Measurement In Malnutrition Of Carcinoma Patients By Mini-nutritional Assessment

Objective: To evaluate the nutritional status in carcinoma patients by using the Mini Nutritional Assessment(MNA) and by conventional assessments,and to investigate malnutritional status of carcinoma patients. And to provide the new idea about diagnosis and nutritional support of clinical malnutrition.Methods: By using the Mini Nutritional Assessment(MNA), to evaluate the carcinoma patients'MNA score ,to survey patients'height ,bodyweight,age, hemoglobin(HB), blood erythrocyte(RBC),and serum albumin concentration(Alb), and serum prealbumin concentrations(PA) were measured in 970 carcinoma patients , respectively.then calculate BMI(BMI= height/bodyweight2).The patients, nutritional status was judged by MNA score in following three categories: malnutrition(MNA score<17), at risk of malnutrition(MNA score 17~23.5), and adequate nutritional status (MNA score≥24).The results of nutritional status assessed by MNA were rather in accordance with BMI, Alb and PA, respectively. The patients with nutritional status defined by MNA are agreed with those with same nutritional status assessed by conventional assessments:BMI, PA and Alb, respectively. TNM staging according to pathology or cytology:Ⅰ(T1N0M0)254 (26.19%),Ⅱ(T0-2N1M0)146(15.05%),Ⅲ(T1-2N2M0 or T3N0-2M0)223(22.99%),Ⅳ(T1-3N0-2M1 or T0N0-2M1)347(35.77%). There are 300 chemotherapy patients were scored by MNA before and after chemotherapy. Result:MNA score significantly correlated with BMI, serum Alb concentrations and serum PA concentrations (r=0·501-0·724,P=0·000). In all the patients, the incidence of patients with malnutrition according to MNA score was 28.66%(278/970).Risk of malnutrition was 30.41%(295/970). Adequate nutritional status was 40.93%(397/970),respectively. There were no significant differences in the incidence of malnutrition between the elderly patients and youngers'judged by MNA. According to MNA score,malnutrition occurred in 59.26%of the patients with hepatic carcinoma,59.09% pancreatic carcinoma,58.88% gastric carcinoma,50.00% esophageal carcinoma,43.88% colorectal carcinoma,32.79% lung carcinoma,27.59% thyroid carcinoma,13.95% lymphoma,13.51% leukemia,13.31% breast carcinoma,10.81% ovarian carcinoma,respectively.The incidence of patients with malnutrition in hepatic carcinoma, pancreatic carcinoma and gastric carcinoma or was more than that in the other(P=0·001~0·002). The prevalence of malnutrition in patients staged by MNAⅠ,Ⅱ,Ⅲ,Ⅳwas 14.96%,19.86%,23.77% and 45.53%, respectively. The later the TNM stage, the higher the prevalence of malnutrition. The prevalence of malnutrition in patients with anemia was higher than that without anemia. There are patients of 68(22.67%)and 113(37.67%),73(24.33%)and 121(40.33%),159(53.00%)and 66(22.00%)with malnutrition, at risk of malnutrition or adequate nutritional status before or after chemotherapy by MNA score,respectively. Chemotherapy can increase the incidence of patients suffered from malnutrition.Conclude:①The results indicate that MNA questionnaire is simple,rapid and effective for diagnosis of malnutrition in oncological patients.②The prevalence of malnutrition and at risk of malnutrition is higher in digestive system tumors like as gastrointestinal or hepatic carcinoma patients. so appropriate nutritional supports should be undertaken.