Serum concentrations of TNF-alpha as a surrogate marker for malnutrition and worse quality of life in patients with gastric cancer.
OBJECTIVE
The aim of our study was to examine, in patients with gastric cancer, the correlation between nutritional status, QoL (quality of life) and serum levels of TNF-alpha, IL-1 and IL-6.


METHODS
Forty-eight patients with gastric cancer were included. Nutritional status was assessed by % of weight loss in the previous 1 and 6 months, Patient-Generated Subjective Global Assessment, bioelectrical impedance analysis and by dynamometry. QoL was assessed by EORTC QLQ-C30 questionnaire. TNF-alpha, IL-1 and IL-6 serum concentrations were determined using an ELISA assay.


RESULTS
Prevalence of malnourished patients varied between 30% and 75% according to various methods used. QoL scores were significantly worse in patients with more advanced disease and in malnourished ones. Malnourished patients had higher values of IL-1 and TNF-alpha (16.7 and 28.0 pg/ml), p<0.05 and p<0.001. QoL was significantly worse in patients with higher levels of IL-1 and TNF-alpha (p<0.01 and p<0.001, respectively). A TNF-alpha cut-off value of 8.72 pg/ml was associated with higher risk of malnutrition (MN) according to PG-SGA (94% sensitivity, 93% specificity). No correlation was observed with perioperative complications.


CONCLUSIONS
The prevalence of MN is high in patients with gastric cancer. A significant correlation was found between higher values of cytokines, especially TNF-alpha, MN and QoL.
Correia
Marta
M
Serviço de Gastrenterologia, Instituto Português de Oncologia Francisco Gentil (Centro Regional de Lisboa), Rua Professor Lima Bastos, 1700 Lisboa, Portugal.
Cravo
Marília
M
Marques-Vidal
Pedro
P
Grimble
Robert
R
Dias-Pereira
António
A
Faias
Sandra
S
Nobre-Leitão
Carlos
C
D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D001823:Body Composition; D005260:Female; D006801:Humans; D007375:Interleukin-1 / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D044342:Malnutrition / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D009367:Neoplasm Staging; D015596:Nutrition Assessment; D009752:Nutritional Status; D011237:Predictive Value of Tests; D015995:Prevalence; D011788:Quality of Life; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000097:blood* / Q000150:complications / Q000601:surgery; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*; D015431:Weight Loss
D014408:Biomarkers, Tumor; D007375:Interleukin-1; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha