Assessment of Malnutrition and Inflammatory status in cervical cancer patients attending Tikur Anbessa specialized hospital.
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Date
2021-06
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Addis Abeba University
Abstract
Background: Globally cervical Cancer is the fourth common cancer accounting for 6.6%
of all female cancers. Oncogenic human papillomavirus (HPV) specifically types 16 and
18 is the most important risk factor associated with cervical cancer. Studies have
indicated that approximately 88.33% of gynecological cancer patients experience
malnutrition; and Inflammation that play a pivotal role in the progression of cervical
cancer. Various nutritional and inflammatory parameters such as serum Total Protein,
Albumin, Ferritin and Hematological parameters; Hemoglobin, LMR NLR, RDW and
PLR used as Prognostic Biomarker of cancer associated with inflammation and
malnutrition in cervical cancer patient.
Objective: The aim of the present study was Assessment of Malnutrition and
Inflammatory Status in Cervical Cancer Patients attending Tikur Anbessa Specialized
Hospital.
Methodology: Hospital based comparative cross-sectional study was conducted on 50
cervical cancer patients and 50 healthy individuals. Socio demographic data were
collected by using standardized questionnaire. Anthropometric data and Blood collection
was done through standardized techniques and Automated COBAS 6000 and Sysmex
KX-21N hematology analyzers were used to analyze the samples. Statistical data analysis
was held by SPSS version 25. Student’s t-test was used to compare the mean value of
continuous variables of two groups, one way analysis of variance (ANOVA) was used to
compare the relationship of categorical variables between deferent stages of the cancer.
Other associations were performed with Pearson’s correlation coefficient. A P-value of
<0.05 at 95% confidence level was considered to be statistically significant in all the
analyses.
Result: The mean age of cervical cancer patient and control group was 52.4 years. The
cervical cancer Patients had significantly decreased Albumin and increased Total Protein
and significantly increased Ferritin levels than controls group. Among hematological
parameters there was a significantly increases in Red blood distribution width (RDW),
Neutrophiles to Lymphocytes ratio (NLR) and Platelet to Lymphocytes ratio (PLR).
There was also decrease in Hemoglobin and Lymphocyte to Monocyte ratio (LMR) in the
cervical cancer Patients and also those parameters expresses their effect in cervical cancer from stage II to stage IV. Albumin negatively correlated with serum ferritin (r=-0.120*,
p=0.002) and RDW (r=-0.018*, p= 0.001) in cervical cancer patient and negatively
correlated with serum total protein (r=0.943*, P<0.001) in control group. NLR positively
correlated with PLR (r=0.764**, p=0.000) and LMR (R=1.000**, P=0.000) in cervical
cancer patients.
Conclusions: Malnutrition and inflammation are common experience in patients with
cervical cancer. The result of this study showed low level of serum Albumin,
Hemoglobin and LMR; and high level of serum Total Protein, Ferritin and other
Hematological Parameters such as NLR, RDW and PLR. This may serve as markers for
assessment of malnutrition and inflammation and may also use as a prognostic factor in
cervical cancer patients. Therefore, further study is recommended on the assessment of
malnutrition and inflammation in cervical cancer patients with a large group of
participants.
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Keywords
Cervical cancer; Malnutrition; inflammation; Biochemical markers; Hematological parameters.