Background:Lung cancer cachexia has received widespread attention as one of the most common complications in patients with advanced lung cancer.As a multifactorial syndrome,lung cancer cachexia is characterized by a p...Background:Lung cancer cachexia has received widespread attention as one of the most common complications in patients with advanced lung cancer.As a multifactorial syndrome,lung cancer cachexia is characterized by a persistent decline in muscle mass that cannot be reversed by conventional nutrition Xiaoyan d ecoction can promote appetite and improve skeletal muscle mass in patients with lung cancer cachexia,while the third lumbar skeletal muscle index(L3-SMI)is able to determine whole-body skeletal muscle mass.To analyze the relationship between L3-SMI and hematological indexes and lung cancer cachexia,and to study the clinical efficacy of Xiaoyan decoction on skeletal muscle atrophy in lung cancer cachexia patients,with the aim of providing a reference basis for the early diagnosis and treatment of lung cancer cachexia patients and skeletal muscle atrophy.Methods:148 patients who were diagnosed with lung cancer in the Department of Oncology of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from January 2020 to December 2022 were included,and were divided into cachexia and non-cachexia groups according to the diagnostic criteria of cachexia,and analyzed the differences of hematological indexes and L3-SMI between cachexia patients and non-cachexia patients.And the patients with cachexia were divided into control group and treatment group,analyzed and compared the changes of body mass index(BMI),L 3-SMI,Karnofsky functional status score,albumin and other hematological indexes of the two groups before and after the treatment,and evaluated the safety of the Xiaoyan decoction in the treatment of cachexia.Results:A total of 148 lung cancer patients were included in this study,including 67 patients in the cachexia group and 81 patients in the non-cachexia group.According to the pre-treatment statistical analysis,the BMI of patients in the cachexia group was lower than that of patients in the non-cachexia group(P<0.05);among the biochemical function indexes,the proportions of creatinine(P<0.05),total protein(P<0.05),The levels of albumin in the cachexia group were significantly lower(P<0.05)compared to the non-cachexia group;in the cachexia group,both males and females had lower L3-SMIs than in the non-cachexia group(P<0.05).A total of 62 cases of lung cancer cachexia were studied,30 cases in the control group and 32 cases in the treatment group,according to statistical analysis,BMI was significantly different before and after treatment(P<0.05);L3-SMI was significantly different in the treatment group before and after treatment(P<0.05);Karnofsky significantly differed in the treatment group before and after treatment(P<0.05);and there was a significant difference in albumin before and after(P<0.05).Conclusion:Cachexia patients had significantly lower third lumbar skeletal muscle mass than non-cachexia patients,according to this study;Xiaoyan decoction was able to improve skeletal muscle mass,nutritional status as well as functional status of patients with cachexia in lung cancer,among others.展开更多
