

body weight loss ； low BMI ； hypoalbuminemia ； glutamine ； arginine