Development of sarcopenia index for patients with recurrent cancer

2023 Fiscal Year Final Research Report

• Project/Area Number: 16K09268
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: General internal medicine(including psychosomatic medicine)
• Research Institution: Fujita Health University
• Principal Investigator: Ito Akihiro 藤田医科大学, 医学部, 教授 (50273355)
• Project Period (FY): 2016-04-01 – 2024-03-31
• Keywords: 悪液質 / ピンチ力 / 終末期がん / ECW/TBW / 予後規定因子 / 亜鉛

Outline of Final Research Achievements

As an indicator of sarcopenia, we conducted a simple pinch force measurement (the force of pinching the button of a testing device between the thumb and index finger using your dominant arm) and demonstrated its usefulness. Body composition analysis at admission showed that skeletal muscle mass was correlated with pinch force, suggesting the usefulness of pinch force. However, no correlation with prognosis was observed. Therefore, we focused on trace elements that show low levels in patients with recurrent or terminal cancer. Serum zinc levels were found to have a significant correlation with cancer cachexia, suggesting that they may influence prognosis. Furthermore, in pancreatic cancer, where sarcopenia is most prominent, ECW/TBW (an indicator of edema) is a prognostic factor, and fluid management in patients with edema is important.

Free Research Field

緩和医療

Academic Significance and Societal Importance of the Research Achievements

再発・終末期がん患者に対するサルコペニアの指標としては、簡便なピンチ力（拇指と人差し指で検査機器のボタンを挟み込み、2本の指で挟む力）測定が有用である。しかし、予後との相関は認めなかった。そこで、予後決定因子に着眼点を変更し、検討した。その結果、再発・終末期がん患者で低値を示す血清亜鉛値が予後規定因子の可能性が示唆された。膵がんにおいては、体組成分析により得られるECW/TBW（浮腫の指標）が独立した予後規定因子であった。再発・終末期がん患者・家族に対し、これらのデータを一助としたインフォームド・コンセントを行い、残された日々を有意義に療養いただくことが重要である。