Since the beginning of 2017,Chinese Journal of Cancer has published a series of important questions in cancer research and clinical oncology,which sparkle diverse thoughts,interesting communications,and potential coll...Since the beginning of 2017,Chinese Journal of Cancer has published a series of important questions in cancer research and clinical oncology,which sparkle diverse thoughts,interesting communications,and potential collaborations among researchers all over the world.In this article,10 more questions are presented as followed.Question 40.Why do mice being used as tumorigenesis models raised in different places or different conditions possess different tumor formation rate? Question 41.How could we generate more effective anti-metastasis drugs? Question 42.What is the molecular mechanism underlying heterogeneity of cancer cachexia in patients with the same pathologic type? Question 43.Will patients with oligo-metastatic disease be curable by immunotherapy plus stereotactic body radiotherapy? Question 44.Can the Warburg effect regulation be targeted for cancer treatment? Question 45.Why do adenocarcinomas seldom occur in the small intestine? Question 46.Is Epstein-Barr virus infection a causal factor for nasal natural killer/T cell lymphoma formation? Question 47.Why will not all but very few human papillomavirusinfected patients eventually develop cervical cancer? Question 48.Why do cervical carcinomas induced by human papilloma virus have a low mutation rate in tumor suppressor genes? Question 49.Can viral infection trigger lung cancer relapse?展开更多
目的研究中药消岩汤对肺癌恶病质大鼠摄食的瘦素抵抗机制。方法建立肺癌恶病质大鼠动物模型,数字随机方法分为正常对照组、恶病质模型组、消岩汤组及阳性对照组,每组10只。大鼠肺癌恶病质模型形成后,恶病质模型组予每日灌服生理盐水2 m...目的研究中药消岩汤对肺癌恶病质大鼠摄食的瘦素抵抗机制。方法建立肺癌恶病质大鼠动物模型,数字随机方法分为正常对照组、恶病质模型组、消岩汤组及阳性对照组,每组10只。大鼠肺癌恶病质模型形成后,恶病质模型组予每日灌服生理盐水2 m L,消岩汤组每日灌服消岩汤2 m L,阳性对照组每日灌服甲羟孕酮混悬液2 m L,共用药14天。观察大鼠一般情况,肿瘤生长情况,运用酶联免疫法检测血清中瘦素及下丘脑中瘦素受体水平含量,运用Real-time PCR技术检测下丘脑中促食欲基因NPY和厌食欲基因POMC表达水平。结果在血清瘦素水平含量比较中,恶病质模型组血清中瘦素水平低于正常对照组,差异有统计学意义(P<0.05);与恶病质模型组比较,消岩汤组及阳性对照组血清中瘦素水平含量升高明显,差异有统计学意义(P<0.05,P<0.01)。在下丘脑瘦素受体水平比较中,恶病质模型组较正常对照组升高,差异有统计学意义(P<0.01),恶病质模型组较其他组瘦素受体水平含量升高(P<0.01),提示无论消岩汤及阳性对照组均可有效地降低瘦素受体水平,且消岩汤组与阳性对照组降低明显,差异有统计学意义(P<0.05)。NPY比较中,恶病质模型组较其他组水平含量升高,差异有统计学意义(P<0.05),正常对照组及其他治疗组之间差异无统计学意义。与正常对照组比较,恶病质模型组POMC明显升高,差异有统计学意义(P<0.05),其他治疗组与恶病质模型组比较,均可使POMC下降(P<0.05),且消岩汤组下降较阳性对照组明显(P<0.05)。结论肺癌恶病质大鼠中存在"瘦素抵抗"现象,中药消岩汤可升高血清中瘦素水平;降低下丘脑中的瘦素受体水平,可通过升高下丘脑中的NPY水平,降低POMC水平,促进食欲,增加摄食,从外周和中枢两条途径达到改善恶病质状态的目的。展开更多
基金National Natural Science Foundation of China(No.81303095)Tianjin Science&Technology Program(No.12ZCDZSY15800).
