营养相关指标在肝癌患者中的应用及研究进展
Nutrition-Related Indicators in Patients with Liver Cancer: Application and Research Progress
DOI: 10.12677/ACM.2022.125580, PDF,  被引量   
作者: 张道峰, 王晓临*:青海大学附属医院,肝胆胰外科,青海 西宁
关键词: 肝细胞癌CONUTNRI营养不良Hepatocellular Carcinoma CONUT NRI Malnutrition
摘要: 肝细胞癌大多数是由慢性肝病发展而来,术后并发营养不良的概率较高,严重影响患者预后。目前临床上进行营养评估的方法有很多,但国内外尚未建立统一的营养评估标准。本综述查阅国内外文献,归纳总结常见的营养状况评估工具及研究进展,为肝癌患者术前营养状况的评估提供参考。综合营养评估工具相对于传统营养指标能更准确地反映肝癌患者的营养状况,临床上在参考传统营养指标的同时应结合使用CONUT、NRI、NRS-2002等多种营养评估工具对患者进行评估。
Abstract: The majority of hepatocellular carcinomas arise from chronic liver disease, and the risk of postop-erative nutritional problems is considerable, negatively affecting patients’ prognoses. There are several clinical approaches for nutritional evaluation, but no universal nutritional assessment standard has been created at home and abroad. This study covers popular nutritional status evalu-ation techniques and research developments by evaluating domestic and foreign literature, and it serves as a reference for determining the nutritional status of liver cancer patients before surgery. Comprehensive nutritional assessment tools can more accurately reflect the nutritional status of liver cancer patients than traditional nutritional indexes, and patients should be clinically assessed using multiple nutritional assessment tools, such as CONUT, NRI, and NRS-2002, in addition to tra-ditional nutritional indexes.
文章引用:张道峰, 王晓临. 营养相关指标在肝癌患者中的应用及研究进展[J]. 临床医学进展, 2022, 12(5): 4005-4012. https://doi.org/10.12677/ACM.2022.125580

参考文献

[1] Sung, H., Ferlay, J., Siegel, R.L., Laversanne, M., Soerjomataram, I., Jemal, A., et al. (2021) Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: A Cancer Journal for Clinicians, 71, 209-249. [Google Scholar] [CrossRef] [PubMed]
[2] Llovet, J.M., Kelley, R.K., Villanue-va, A., Singal, A.G., Pikarsky, E., Roayaie, S., Lencioni, R., Koike, K., Zucman- Rossi, J. and Finn, R.S. (2021) Hepa-tocellular Carcinoma. Nature Reviews Disease Primers, 7, Article No. 6. [Google Scholar] [CrossRef] [PubMed]
[3] 刘小青, 李静. 住院患者营养状况评估方法及其临床应用进展[J]. 中国护理管理, 2013, 13(8): 108-110+111.
[4] Ponziani, F.R. and Gasbarrini, A. (2018) Sarcopenia in Patients with Advanced Liver Disease. Current Protein & Peptide Science, 19, 681-691. [Google Scholar] [CrossRef] [PubMed]
[5] Vasques, J., Guerreiro, C.S., Sousa, J., Pinto, M. and Cortez-Pinto, H. (2019) Nutritional Support in Cirrhotic Patients with Sarcopenia. Clinical Nutrition ESPEN, 33, 12-17. [Google Scholar] [CrossRef] [PubMed]
[6] 肖慧娟, 张明, 齐玉梅, 韩涛. 肌肉减少症与慢性肝脏病的研究进展[J]. 中华肝脏病杂志, 27(7): 563-566.
[7] Ney, M., Li, S., Vandermeer, B., Gramlich, L., Ismond, K.P., Raman, M., et al. (2020) Systematic Review with Meta-Analysis: Nutritional Screening and Assessment Tools in Cir-rhosis. Liver International, 40, 664-673. [Google Scholar] [CrossRef] [PubMed]
[8] Kamran, U., Towey, J., Khanna, A., Chauhan, A., Rajoriya, N. and Holt, A. (2020) Nutrition in Alcohol-Related Liver Disease: Physiopathology and Management. World Journal of Gastroenterol-ogy, 26, 2619-2930. [Google Scholar] [CrossRef] [PubMed]
[9] 徐飞, 汪光海, 邱伟. 肝癌手术前后血清甲胎蛋白和白蛋白及载脂蛋白水平的变化及意义[J]. 中国肿瘤临床与康复, 2021, 28(9): 1107-1110.
[10] 张鹭坚, 蔡梅真. 肝炎肝硬化患者血清总胆固醇、血清白蛋白与胆碱酯酶水平在肝功能评估中的应用[J]. 吉林医学, 2022, 43(2): 482-484.
