Medical Oncology

, Volume 28, Issue 3, pp 689–696 | Cite as

Comparison of PG-SGA, SGA and body-composition measurement in detecting malnutrition among newly diagnosed lung cancer patients in stage IIIB/IV and benign conditions

  • Rong Li
  • Jing Wu
  • Meili Ma
  • Jun Pei
  • Yiyi Song
  • Xueyan Zhang
  • Baohui HanEmail author
Original Paper


Assessment tools and body-composition measurements are useful in diagnosing malnutrition. Which one is better for lung disease patients is unclear. The objectives of the present study are: to assess relationships between different methods of nutritional measurements in lung diseases patients; to determine which one is better in diagnosing malnutrition for lung disease patients; and to determine whether lung cancer patients can be differentiated from benign lung disease patients using different measurements. A total of 96 newly diagnosed primary lung cancer patients in stage IIIB/IV and 52 benign lung disease patients nutritional status were assessed according to the SGA, the scored PG-SGA, and serum albumin, prealbumin, transferrin, hemoglobin, total lymphocyte count, body mass index (BMI), and weight. A total of 40% of lung cancer patients were severely malnourished, with men or elder having a higher rate of malnutrition. Significantly lower values of weight, BMI, total lymphocyte count, transferrin, prealbumin and serum albumin were found for them. Age, sex, weight, weight half year ago and prealbumin are in the regression equation to predict them. For benign lung disease patients, 21.2% were severely malnourished with significantly lower values of weight and transferrin. Age and prealbumin are in the equation to predict severely malnourished benign lung disease patients. The highest receiver operation characteristic area under the curve was found for the PG-SGA score, BMI and weight. PG-SGA global rating, age and iron-transferring protein are in the equation for predicting disease status. The SGA and PG-SGA are appropriate for identifying malnutrition in lung disease patients. Lung cancer patients can be differentiated from benign conditions by PG-SGA.


Lung Lung diseases Carcinoma Lung neoplasms Malnutrition Complication Diagnosis Cohort studies Screening Weight loss 



We would like to thank the patients for participating in this study. Science and Education Division of Shanghai Chest Hospital approved the present nutrition study (subject number: Y206-19) and provided funding.

Conflict of interest statement



  1. 1.
    Inui A. Cancer anorexia-cachexia syndrome: current issues in research and management. CA Cancer J Clin. 2002;52(2):72–91.PubMedCrossRefGoogle Scholar
  2. 2.
    MacDonald N, Easson AM, Mazurak VC, Dunn GP, Baracos VE. Understanding and managing cancer cachexia. J Am Coll Surg. 2003;197(1):143–61.PubMedCrossRefGoogle Scholar
  3. 3.
    Songür N, Kuru B, Kalkan F, Ozdilekcan C, Cakmak H, Hizel N. Serum interleukin-6 levels correlate with malnutrition, survival in patients with advanced non-small cell lung cancer. Tumori. 2004;90(2):196–200.PubMedGoogle Scholar
  4. 4.
    Heber D, Byerly LO, Chlebowski RT. Metabolic abnormalities in the cancer patient. Cancer. 1985;55(1 Suppl):225–9.PubMedCrossRefGoogle Scholar
  5. 5.
    Jagoe RT, Goodship TH, Gibson GJ. Nutritional status of patients undergoing lung cancer operations. Ann Thorac Surg. 2001;71(3):929–35.PubMedCrossRefGoogle Scholar
  6. 6.
    Naber TH, Schermer T, de Bree A, Nusteling K, Eggink L, Kruimel JW, et al. Prevalence of malnutrition in nonsurgical hospitalized patients, its association with disease complications. Am J Clin Nutr. 1997;66(5):1232–9.PubMedGoogle Scholar
  7. 7.
    Delbecque-Boussard L, Gottrand F, Ategbo S, Nelken B, Mazingue F, Vic P, et al. Nutritional status of children with acute lymphoblastic leukemia: a longitudinal study. Am J Clin Nutr. 1997;65(1):95–100.PubMedGoogle Scholar
  8. 8.
    Guo CB, Ma DQ, Zhang KH. Nutritional status of patients with oral, maxillofacial malignancies. J Oral Maxillofac Surg. 1994;52(6):559–62.PubMedCrossRefGoogle Scholar
  9. 9.
    Geisler JP, Linnemeier GC, Thomas AJ, Manahan KJ. Nutritional assessment using prealbumin as an objective criterion to determine whom should not undergo primary radical cytoreductive surgery for ovarian cancer. Gynecol Oncol. 2007;106:128–31. [Epub 2007 Apr 26].PubMedCrossRefGoogle Scholar
  10. 10.
    Unsal D, Mentes B, Akmansu M, Uner A, Oguz M, Pak Y. Evaluation of nutritional status in cancer patients receiving radiotherapy: a prospective study. Am J Clin Oncol. 2006;29(2):183–8.PubMedCrossRefGoogle Scholar
  11. 11.
    Read JA, Crockett N, Volker DH, MacLennan P, Choy ST, Beale P, et al. Nutritional assessment in cancer: comparing the Mini- Nutritional Assessment (MNA) with the scored Patient-Generated Subjective Global Assessment (PGSGA). Nutr Cancer. 2005;53(1):51–6.PubMedCrossRefGoogle Scholar
  12. 12.
    Laky B, Janda M, Cleghorn G, Obermair A. Comparison of different nutritional assessments, body-composition measurements in detecting malnutrition among gynecologic cancer patients. Am J Clin Nutr. 2008;87(6):1678–85.PubMedGoogle Scholar
  13. 13.
    Detsky AS, McLaughlin JR, Baker JP, Johnston N, Whittaker S, Mendelson RA, et al. What is subjective global assessment of nutritional status? JPEN J Parenter Enteral Nutr. 1987;11:8–13.PubMedCrossRefGoogle Scholar
  14. 14.
    Santoso JT, Cannada T, O’Farrel B, Alladi K, Coleman RL. Subjective versus objective nutritional assessment study in women with gynecological cancer: a prospective cohort trial. Int J Gynecol Cancer. 2004;14:220–3.PubMedCrossRefGoogle Scholar
  15. 15.
    Girón R, Matesanz C, García-Río F, de Santiago E, Mancha A, Rodríguez-Salvanés F, et al. Nutritional state during COPD exacerbation: clinical and prognostic implications. Ann Nutr Metab. 2009;54(1):52–8.PubMedCrossRefGoogle Scholar
  16. 16.
    Budweiser S, Meyer K, Jörres RA, Heinemann F, Wild PJ, Pfeifer M. Nutritional depletion, its relationship to respiratory impairment in patients with chronic respiratory failure due to COPD or restrictive thoracic diseases. Eur J Clin Nutr. 2008;62(3):436–43.PubMedCrossRefGoogle Scholar
  17. 17.
    Yoon SH, Choi NW, Yun SR. Pulmonary dysfunction is possibly a marker of malnutrition and inflammation but not mortality in patients with end-stage renal disease. Nephron Clin Pract. 2009;111(1):c1–6.PubMedCrossRefGoogle Scholar
  18. 18.
    Phairin T, Kwanjaroensub V. Impact of declines in nutritional status on outcomes in adult patients hospitalized for more than 7 days. J Am Diet Assoc. 2000;100(11):1316–22.CrossRefGoogle Scholar
  19. 19.
    ASPEN Board of Directors and the Clinical Guidelines Task Force. Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients. JPEN J Parenter Enteral Nutr 2002; 26:1SA–138SA.Google Scholar
  20. 20.
    Weimann A, Braga M, Harsanyi L, Laviano A, Ljungqvist O, Soeters P, et al. ESPEN guidelines on enteral nutrition: surgery including organ transplantation. Clin Nutr. 2006;25:224–44.PubMedCrossRefGoogle Scholar
  21. 21.
    McCallum PD, Polisena CG. The clinical guide to oncology nutrition. Chicago, IL: The American Dietetic Association; 2000.Google Scholar
  22. 22.
    Segura A, Pardo J, Jara C, Zugazabeitia L, Carulla J, de Las Peñas R, et al. An epidemiological evaluation of the prevalence of malnutrition in Spanish patients with locally advanced or metastatic cancer. Clin Nutr. 2005;24(5):801–14.PubMedCrossRefGoogle Scholar
  23. 23.
    Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser 2000; 894:1–253.Google Scholar
  24. 24.
    Desbrow B, Bauer J, Blum C, Kandasamy A, McDonald A, Montgomery K. Assessment of nutritional status in hemodialysis patients using patient-generated subjective global assessment. J Ren Nutr. 2005;15:211–6.PubMedCrossRefGoogle Scholar
  25. 25.
    Isenring E, Cross G, Daniels L, Kellett E, Koczwara B. Validity of the malnutrition screening tool as an effective predictor of nutritional risk in oncology outpatients receiving chemotherapy. Support Care Cancer. 2006;14:1152–6.PubMedCrossRefGoogle Scholar
  26. 26.
    Foster NR, Mandrekar SJ, Schild SE, Nelson GD, Rowland KM Jr, Deming RL, et al. Prognostic factors differ by tumor stage for small cell lung cancer: a pooled analysis of North Central Cancer Treatment Group trials. Cancer. 2009;115(12):2721–31.PubMedCrossRefGoogle Scholar
  27. 27.
    Kagansky N, Berner Y, Koren-Morag N, Perelman L, Knobler H, Levy S. Poor nutritional habits are predictors of poor outcome in very old hospitalized patients. Am J Clin Nutr. 2005;82(4):784–91.PubMedGoogle Scholar
  28. 28.
    Nourissat A, Mille D, Delaroche G, Jacquin JP, Vergnon JM, Fournel P, et al. Estimation of the risk for nutritional state degradation in patients with cancer: development of a screening tool based on results from a cross-sectional survey. Ann Oncol. 2007;18(11):1882–6.PubMedCrossRefGoogle Scholar
  29. 29.
    Chang JW, Asamura H, Kawachi R, Watanabe S. Gender difference in survival of resected non-small cell lung cancer: histology-related phenomenon? J Thorac Cardiovasc Surg. 2009;137(4):807–12.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Rong Li
    • 1
    • 2
  • Jing Wu
    • 3
  • Meili Ma
    • 1
    • 2
  • Jun Pei
    • 1
    • 2
  • Yiyi Song
    • 1
    • 2
  • Xueyan Zhang
    • 1
    • 2
  • Baohui Han
    • 1
    • 2
    Email author
  1. 1.Shanghai Jiao Tong University School of MedicineShanghaiChina
  2. 2.Pulmonary Medicine of Shanghai Chest Hospital Ward 12ShanghaiChina
  3. 3.The Biochemical Laboratory of Shanghai Chest HospitalShanghai Jiao Tong University School of MedicineShanghaiChina

Personalised recommendations