文摘Background:Lung cancer cachexia has received widespread attention as one of the most common complications in patients with advanced lung cancer.As a multifactorial syndrome,lung cancer cachexia is characterized by a persistent decline in muscle mass that cannot be reversed by conventional nutrition Xiaoyan d ecoction can promote appetite and improve skeletal muscle mass in patients with lung cancer cachexia,while the third lumbar skeletal muscle index(L3-SMI)is able to determine whole-body skeletal muscle mass.To analyze the relationship between L3-SMI and hematological indexes and lung cancer cachexia,and to study the clinical efficacy of Xiaoyan decoction on skeletal muscle atrophy in lung cancer cachexia patients,with the aim of providing a reference basis for the early diagnosis and treatment of lung cancer cachexia patients and skeletal muscle atrophy.Methods:148 patients who were diagnosed with lung cancer in the Department of Oncology of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from January 2020 to December 2022 were included,and were divided into cachexia and non-cachexia groups according to the diagnostic criteria of cachexia,and analyzed the differences of hematological indexes and L3-SMI between cachexia patients and non-cachexia patients.And the patients with cachexia were divided into control group and treatment group,analyzed and compared the changes of body mass index(BMI),L 3-SMI,Karnofsky functional status score,albumin and other hematological indexes of the two groups before and after the treatment,and evaluated the safety of the Xiaoyan decoction in the treatment of cachexia.Results:A total of 148 lung cancer patients were included in this study,including 67 patients in the cachexia group and 81 patients in the non-cachexia group.According to the pre-treatment statistical analysis,the BMI of patients in the cachexia group was lower than that of patients in the non-cachexia group(P<0.05);among the biochemical function indexes,the proportions of creatinine(P<0.05),total protein(P<0.05),The levels of albumin in the cachexia group were significantly lower(P<0.05)compared to the non-cachexia group;in the cachexia group,both males and females had lower L3-SMIs than in the non-cachexia group(P<0.05).A total of 62 cases of lung cancer cachexia were studied,30 cases in the control group and 32 cases in the treatment group,according to statistical analysis,BMI was significantly different before and after treatment(P<0.05);L3-SMI was significantly different in the treatment group before and after treatment(P<0.05);Karnofsky significantly differed in the treatment group before and after treatment(P<0.05);and there was a significant difference in albumin before and after(P<0.05).Conclusion:Cachexia patients had significantly lower third lumbar skeletal muscle mass than non-cachexia patients,according to this study;Xiaoyan decoction was able to improve skeletal muscle mass,nutritional status as well as functional status of patients with cachexia in lung cancer,among others.
