{"created":"2024-04-22T05:19:20.522017+00:00","id":2000296,"links":{},"metadata":{"_buckets":{"deposit":"73892928-7600-4a7c-b5a4-8aca75768dc3"},"_deposit":{"created_by":18,"id":"2000296","owners":[18],"pid":{"revision_id":0,"type":"depid","value":"2000296"},"status":"published"},"_oai":{"id":"oai:ir.kagoshima-u.ac.jp:02000296","sets":["228:230:6144","57:58:59"]},"author_link":["144057","144058","144059","144060","124824","144061"],"item_7_biblio_info_5":{"attribute_name":"収録雑誌名","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2023","bibliographicIssueDateType":"Issued"},"bibliographicPageEnd":"28","bibliographicPageStart":"20","bibliographicVolumeNumber":"75","bibliographic_titles":[{"bibliographic_title":"鹿児島大学医学雑誌","bibliographic_titleLang":"ja"},{"bibliographic_title":"Medical journal of Kagoshima University","bibliographic_titleLang":"en"}]}]},"item_7_date_6":{"attribute_name":"作成日","attribute_value_mlt":[{"subitem_date_issued_datetime":"2023","subitem_date_issued_type":"Issued"}]},"item_7_description_4":{"attribute_name":"要約(Abstract)","attribute_value_mlt":[{"subitem_description":"OBJECTIVES: Malnutrition in cancer patients is associated with a poor prognosis. Nitrogen death occurs when lean body mass, a measure of muscle protein, falls below 70% of normal range.Cholinesterase (ChE) reflects protein concentration and has a shorter half-life than albumin (Alb); however, its utility as a biomarker has not been fully understood. To estimate ChE levels in colorectal cancer patients upon admission and prior to death, and to determine the cutoff value and usefulness of ChE as a biomarker for estimating in-hospital mortality.\nMETHODS: We measured ChE in 69 colorectal cancer patients hospitalized from April 2019 to March 2021. Changes in ChE levels were compared with those in Alb and other blood parameters. We also performed a multivariate analysis to assess the hazard ratio between the changes in ChE and in-hospital mortality.\nRESULTS: In the blood draw prior to death, ChE exhibited a bimodal mixed normal distribution, with a hazard ratio of 2.52 for in-hospital mortality in the low ChE group (47%) with <100 IU/L as compared to the high ChE group (53%).\nCONCLUSIONS: Our findings suggest that a cutoff ChE level of 100 IU/L could serve as a useful biomarker for estimating in-hospital mortality in colorectal cancer patients.","subitem_description_language":"en","subitem_description_type":"Other"},{"subitem_description":"【背景】癌患者の栄養不良は生存期間に影響があり，筋蛋白量を示す除脂肪体重が健常時の70％になると窒素死が生じる．筋蛋白量と相関を持つコリンエステラーゼ (ChE) はアルブミン (Alb)より半減期が約1/2と短くAlbと強く相関して蛋白質濃度を間接的に反映する為，緩和ケア病棟では栄養評価に有用と思われるが，これまでChEの有用性が明らかにされていない．\n【目的】当院緩和ケア病棟における大腸癌患者の死亡前ChE値がどのような変化を呈しているかを検討し，在院死亡率推定のバイオマーカーとしての有用性とカットオフ値を示すことである．\n【方法】2019年4月から2021年3月までに鹿児島市医師会病院緩和ケア病棟を退院した大腸癌患者69 名を後ろ向きに抽出した．入院時と死亡前の採血でChEを測定し，その変化とChE，Alb， 赤血球，白血球, 総コレステロール，中性脂肪，C反応性タンパク質の値，水腎症との相関はピアソンのカイ二乗検定 を用いた．入院時と死亡前のWBC≥10,000/μLの値の割合の変化をマクネマーテストで比較検定し感染症の増加を評価した．主要評価項目としてコリンエステラーゼの結果で在院生存率をカプラン・マイヤー法，在院死亡率のハザード比を コックス比例ハザードモデルを用いて多変量解析した．また二次的評価項目として重症合併症の関係はピアソンのカイ二乗検定を用いて評価した．\n【結果】死亡前採血（中央値8日）ではChE値が100 IU/L以上のA群とChE値が100 IU/L以下となったB群の２峰性混合正規分布を示した．A群で有意に在院生存率が高く，ChEの低値群は高値群より経時的な在院死亡率のハザード比が2.52と上昇していた．また死亡前は白血球が10,000/μL以上になった割合が増加していた．\n【結論】２峰性混合正規分布となった因子分析として，大腸癌患者では感染症を併発してChEが早々に減少して死亡する群(47％ )と，癌が進行してChEが緩徐に低下して死亡する群(53％ )の2群があり，悪液質の発生割合（50％）とほぼ一致した．　