肿瘤肌肉减少症和肿瘤恶液质的概念辨析  

Conceptual distinction between sarcopenia and cachexia in cancer patients

作　　者：张锋敏 吴浩凡 庄成乐 Zhang Fengmin;Wu Haofan;Zhuang Chengle(Department of Gastrointestinal Surgery/Colorectal Cancer Center,Shanghai Tenth People's Hospital,School of Medicine,Tongji University,Shanghai 200072,China)

机构地区：[1]同济大学附属第十人民医院胃肠外科/结直肠肿瘤中心,上海200072

出　　处：《肿瘤代谢与营养电子杂志》2024年第2期157-163,共7页Electronic Journal of Metabolism and Nutrition of Cancer

基　　金：国家自然科学基金面上项目(82171565)。

摘　　要：肌肉减少症是一种进行性的骨骼肌疾病,以肌肉含量和功能的病理性下降为特征,好发于老年人群。大多数肿瘤患者都是高龄患者,患者在肿瘤发生前可能已经患有肌肉减少症。同时,肿瘤促进了肌肉衰退,使肿瘤患者更容易发生肌肉减少症。恶液质也是肿瘤患者常见的多因素综合征,表现为厌食、非自愿体重下降,可伴有持续的骨骼肌萎缩,不能通过传统的营养治疗完全逆转,最终可能导致进行性的功能障碍。肿瘤肌肉减少症和肿瘤恶液质在病因和特征上有许多相似之处,如肌肉含量的减少是这两种综合征的常见诊断要素,故肌肉减少症和恶液质常常相互指代。因此,详细阐述两者在肿瘤患者中的特点和差异具有重要意义。本文对肿瘤患者的肌肉减少症和恶液质进行了全面的比较,阐明了这两种疾病的异同,并为肿瘤肌肉减少症患者的管理提供了循证策略。Sarcopenia is a progressive skeletal muscle disease characterized by a pathological decrease in muscle mass and function,and is common in the elderly.Most cancer patients are elderly,and patients may already have sarcopenia before the onset of cancer.Additionally,cancer promotes muscle aging,making cancer patients more susceptible to sarcopenia.Cachexia,another common multifactorial syndrome in cancer patients,manifests as anorexia,involuntary weight loss,and persistent skeletal muscle wasting,which cannot be fully reversed by conventional nutritional therapy and may eventually lead to progressive functional impairment.Sarcopenia and cachexia share many similarities in their causes and characteristics.For example,loss of muscle mass is a common diagnostic factor in both syndromes,thus sarcopenia and cachexia are often referred to as each other in cancer patients.Therefore,it is of great significance to elaborate on their characteristics and differences in cancer patients.Here,we provide a comprehensive comparison of sarcopenia and cachexia in cancer patients,elucidate the similarities and differences between the two diseases,and provide evidence-based strategies for the management of cancer patients with sarcopenia.

关 键 词：肿瘤 肌肉减少症 恶液质 防治策略 

分 类 号：R730[医药卫生—肿瘤] R685[医药卫生—临床医学]