我国肿瘤营养事业的发展与挑战

我国肿瘤患者营养不良发生率高而且治疗率低，导致治疗效果差，合并症增加，住院时间延长，生存时间缩短。对营养不良的认知误区和不规范治疗，严重制约着我国肿瘤营养事业的发展。近年来，肿瘤营养问题开始得到关注并取得瞩目成绩：①探讨了基于肿瘤代谢特点的营养代谢分子机制及个体差异，为个体化营养治疗提供了研究依据；②摸清了我国肿瘤营养现状，发现我国肿瘤患者营养不良状况严重，医务人员及患者肿瘤营养知识匮乏、认识不足、行为失范，为国家决策的制定、学科发展、临床治疗提供了依据；③创立我国肿瘤营养学科、建立肿瘤营养诊疗体系。创新性提出营养不良三级诊断、营养不良四维度分析、营养五阶梯治疗；④宣传肿瘤营养，提高了认知、规范了诊疗行为，促进了肿瘤营养应用和推广。但是，我国肿瘤营养的发展仍需提高认知水平，改进管理模式，最终还营养治疗为一线治疗。

Cancer nutrition in China: development and challenges

In China, the incidence of cancer malnutrition is high and it leads to poor clinical outcome, increased complications, extension of hospital stay and shortened survival time. Misunderstanding on cancer nutrition therapy and non-standard treatment restricts the development of cancer nutrition. In recent years, the development of cancer nutrition in China has attracted more attention and made a great progress:①exploring the molecular mechanisms and the individual differences of nutritional metabolism based on the characteristics of tumor metabolism, which provide the basis for individualized nutritional therapy; ②conforming the cancer nutritional status in China:the high incidence of severe malnutrition, lack of nutrition knowledge in patients and medical personnel, improper practice,which is helpful for government policies making and the development of disciplines and clinical treatment;③established the disciplines of cancer nutrition, the diagnosis and treatment system of cancer nutrition in China. Proposed three level diagnosis, four dimensional analysis and five ladder therapy of malnutrition;④Promoting the awareness of cancer nutrition, standardizing diagnosis and treatment,which promote the application and popularity of cancer nutrition care. However, further work is needed to revise the awareness and remedy inappropriate management of cancer nutrition in China. Ultimately it bring nutrition care to the first-line therapy.