ChEのカットオフ値を100 IU/Lとすると低値群は高値群に比較して在院死亡率が2.52倍高く，ChEは100 IU/Lをカットオフ値として大腸癌患者の在院死亡率推定のバイマーカーとして有用と考えられた．","subitem_description_language":"ja","subitem_description_type":"Other"}]},"item_7_publisher_23":{"attribute_name":"公開者・出版者","attribute_value_mlt":[{"subitem_publisher":"鹿児島大学","subitem_publisher_language":"ja"},{"subitem_publisher":"Kagoshima University","subitem_publisher_language":"en"}]},"item_7_source_id_7":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"03685063","subitem_source_identifier_type":"PISSN"}]},"item_7_source_id_9":{"attribute_name":"NII書誌ID","attribute_value_mlt":[{"subitem_source_identifier":"AN00040104","subitem_source_identifier_type":"NCID"}]},"item_7_version_type_14":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"馬見塚, 勝郎","creatorNameLang":"ja"},{"creatorName":"Mamitsuka, Katsuro","creatorNameLang":"en"}],"familyNames":[{},{}],"givenNames":[{},{}],"nameIdentifiers":[{"nameIdentifier":"144057","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"髙濵, 哲也","creatorNameLang":"ja"},{"creatorName":"Takahama, Tetsuya","creatorNameLang":"en"}],"familyNames":[{},{}],"givenNames":[{},{}],"nameIdentifiers":[{"nameIdentifier":"144058","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"中堀, 恵","creatorNameLang":"ja"},{"creatorName":"Nakabori, Megumi","creatorNameLang":"en"}],"familyNames":[{},{}],"givenNames":[{},{}],"nameIdentifiers":[{"nameIdentifier":"144059","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"中島, 誠","creatorNameLang":"ja"},{"creatorName":"Nakashima, Makoto","creatorNameLang":"en"}],"familyNames":[{},{}],"givenNames":[{},{}],"nameIdentifiers":[{"nameIdentifier":"144060","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"林, 岳宏","creatorNameLang":"ja"},{"creatorName":"ハヤシ, タケヒロ","creatorNameLang":"ja-Kana"},{"creatorName":"Hayashi, Takehiro","creatorNameLang":"en"}],"familyNames":[{},{},{}],"givenNames":[{},{},{}],"nameIdentifiers":[{"nameIdentifier":"124824","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"大迫, 政彦","creatorNameLang":"ja"},{"creatorName":"Oosako, Masahiko","creatorNameLang":"en"}],"familyNames":[{},{}],"givenNames":[{},{}],"nameIdentifiers":[{"nameIdentifier":"144061","nameIdentifierScheme":"WEKO"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2024-04-22"}],"displaytype":"detail","filename":"Med._J._Kagoshima_Univ_75_p20-28.pdf","filesize":[{"value":"1.58 MB"}],"format":"application/pdf","mimetype":"application/pdf","url":{"label":"Med._J._Kagoshima_Univ_75_p20-28","objectType":"fulltext","url":"https://ir.kagoshima-u.ac.jp/record/2000296/files/Med._J._Kagoshima_Univ_75_p20-28.pdf"},"version_id":"d22f9d57-d794-42f1-8a22-c653dfc28626"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"malnutrition","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"cholinesterase","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"colorectal cancer","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"complications","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"biomarker","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"in-hospital mortality","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"bimodal mixed normal distribution","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"eng"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"departmental bulletin paper","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"Bimodal mixed normal distribution of cholinesterase and in-hospital mortality in patients with terminal colorectal cancer","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"Bimodal mixed normal distribution of cholinesterase and in-hospital mortality in patients with terminal colorectal cancer","subitem_title_language":"en"},{"subitem_title":"終末期大腸癌患者のコリンエステラーゼの2峰性混合正規分布と在院死亡率","subitem_title_language":"ja"}]},"item_type_id":"7","owner":"18","path":["59","6144"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2024-04-22"},"publish_date":"2024-04-22","publish_status":"0","recid":"2000296","relation_version_is_last":true,"title":["Bimodal mixed normal distribution of cholinesterase and in-hospital mortality in patients with terminal colorectal cancer"],"weko_creator_id":"18","weko_shared_id":-1},"updated":"2024-05-27T05:40:26.607690+00:00"}