Nutrition and Cancer-An International Journal最新文献

Objective: Identifying early predictive indicators of symptomatic hypocalcemia in patients after thyroidectomy with neck lymph node dissection can help to identify high-risk patients, provide timely intervention, and improve prognosis.

Methods: A retrospective analysis of all relevant information was conducted for patients who underwent total thyroidectomy with neck lymph node dissection at our hospital between April 2021 and September 2022. The primary outcome measure was symptomatic hypocalcemia.

Results: Of the 210 patients who underwent total thyroidectomy with l neck lymph node dissection, 76 patients (36%) experienced symptoms of hypocalcemia. The analysis confirmed that the rate of parathyroid hormone (PTH) decline (OR = 238.414, 95%CI: 51.904-1095.114, P = 0.000) was an independent risk factor for symptomatic hypocalcemia after total thyroidectomy with neck lymph node dissection. The ROC curve indicated that a PTH decline cutoff value of 0.7425 was significantly correlated with symptoms of hypocalcemia, with a sensitivity of 89% and specificity of 69%, which could effectively predict symptomatic hypocalcemia.

Conclusion: A PTH decline rate greater than the cutoff value of 0.7425 is a predictive factor for symptomatic hypocalcemia in adults and may be considered as a high-risk patient and actively managed to supplement calcium as soon as possible to ensure patient safety.

Objective: The primary objective of this investigation was to assess the impact of acupuncture intervention and explore the intricacies of acupoint selection as a therapeutic strategy for chemotherapy-induced Anorexia (CIA).

Method: Eight electronic databases were searched to identify relevant studies on the use of acupuncture for the treatment of CIA to conduct a comprehensive meta-analysis. Following this, the Apriori algorithm, correlation analysis, and cluster analysis were performed to identify correlations between the selection of acupoints.

Results: Acupuncture significantly reduced the incidence of anorexia (RR = 0.76, 95%CI: 0.65, 0.90; I²=63%; p = 0.001; n = 503) and anorexia score (SMD=-0.33, 95%CI: -0.53, -0.14; I²=22%; p = 0.0008; n = 419), as well as preserved body mass (MD = 2.70, 95%CI: 1.08, 4.32; I²=0%; p = 0.001; n = 187) and enhanced physical strength (MD = 4.23, 95%CI: 1.90, 6.55; I²=58%; p = 0.0004; n = 377). Moreover, subgroup analysis highlighted its efficacy in managing anorexia associated with non-gastrointestinal tumors and mitigating the severity of cisplatin-induced anorexia. Meanwhile, Zusanli (ST36), Neiguan (PC6), Tianshu (ST25), Zhongwan (RN12), and Qihai (RN6) were identified as crucial acupoints in CIA management.

Conclusion: Acupuncture holds promise as a potential non-pharmacological approach for managing anorexia during cancer chemotherapy. To provide robust evidence of its effectiveness, well-designed Randomized Controlled Trials (RCTs) with larger participant cohorts, and consistent core outcome measures are essential.

Aflatoxin B1 (AFB1) may be associated with not only developing liver cancer but also gallbladder cancer (GBC). We aimed to investigate whether serum AFB1 level of GBC patients is higher than chronic cholecystitis (CC) patients or healthy subjects (HS). Serum was collected from 45 GBC patients (18 men, 27 women), 57 CC patients (22 men, 35 women), and 55 HS (20 men, 35 women) from May 2021 to February 2024. Serum AFB1-lysine adduct level was measured using a commercial ELISA kit. Detection frequency (≥0.1 ng/ml), median and mean levels of serum AFB1-lysine adduct were compared among three groups. The detection rate was 71% (35/45) in GBC patients, 39% (22/57) in CC, and 7% (4/55) in HS (p < 0.001). Age- and gender-adjusted odds ratios of AFB1 detection in GBC patients were 4.1 and 16.8 times higher than in CC patients and HS, respectively. The median levels were 5.0 ng/mL in GBC patients and < 0.1 ng/mL in CC patients and HS. The mean level in GBC patients (7.9 ± 8.4 ng/mL) was significantly higher than that in CC patients (2.7 ± 4.5 ng/mL) or HS (0.3 ± 1.1 ng/mL). Our findings show direct evidence that AFB1 exposure may be associated with risk of developing GBC in India.