[11] 宋戈, 樊海宁, 王海久, 王鹏, 李晓龙, 王展, 等. 肝癌患者临床营养评价方法及其进展[J]. 中国普外基础与临床杂志, 2017, 24(6): 760-764.
[12] Ratti, F., Pulitanò, C., Catena, M., Paganelli, M. and Aldrighetti, L. (2015) Serum levels of endothelin-1 after liver resection as an early predictor of postoperative liver failure. A prospective study. Hepatology Research, 46, 529-540. [Google Scholar] [CrossRef] [PubMed]
[13] 贾克丽, 韩际奥, 高晓. 血清前白蛋白和MELD评分对失代偿期乙型肝炎肝硬化患者预后的预测价值[J]. 实用肝脏病杂志, 2018, 21(3): 348-351.
[14] 贺尼娅, 王琳. 慢性乙型肝炎患者血清胆固醇与肝纤维化的相关性研究[J]. 肝脏, 2020, 25(6): 645-647+654.
[15] Lukaski, H.C., Johnson, P.E., Bolonchuk, W.W. and Lykken, G.I. (1985) Assessment of Fat-Free Mass Using Bioelectrical Impedance Measurements of the Human Body. American Journal of Clinical Nutrition, 41, 810-817. [Google Scholar] [CrossRef] [PubMed]
[16] 曹峻, 姜靖滔, 马建红, 马建红, 沈红艺, 吴嘉珍. 相位角评估喉癌病人营养状况可行性研究[J]. 肠外与肠内营养, 2021, 28(4): 199-203.
[17] Di Vincenzo, O., Marra, M., Di Gre-gorio, A., Pasanisi, F. and Scalfi, L. (2021) Bioelectrical Impedance Analysis (BIA)-Derived Phase Angle in Sarcopenia: A Systematic Review. Clinical Nutrition, 40, 3052-3061. [Google Scholar] [CrossRef] [PubMed]
[18] Rimsevicius, L., Gincaite, A., Vicka, V., Sukackiene, D., Pavinic, J., Miglinas, M., et al. (2016) Malnutrition Assessment in Hemodialysis Patients: Role of Bioelectrical Impedance Anal-ysis Phase Angle. Journal of Renal Nutrition, 26, 391-395. [Google Scholar] [CrossRef] [PubMed]
[19] 肖慧娟, 张明, 齐玉梅, 韩涛, 王昕. 相位角与原发性肝癌患者营养状况及临床结局的关系[J]. 肿瘤防治研究, 2021, 48(5): 503-507.
[20] Ulíbarri, J.I.D., González-Madroo, A., Villar, N., González, P., González, B., Mancha, A., et al. (2005) CONUT: A Tool for Controlling Nutritional Status. First validation in a Hospital Population. Nutricion Hospita-laria, 20, 38-45.
[21] Shimose, S., Kawaguchi, T., Iwamoto, H., Tanaka, M., Miyazaki, K., Ono, M., et al. (2020) Con-trolling Nutritional Status (CONUT) Score Is Associated with Overall Survival in Patients with Unresectable Hepatocel-lular Carcinoma Treated with Lenvatinib: A Multicenter Cohort Study. Nutrients, 12, Article No. 1076. [Google Scholar] [CrossRef] [PubMed]
[22] Lin, Z.X., Ruan, D.Y., Jia, C.C., Wang, T.-T., Cheng, J.-T., Huang, H.-Q., et al. (2019) Controlling Nutritional Status (CONUT) Score-Based Nomogram to Predict Overall Survival of Pa-tients with HBV-Associated Hepatocellular Carcinoma after Curative Hepatectomy. Clinical and Translational Oncology, 22, 370-380. [Google Scholar] [CrossRef] [PubMed]
[23] 罗旭, 林志强, 穆华, 谭广. 术前控制营养状态评分与肝细胞癌肝切除术后预后的研究进展[J]. 中华实验外科杂志, 2022, 39(1): 187-190.
[24] Leon-Sanz, M. (1992) Periop-erative Total Parenteral Nutrition in Surgical Patients. New England Journal of Medicine, 326, 273-274. [Google Scholar] [CrossRef
[25] Doyle, M.P., Barnes, E. and Moloney, M. (2000) The Evaluation of an Undernutrition Risk Score to Be Used by Nursing Staff in a Teaching Hospital to Identify Surgical Pa-tients at Risk of Malnutrition on Admission: A Pilot Study. Journal of Human Nutrition & Dietetics, 13, 433-441.
[26] 孙政, 阙海峰, 楼建, 徐宏涛. 营养风险指数在Ⅳ期胃癌预后评价中的意义[J]. 临床外科杂志, 2022, 30(1): 58-61.
[27] Liu, G., Zhang, S., Mao, Z., Wang, W. and Hu, H. (2020) Clinical Significance of Nutritional Risk Screen-ing for Older Adult Patients with COVID-19. European Journal of Clinical Nutrition, 74, 876-883. [Google Scholar] [CrossRef] [PubMed]
[28] Amodio, P., Bemeur, C., Butterworth, R., Cordoba, J., Kato, A., Montagnese, S., Uribe, M., Vilstrup, H., Morgan, M.Y. (2013) The Nutritional Management of Hepatic Encephalopathy in Patients with Cirrhosis: International Society for Hepatic Encephalopathy and Nitrogen Metabolism Consensus. Hepatology, 58, 325-336. [Google Scholar] [CrossRef] [PubMed]
[29] Borhofen, S.M., Gerner, C., Lehmann, J., Fimmers, R., Görtzen, J., Hey, B., et al. (2016) The Royal Free Hospital- Nutritional Prioritizing Tool Is an Independent Predictor of Deterioration of Liver Function and Survival in Cirrhosis. Digestive Diseases and Sciences, 61, 1735-1743. [Google Scholar] [CrossRef] [PubMed]
[30] 王娜, 彭琼, 戴夫. RFH-NPT在肝硬化患者营养评估中的应用[J]. 医学信息, 2020, 33(17): 85-88.
[31] 朱娅鸽, 吴宇超, 王娟, 陈天艳, 杨瑗. 两种营养不良风险筛查工具在原发性肝癌住院患者中的应用比较[J]. 医学综述, 2021, 27(8): 1616-1620.
[32] Kondrup, J., Rasmussen, H.H., Hamberg, O. and Stanga, Z. (2003) Nutritional Risk Screening (NRS 2002): A New Method Based on an Analysis of Controlled Clinical Trials. Clinical Nutrition, 22, 321-336. [Google Scholar] [CrossRef
[33] Kondrup, J., Allison, S.P., Elia, M., Vellas, B. and Plauth, M. (2003) ESPEN Guidelines for Nutrition Screening 2002. Clinical Nutrition, 22, 415-421. [Google Scholar] [CrossRef
[34] 王伟仙, 曾莉, 周丰勤, 柯雨停. 原发性肝癌患者营养风险筛查及影响因素分析[J]. 护理学杂志, 2018, 33(19): 86-88.
[35] 陈颖君, 卞晓洁, 陈大宇, 凡银银, 徐悦, 毛谅, 等. 多学科联合营养测评在肝癌病人营养评估中的价值和护理体会[J]. 肠外与肠内营养, 2020, 27(2): 94-99.
[36] Detsky, A.S., McLaughlin, J.R., Baker, J.P., Johnston, N., Whittaker, S., Mendelson, R.A., et al. (1987) What Is Subjective Global Assessment of Nutritional Status? Journal of Parenteral and Enteral Nutrition, 11, 8-13. [Google Scholar] [CrossRef] [PubMed]
[37] Shin, S., Jun, D.W., Saeed, W.K. and Koh, D.H. (2021) A Narrative Review of Malnutrition in Chronic Liver Disease. Annals of Translational Medicine, 9, 172. [Google Scholar] [CrossRef] [PubMed]
[38] Ottery, F.D. (1994) Rethinking Nutritional Support of the Cancer Pa-tient: The New Field of Nutritional Oncology. Seminars in Oncology, 21, 770-778.
[39] 唐中权. 原发性肝癌营养不良三级诊断的营养筛查手段和评价工具[J]. 肿瘤代谢与营养电子杂志, 2019, 6(1): 120-124.
[40] Guigoz, Y., Vellas, B. and Garry, P.J. (1994) Mini Nutritional Assessment: A Practical Assessment Tool for Grading the Nutritional State of Elderly Patients. Facts and Research in Gerontology, 2, 31-36.
[41] Rubenstein, L.Z., Harker, J.O., Salvà, A., Guigoz, Y. and Vellas, B. (2001) Screening for Undernutrition in Geriatric Practice: Developing the Short-Form Mini-Nutritional Assessment (MNA-SF). The Journals of Gerontology Series A: Biological Sciences and Medical Sci-ences, 56, M366-M372. [Google Scholar] [CrossRef
[42] Bouillanne, O., Morineau, G., Dupont, C., Coulombel, I., Vincent, J.P., Nicolis, I., et al. (2005) Geriatric Nutritional Risk Index: A New Index for Evaluating At-Risk Elderly Medical Patients. American Journal of Clinical Nutrition, 82, 777-783. [Google Scholar] [CrossRef] [PubMed]
[43] Dent, E., Hoogendijk, E.O., Visvanathan, R. and Wright, O.R.L. (2019) Malnutrition Screening and Assessment in Hospitalised Older People: A Review. The Journal of Nutrition, Health & Aging, 23, 431-441. [Google Scholar] [CrossRef] [PubMed]