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首页> 外文期刊>The American Journal of Clinical Nutrition: Official Journal of the American Society for Clinical Nutrition >Central tenet of cancer cachexia therapy: Do patients with advanced cancer have exploitable anabolic potential?
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Central tenet of cancer cachexia therapy: Do patients with advanced cancer have exploitable anabolic potential?

机译：癌症恶病质治疗的中心原则：晚期癌症患者是否具有可开发的合成代谢潜力？

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Background: Skeletal muscle wasting is considered the central feature of cachexia, but the potential for skeletal muscle anabolism in patients with advanced cancer is unproven Objective: We investigated the clinical course of skeletal muscle wasting in advanced cancer and the window of possible muscle anabolism Design: We conducted a quantitative analysis of computed tomography (CT) images for the loss and gain of muscle in populationbased cohorts of advanced cancer patients (lung, colorectal, and pancreas cancer and cholangiocarcinoma) in a longitudinal observational study Results: Advanced-cancer patients (n = 368; median survival: 196 d) had a total of 1279 CT images over the course of their disease With consideration of all time points, muscle loss occurred in 39% of intervals between any 2 scans. However, the overall frequency of muscle gain was 15.4%, and muscle was stable in 45.6% of intervals between any 2 scans, which made the maintenance or gain of muscle the predominant behavior. Multinomial logistic regression revealed that being within 90 d (compared with .90 d) from death was the principal risk factor for muscle loss (OR: 2.67; 95% CI: 1.45, 4.94; P = 0.002), and muscle gain was correspondingly less likely (OR: 0.37; 95% CI: 0.20, 0.69; P = 0.002) at this time. Sex, age, BMI, and tumor group were not significant predictors of muscle loss or gain Conclusions: A window of anabolic potential exists at defined early phases of the disease trajectory (.90 d survival), creating an opportunity for nutritional intervention to stop or reverse cachexia. Cancer patients within 90 d of death have a low likelihood of anabolic potential.
机译：背景：骨骼肌消耗被认为是恶病质的主要特征，但晚期癌症患者骨骼肌合成代谢的潜力尚未得到证实。目的：我们研究了晚期癌症骨骼肌消耗的临床过程以及可能的肌肉合成代谢设计窗口：在一项纵向观察研究中，我们对计算机断层扫描（CT）图像进行了定量分析，以分析晚期癌症患者（肺癌，结肠直肠癌，胰腺癌和胆管癌）的人群队列中肌肉的丢失和增加。结果：晚期癌症患者（n = 368;中位生存期：196 d）在其疾病过程中总共获得了1279张CT图像。考虑到所有时间点，两次扫描之间的间隔为39％发生了肌肉丢失。但是，肌肉获得的总频率为15.4％，并且在两次扫描之间的间隔为45.6％的时间内，肌肉保持稳定，这使维持或获得肌肉成为主要行为。多项式Lo​​gistic回归分析显示，距死亡90 d之内（与0.90 d之内）是造成肌肉损失的主要危险因素（OR：2.67; 95％CI：1.45、4.94; P = 0.002），而肌肉增长相应减少此时（OR：0.37; 95％CI：0.20，0.69; P = 0.002）。性别，年龄，BMI和肿瘤组不是肌肉丢失或获得的重要预测指标结论：在疾病轨迹的定义早期阶段（.90 d生存期）存在合成代谢潜能的窗口，这为营养干预提供了机会来停止或逆向恶病质。死亡90天内的癌症患者发生合成代谢潜能的可能性很小。

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