Tumor-associated macrophages (TAMs) and cancer-associated fibroblasts (CAFs) are the most abundant stromal cells in the bladder cancer (BC) microenvironment (TME). However, the detailed mechanisms underlying TAM-CAF communication and their contributions to BC progression remain incompletely understood. Emerging evidence shows that Emodin exerts anti-tumor effect on several tumor models by targeting TME. To date, the impact of Emodin on BC has not been previously reported. Our study firstly demonstrated that Emodin significantly inhibited tumor growth and reduced TAM accumulation in a murine BC model. Emodin markedly decreased serum levels of multiple chemokines in tumor-bearing mice, with CXCL1 showing the most pronounced reduction. Strikingly, Emodin selectively suppressed CXCL1 secretion in CAFs but not in TAMs or tumor cells. Furthermore, the decrease in TAM migration induced by Emodin was dependent on CAF-derived CXCL1. Using a subcutaneous tumor model, we found that Emodin failed to inhibit tumor growth when CXCL1-deficient CAFs were co-injected with tumor cells, underscoring the critical role of CXCL1 in this process. Bioinformatics analysis further revealed that elevated CXCL1 levels correlated negatively with invasive/metastatic potential and overall survival in BC patients. In conclusion, our findings establish that Emodin delays BC progression by disrupting CXCL1-mediated crosstalk between CAFs and TAMs.

Breast cancer (BC) is listed as the most prevalent cancer form in women worldwide, with major subtypes classified by hormone receptor (HR) and HER2 status including, HR+/HER2- (∼65-70%), HER2+ (∼15-20%), Triple-Negative-HR-/HER2- (∼10-15%) and rare sybtypes (<5%). Scientific evidence has revealed that PI3K/AKT/mTOR signaling cascade plays an important role in the development and progression of BC, contributing to key cellular processes including cell growth, proliferation, angiogenesis, and metastasis. Dysregulation of the components of this cascade including functional loss of Phosphatase and TENsin homolog (PTEN), PI3K hyperactivation, and gain-of-function of AKT, are frequently observed in BC subtypes, making it a promising target for therapeutic intervention. A myriad of studies have documented the potential of phytochemicals, including curcumin, chrysin, fisetin, genistein, resveratrol and lycopene as modulators of the PI3K/AKT/mTOR axis. These phytochemicals exhibit multifaceted mechanisms of action, including inhibition of key kinases, induction of apoptosis, suppression of angiogenesis, and reversal of resistance to chemotherapy. This review aims to provide a detailed overview about the role of PI3K/AKT/mTOR alteration in BC development and the current research on phytochemicals that modulate the PI3K/AKT/mTOR pathway in BC. We documented the molecular mechanisms through which these compounds exert their effects, their potential synergistic interactions with conventional therapies, and the challenges and prospects for their clinical application. The evidence presented underscores the promise of phytochemicals as novel, less toxic adjuncts to traditional BC therapies, warranting further exploration and development for clinical use.

Various studies have demonstrated metabolic disorders in patients with esophageal squamous cell carcinoma (ESCC), although their potential role in ESCC development remains unclear. Here, we investigated alterations in the serum and fecal metabolomes of 23 ESCC patients and 23 healthy controls using untargeted metabolomics. Further analysis identified lauric acid as a biomarker for ESCC through targeted metabolomics, with validation in 88 ESCC patients and 44 healthy controls. Then, we examined the effects and mechanisms of lauric acid on EC109 cell physiological functions. Significant alterations occurred in serum and fecal samples from ESCC patients versus healthy controls, with lipid metabolites and associated pathways showing the most pronounced changes. Lauric acid was identified as a characteristic altered metabolite and an independent risk factor for ESCC (OR = 1.71, 95% CI: 1.05-2.79, p < 0.05). Mechanistic studies demonstrated that lauric acid promotes EC109 survival, invasion, and migration by interacting with the highly expressed fatty acid receptor GPR84 in ESCC tissues. Our research provides new insights into the relationship between lipid metabolism disorders and ESCC development, suggesting that lauric acid serves as an ESCC risk factor and may offer therapeutic intervention avenues.

This study explored the effect of symptom-based individualized nutritional intervention on chemotherapy tolerance and quality of life (QOL) in patients with colorectal cancer (CRC) undergoing postoperative chemotherapy. Postoperative patients with CRC (n = 88) were randomly assigned to the control group (CG, n = 45) and intervention group (IG, n = 43) receiving conventional diet counseling and symptom-based individualized nutritional intervention, respectively, and chemotherapy tolerance, adverse effects, and QOL were compared. Participants in the IG exhibited better nutritional status at the last chemotherapy cycle, with lower Nutrition Risk Screening 2002 (2.37 ± 0.65 vs. 3.78 ± 0.65, p < 0.01) and Patient-Generated Subjective Global Assessment (6.26 ± 0.76 vs. 7.78 ± 0.70, p < 0.01) scores. Compared with CG, relative dose intensity reduction (9.3% vs. 25.89%, p = 0.02), chemotherapy regimen change (25.58% vs. 53.33%, p < 0.01), and chemotherapy delay (13.95% vs. 35.56%, p = 0.019) were lower in the IG. Nausea/vomiting (2.33% vs. 17.78%, p = 0.017), thrombocytopenia (2.33% vs. 28.89%, p < 0.01), and hand-foot syndrome (4.65% vs. 22.22%, p = 0.03) were less frequent in the IG. Participants in the IG had better QOL, with higher physical function scores at cycles 4 (67.91 ± 5.22 vs. 62.22 ± 4.02, p < 0.01) and 8 (72.71 ± 6.31 vs. 57.63 ± 4.75, p < 0.01). Individualized nutritional interventions improved chemotherapy tolerance and QOL and reduced adverse effects in this patient cohort.

