title: Serum concentrations of TNF-alpha as a surrogate marker for malnutrition and worse quality of life in patients with gastric cancer.
abstract: 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.
authors.affiliation: Serviço de Gastrenterologia, Instituto Português de Oncologia Francisco Gentil (Centro Regional de Lisboa), Rua Professor Lima Bastos, 1700 Lisboa, Portugal.
authors.forename: Marta
authors.initials: M
authors.lastname: Correia
authors.forename: Marília
authors.initials: M
authors.lastname: Cravo
authors.forename: Pedro
authors.initials: P
authors.lastname: Marques-Vidal
authors.forename: Robert
authors.initials: R
authors.lastname: Grimble
authors.forename: António
authors.initials: A
authors.lastname: Dias-Pereira
authors.forename: Sandra
authors.initials: S
authors.lastname: Faias
authors.forename: Carlos
authors.initials: C
authors.lastname: Nobre-Leitão
mesh_terms: 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
chemical_list: D014408:Biomarkers, Tumor; D007375:Interleukin-1; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha