CT- and MRI-Based Assessment of Body Composition and Pancreatic Fibrosis Reveals High Incidence of Clinically Significant Metabolic Changes That Affect the Quality of Life and Treatment Outcomes of Patients with Chronic Pancreatitis and Pancreatic Cancer

Bieliuniene, Edita; Frøkjær, Jens Brøndum; Pockevičius, Alius; Kemėšienė, Jūratė; Lukoševičius, Saulius; Basevičius, Algidas; Atstupėnaitė, Vaida; Barauskas, Giedrius; Ignatavičius, Povilas; Gulbinas, Antanas; Dambrauskas, Žilvinas

doi:10.3390/medicina55100649

Cited by 23 publications

(24 citation statements)

References 35 publications

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“…Magnetic resonance imaging (MRI) 32 is a highprecision method for measuring the composition of the human body. It is equivalent to CT imaging, 33 and does not expose patients to ionizing radiation, but it is costly. Other methods for assessing the overall composition of the body include water density (underwater weighing) and air plethysmography (Bod Pod), 34,35 but they cannot distinguish between local fat or muscle.…”

Section: Discussionmentioning

confidence: 99%

<p>Cancer Cachexia: Definition, Staging, and Emerging Treatments</p>

Ni¹,

Zhang²

2020

CMAR

169

129

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Cachexia is a multifactorial disease characterized by weight loss via skeletal muscle and adipose tissue loss, an imbalance in metabolic regulation, and reduced food intake. It is caused by factors of catabolism produced by tumors in the systemic circulation as well as physiological factors such as the imbalanced inflammatory activation, proteolysis, autophagy, and lipolysis that may occur with gastric, pancreatic, esophageal, lung cancer, liver, and bowel cancer. Cancer cachexia not only negatively affects the quality of life of patients with cancer but also reduces the effectiveness of anti-cancer chemotherapy and increases its toxicity, leading to increased cancer-related mortality and expenditure of medical resources. Currently, there are no effective medical interventions to completely reverse cachexia and no approved drugs. Adequate nutritional support is the main method of cachexia treatment, while drugs that target the inhibition of catabolism, cell damage, and excessive activation of inflammation are under study. This article reviews recent advances in the diagnosis, staging, and evaluation of cancer cachexia.

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Section: Discussionmentioning

confidence: 99%

<p>Cancer Cachexia: Definition, Staging, and Emerging Treatments</p>

Ni¹,

Zhang²

2020

CMAR

169

129

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“…Six studies, which comprised of a total population of 450 patients, were reviewed (Table 1). There were two retrospective studies [17,18] and four [11,[19][20][21] prospective studies. All studies were performed in a single institution.…”

Section: Resultsmentioning

confidence: 99%

“…The faecal elastase or faecal fat test was used as a measure of the exocrine pancreatic function [ 19 , 20 ]. PEI was defined as a fat excretion (aliphatic carboxylate [C14-C26]) > 25 mmol per 24 h or faecal elastase-1 level < 200 mg/g.…”

Section: Resultsmentioning

confidence: 99%

Prevalence and Impact of Sarcopenia in Chronic Pancreatitis: A Review of the Literature

2020

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Introduction Malnutrition is a common sequela of chronic pancreatitis (CP). Alterations in body composition and the assessment of sarcopenia have gained the interest of clinicians in recent years. There is a scarcity of data currently available concerning sarcopenia in patients with CP. This review aims to investigate the prevalence and impact of sarcopenia in CP. Methods Embase and Medline databases were used to identify all studies that evaluated sarcopenia and outcomes in patients with chronic pancreatitis. Due to paucity of data, conference abstracts were included. PRISMA guidelines for systematic reviews were followed. Results Six studies, with a total of 450 individuals were reviewed. Three full-text studies and three conference abstracts met the predetermined eligibility criteria. The prevalence of sarcopenia in CP from all studies ranged from 17–62%. Pancreatic exocrine insufficiency was associated as an independent and significant risk factor for sarcopenia. Sarcopenia was found to be associated with a reduced quality of life, increased hospitalisation, and reduced survival. It was associated with significantly lower islet yield following total pancreatectomy with islet auto transplantation in CP. Conclusion The review of these existing studies amalgamates the limited data on sarcopenia and its impact on CP. It has shown that sarcopenia is exceedingly prevalent and an important risk factor in CP patients. The data presented emphasises that sarcopenia has a significant prognostic value and should be included in future prospective analyses in the outcomes of CP.

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“…Как правило, мультиспиральная КТ использовалась для оценки фиброза стромы опухоли [24] или прогнозирования развития послеоперационной панкреатической фистулы [30]. ХП в связи с фиброзом рассматривался только в работе E. Bieliuniene и соавт., где панкреатический фиброз изучали в контексте развития саркопении при ХП и раке ПЖ, опираясь на КТ-волюметрию ПЖ [31].…”

Section: гастроэнтерология том 19 № 7 (2020) | | введениеunclassified

Novel Approaches to Non-invasive Diagnosis of Pancreatic Fibrosis in Chronic Pancreatitis

Lesko¹,

Scientific²,

Варванина³

et al. 2020

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Study Objective: to search for novel approaches to non-invasive diagnosis of pancreatic fibrosis in chronic pancreatitis (CP) patients. Study Design: prospective comparative non-randomised study. Materials and Methods. 43 subjects were examined: 22 (51.2%) patients with calcific CP and 21 (48.8%) patients with CP resulting from acute pancreatitis with pancreonecrosis, aged 35 to 82 years old. All patients underwent multislice computer-aided tomography (CT) of abdomen with IV contrast, and had their fibronectin (FN), С-peptide and faecal pancreatic elastase 1 concentrations measured. Study Results. There were no differences in C-peptide between study groups (p = 0,18). Faecal elastase 1 concentration (108.36 ± 144 μg/g) was significantly lower in calcific CP (p = 0.03) vs. patients with post-pancreonecrosis CP (185.67 ± 145.1 μg/g). Blood FN level negatively correlated with CP severity (M-ANNHEIM system) (r = –0.36, p = 0.018). In calcific CP, median contrast ratio (1.01 ± 0.06) was significantly higher (p = 0.033) than in post-pancreonecrosis CP (0.95 ± 0.14). Conclusion. Patients with calcific CP demonstrated more severe exocrine insufficiency. Decreased FN levels in severe CP are likely to be due to long-term increased FN intake because of pacreatic fibrosis. Pancreatic fibrosis augmentation impacts pancreas contrast study and results in higher contrast ratio at CT. Therefore, it allows using this parameter for non-invasive diagnosis of pancreas fibrosis in patients with CP. Keywords: fibrosis, chronic pancreatitis, pancreas, computer-aided tomography.

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CT- and MRI-Based Assessment of Body Composition and Pancreatic Fibrosis Reveals High Incidence of Clinically Significant Metabolic Changes That Affect the Quality of Life and Treatment Outcomes of Patients with Chronic Pancreatitis and Pancreatic Cancer

Cited by 23 publications

References 35 publications

<p>Cancer Cachexia: Definition, Staging, and Emerging Treatments</p>

<p>Cancer Cachexia: Definition, Staging, and Emerging Treatments</p>

Prevalence and Impact of Sarcopenia in Chronic Pancreatitis: A Review of the Literature

Novel Approaches to Non-invasive Diagnosis of Pancreatic Fibrosis in Chronic Pancreatitis

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