文摘Since the beginning of 2017,Chinese Journal of Cancer has published a series of important questions in cancer research and clinical oncology,which sparkle diverse thoughts,interesting communications,and potential collaborations among researchers all over the world.In this article,10 more questions are presented as followed.Question 40.Why do mice being used as tumorigenesis models raised in different places or different conditions possess different tumor formation rate? Question 41.How could we generate more effective anti-metastasis drugs? Question 42.What is the molecular mechanism underlying heterogeneity of cancer cachexia in patients with the same pathologic type? Question 43.Will patients with oligo-metastatic disease be curable by immunotherapy plus stereotactic body radiotherapy? Question 44.Can the Warburg effect regulation be targeted for cancer treatment? Question 45.Why do adenocarcinomas seldom occur in the small intestine? Question 46.Is Epstein-Barr virus infection a causal factor for nasal natural killer/T cell lymphoma formation? Question 47.Why will not all but very few human papillomavirusinfected patients eventually develop cervical cancer? Question 48.Why do cervical carcinomas induced by human papilloma virus have a low mutation rate in tumor suppressor genes? Question 49.Can viral infection trigger lung cancer relapse?
文摘目的基于癌毒理论探讨沙参麦冬汤加减治疗肺癌恶病质的临床疗效,观察其对患者血清肿瘤坏死因子(tumor necrosis factor,TNF)-α、白介素(interleukin,IL)-6水平的影响。方法选取本院肿瘤科2018年1月—2019年1月接诊的104例原发性肺癌恶病质患者作为研究对象,通过随机数字表法随机分成2组,每组52例。对照组患者予以营养支持和常规治疗,观察组患者在对照组治疗基础上联合沙参麦冬汤治疗。连续治疗4周后,比较2组患者治疗前后中医证候积分、患者参与的主观全面评定(patient-generated subjective global assessment,PG-SGA)、身体质量指数(body mass index,BMI)及卡诺夫斯凯计分(Kanofsky performance scores,KPS),测定血清TNF-α及IL-6的水平变化,对比临床疗效。结果治疗后,观察组患者中医证候积分、PG-SGA评分及血清TNF-α、IL-6水平显著低于对照组(P<0.05),KPS评分显著高于对照组(P<0.05)。观察组临床疗效为92.31%,显著高于对照组的71.15%(P<0.05)。结论以癌毒理论为指导,应用沙参麦冬汤辨证加减治疗肺癌恶病质可有效缓解患者临床症状,改善营养及健康状态,减轻机体炎症反应,具有确切疗效。
文摘目的探讨消岩汤治疗肺癌恶病质的可能作用机制。方法将40只小鼠随机分为健康组、模型组、消岩汤组、醋酸甲地孕酮组,每组10只。除健康组外,其余各组通过接种肿瘤细胞建立肺癌恶病质模型。造模成功后模型组小鼠每日灌服生理盐水1 ml,消岩汤组每日灌服消岩汤0.42 g,醋酸甲地孕酮组每日灌服醋酸甲地孕酮3.75 mg/d,均给药14天。测定腓肠肌重量,血清肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)含量及肌肉萎缩盒F基因(MAFbx)和肌肉环状指基因1(MURF-1)m RNA表达。结果与健康组比较,模型组腓肠肌重量下降,模型组和醋酸甲地孕酮组TNF-α、IL-6水平及MAFbx、MURF-1m RNA表达均明显上升(P<0.01);与模型组比较,消岩汤组腓肠肌重量明显增加,血清TNF-α、IL-6水平及MAFbx、MURF-1 m RNA表达均明显下降(P<0.05或P<0.01),醋酸甲地孕酮组TNF-α、IL-6水平均明显下降(P<0.05);醋酸甲地孕酮组腓肠肌重量明显低于消岩汤组(P<0.01),血清TNF-α、IL-6水平及MAFbx、MURF-1 m RNA表达明显高于消岩汤组(P<0.05或P<0.01)。结论消岩汤可能通过减少炎症细胞因子产生,抑制MAFbx和MURF-1基因表达,改善肺癌恶病质肌肉蛋白质降解,从而改善肺癌恶病质状态。
文摘目的研究中药消岩汤对肺癌恶病质大鼠摄食的瘦素抵抗机制。方法建立肺癌恶病质大鼠动物模型,数字随机方法分为正常对照组、恶病质模型组、消岩汤组及阳性对照组,每组10只。大鼠肺癌恶病质模型形成后,恶病质模型组予每日灌服生理盐水2 m L,消岩汤组每日灌服消岩汤2 m L,阳性对照组每日灌服甲羟孕酮混悬液2 m L,共用药14天。观察大鼠一般情况,肿瘤生长情况,运用酶联免疫法检测血清中瘦素及下丘脑中瘦素受体水平含量,运用Real-time PCR技术检测下丘脑中促食欲基因NPY和厌食欲基因POMC表达水平。结果在血清瘦素水平含量比较中,恶病质模型组血清中瘦素水平低于正常对照组,差异有统计学意义(P<0.05);与恶病质模型组比较,消岩汤组及阳性对照组血清中瘦素水平含量升高明显,差异有统计学意义(P<0.05,P<0.01)。在下丘脑瘦素受体水平比较中,恶病质模型组较正常对照组升高,差异有统计学意义(P<0.01),恶病质模型组较其他组瘦素受体水平含量升高(P<0.01),提示无论消岩汤及阳性对照组均可有效地降低瘦素受体水平,且消岩汤组与阳性对照组降低明显,差异有统计学意义(P<0.05)。NPY比较中,恶病质模型组较其他组水平含量升高,差异有统计学意义(P<0.05),正常对照组及其他治疗组之间差异无统计学意义。与正常对照组比较,恶病质模型组POMC明显升高,差异有统计学意义(P<0.05),其他治疗组与恶病质模型组比较,均可使POMC下降(P<0.05),且消岩汤组下降较阳性对照组明显(P<0.05)。结论肺癌恶病质大鼠中存在"瘦素抵抗"现象,中药消岩汤可升高血清中瘦素水平;降低下丘脑中的瘦素受体水平,可通过升高下丘脑中的NPY水平,降低POMC水平,促进食欲,增加摄食,从外周和中枢两条途径达到改善恶病质状态的目的。
