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Albumin huyết thanh trước điều trị như một chỉ số dự đoán sống còn trong ung thư: Một tổng quan hệ thống về tài liệu dịch tễ học
Tóm tắt
Có nhiều phương pháp để đánh giá tình trạng dinh dưỡng ở bệnh nhân ung thư, trong đó albumin huyết thanh là một trong những chỉ số thường được sử dụng nhất. Trong những năm gần đây, vai trò của tình trạng suy dinh dưỡng như một yếu tố dự đoán sự sống còn ở bệnh nhân ung thư đã nhận được sự chú ý đáng kể. Do đó, việc tìm hiểu xem albumin huyết thanh có thể được sử dụng như một chỉ số tiên đoán sự sống còn trong ung thư là hoàn toàn hợp lý. Tổng quan này tóm tắt tất cả các tài liệu dịch tễ học hiện có về mối liên hệ giữa mức albumin huyết thanh trước điều trị và sự sống còn ở các loại ung thư khác nhau. Một tìm kiếm hệ thống trong tài liệu sử dụng cơ sở dữ liệu MEDLINE (từ tháng 1 năm 1995 đến tháng 6 năm 2010) đã được thực hiện để xác định các nghiên cứu dịch tễ học về mối quan hệ giữa albumin huyết thanh và sự sống còn trong ung thư. Để được đưa vào tổng quan, một nghiên cứu phải được: công bố bằng tiếng Anh, báo cáo dữ liệu thu thập trên người với bất kỳ loại ung thư nào, có albumin huyết thanh là một trong các yếu tố dự đoán hoặc yếu tố duy nhất, có sống còn là một trong các tiêu chí kết quả (chính hoặc thứ yếu) và có bất kỳ thiết kế nghiên cứu nào sau đây (nghiên cứu trường hợp đối chứng, đoàn hệ, cắt ngang, chuỗi trường hợp, hồi cứu, trường hợp đối chứng lồng ghép, sinh thái, thử nghiệm lâm sàng, phân tích tổng hợp). Trong số 29 nghiên cứu được xem xét về ung thư đường tiêu hóa, tất cả trừ ba nghiên cứu tìm thấy mức albumin huyết thanh cao hơn có liên quan đến sự sống còn tốt hơn trong phân tích đa biến. Trong số 10 nghiên cứu về ung thư phổi, tất cả trừ một nghiên cứu cũng tìm thấy mức albumin huyết thanh cao hơn có mối liên hệ với sống còn tốt hơn. Trong 6 nghiên cứu về ung thư nữ và nhiều loại ung thư, mức albumin huyết thanh thấp hơn có liên quan đến sống còn kém. Cuối cùng, trong tất cả 8 nghiên cứu trên bệnh nhân với các vị trí ung thư khác, mức albumin huyết thanh thấp hơn cũng liên quan đến sống còn kém. Mức albumin huyết thanh trước điều trị cung cấp ý nghĩa tiên đoán hữu ích trong ung thư. Do đó, mức albumin huyết thanh có thể được sử dụng trong các thử nghiệm lâm sàng để xác định rõ hơn nguy cơ cơ bản ở bệnh nhân ung thư. Tuy nhiên, một khoảng trống quan trọng để chứng minh mối quan hệ nhân quả là sự thiếu vắng các thử nghiệm lâm sàng chứng minh rằng việc tăng cường mức albumin thông qua truyền tĩnh mạch hoặc dinh dưỡng qua đường tĩnh mạch giảm thiểu nguy cơ tử vong thừa ở bệnh nhân ung thư.
Từ khóa
#albumin huyết thanh #ung thư #sống còn #dự đoán #dinh dưỡngTài liệu tham khảo
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