Radiotherapy is a common cancer treatment, and concurrent nutritional interventions can maintain nutritional status and improve clinical and supportive care outcomes. However, optimal nutritional interventions during radiotherapy are not firmly established. Herein, we assessed the feasibility, safety, and efficacy of dietary counseling interventions without oral nutrition supplements on health outcomes in adults receiving radiotherapy for cancer in a systematic review. Prospective clinical trials that implemented nutritional counseling interventions during radiotherapy were identified from four databases from inception through December 2023. Feasibility, safety, and efficacy were extracted from 32 articles that described 23 randomized and 4 non-randomized clinical trials. The interventions included individualized nutritional counseling (n = 14 articles), nutritional counseling plus exercise (n = 4), and nutritional counseling focused on increasing or reducing intake of specific nutrients (n = 9). Trials targeted head and neck (n = 12), pelvic cancers (n = 14), and/or breast (n = 5) cancers. Control groups had variable designs and included general nutrition education and intervention as needed. Studies recruited 120 ± 104 participants (range 26-468). Interventions tended to be feasible regarding retention and attendance at sessions, though feasibility metrics varied among different interventions. Most interventions were safe with no studies reporting adverse events attributable to dietary intervention. Individualized dietary counseling interventions tended to lead to between-group differences favoring the intervention group in regard to improved nutritional status, maintenance or attenuation of loss of body mass, improved quality of life, and reduced radiation-induced toxicities. Diets that encouraged/discouraged specific nutrients tended to recruit patients receiving radiation to the pelvic area and resulted in positive or neutral effects on gastrointestinal symptoms. In conclusion, nutritional interventions appear to be feasible, safe, and effective during radiotherapy for various symptom outcomes.

Previous studies demonstrated that diabetes and hyperglycemia promote cholangiocarcinoma (CCA) progression, in vitro and in vivo. However, the predictive abilities of blood glucose levels for CCA prognosis remain unclear. This retrospective cohort analysis included 85 patients with histologically confirmed CCA at Srinagarind Hospital, Khon Kaen University, between 1998 and 2000, comprised 57 males and 28 females with a median age of 56 ± 13 years. The glucose-lymphocyte ratio (GLR) was calculated from preoperative fasting blood glucose and absolute lymphocyte counts, and the cutoff was determined using the receiver operating characteristic curve. Survival analysis revealed that higher GLR was significantly associated with shorter overall survival (P < 0.05). A higher GLR was negatively correlated with total protein, globulin, and lymphocyte counts (P < 0.05). Univariate analysis revealed that a high GLR was associated with male sex and a survival time < 6 months (P < 0.05). The multivariable Cox proportional hazard model showed that a higher GLR was an independent prognostic factor for CCA (adjusted hazard ratio: 1.887; 95% confidence interval: 1.101-3.237), alongside carbohydrate antigen 19-9, staging, neutrophil count, and histological grading. Collectively, these findings indicate that the GLR is a significant prognostic biomarker for CCA, underscoring the importance of metabolic and nutritional status in CCA management.

The nutritional status of adults before the initiation of chemotherapy in low-income countries has been poorly explored. This study aimed to determine the prevalence of malnutrition and its associated factors before initiating chemotherapy at major cancer centers in Ethiopia. A multicenter cross-sectional study was conducted from February 13 to June 4, 2024, involving 400 adults diagnosed with solid tumors. The Patient-Generated Subjective Global Assessment (PG-SGA) was used to evaluate nutritional status. A multiple ordinal logistic regression model was used to determine associated factors. The results showed that 65% (60.2 - 69.5%) of patients were malnourished. Of these, 26% exhibited moderate malnutrition, and 39% experienced severe malnutrition. The factors that increased the odds of the highest category (severe malnutrition) were male sex (adjusted odds ratio [AOR] = 1.83), lack of regular physical activity (AOR = 1.59), presence of nutrition-impact symptoms (AOR = 33.1), gastrointestinal cancer diagnosis (AOR = 3.3), stage 4 cancer (AOR = 2.2), and preexisting comorbidities (AOR = 1.96). Conversely, a history of surgery was associated with lower odds of malnutrition (AOR = 0.46). Overall, two-thirds of adults with cancer were malnourished. Therefore, early nutritional assessment, management of nutritional impact symptoms, increased cancer awareness for early detection, and regular physical activity are recommended.