Bioelectrical Impedance Analysis to Increase the Sensitivity of Screening Methods for Diagnosing Cancer Cachexia in Patients with Colorectal Cancer

Abstract

Background. Currently used methods for detecting and monitoring cancer cachexia (CC) are not sensitive enough. In this field, there is a need to implement new instruments into clinical practice. Objective. Determining the usefulness of bioelectrical impedance analysis (BIA) for detecting and monitoring CC in patients with colorectal cancer (CRC). Methods. 158 people were invited to the study (70 from CRC and 88 controls). Their body composition was determined using BIA, and their nutritional status was determined according to NRS 2002, SGA, and BMI criteria. For statistical data analysis, Student's t-test, Mann-Whitney U test, and AUC ROC were used. Results. Men with CRC stage I had higher values of FMI, SMMI, and ECW/TBW (p<0.05) than in stages II-IV, and women with CRC stage I had higher values of FMI, FFMI, and FM/FFM than in the group of stages II-IV (p<0.05). The ability of FFMI to detect malnutrition relative to SGA was low (sensitivity: women 40%, men 40% and specificity: women 74%, men 70%). Conclusions. SGA and NRS 2002 scales are dynamic and consider changes in nutritional status over time, while BIA is static and does not consider these changes. Therefore, BIA is not a good tool for screening nutritional status. BIA successfully identifies differences in body composition depending on cancer stage and advancement of CC. Therefore, after the diagnosis CRC, just to monitor the disease advancement and state of CC, it is worth comparing the results of periodically repeated BIA.