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目的:探讨胃癌癌症恶病质患者术前的临床特征，重点研究患者术前血清炎症和脂肪代谢相关指标的变化。方法:对2018年1月至12月入住复旦大学附属中山医院普外科的128例胃癌患者，收集术前患者的年龄、性别、身高、体重、血液学检查和血脂水平等相关临床数据。同时用Elisa法检测血清中白细胞介素6（interleukin-6，IL-6）和肿瘤坏死因子-α（tumour necrosis factor-alpha，TNF-α）等炎症因子水平。用CT法测量皮下脂肪和内脏脂肪面积。统计学方法比较恶病质组和恶病质前期组以上指标的差异。结果:将128例患者分为恶病质前期组97例和恶病质组31例。与恶病质前期组相比，恶病质组患者体重指数明显降低（23.4±0.3比21.9±0.6，n t=2.359，n P=0.019），淋巴细胞计数明显降低［（1.67±0.05）×10n 9 /L比（1.42±0.12）×10n 9 /L，n t=2.251，n P=0.026］，总蛋白量明显降低［（64.9±0. 8）g/L比（61.5±1.1）g/L，n t=2.208，n P=0.029］，前白蛋白水平也明显降低［（0.22±0.01）g/L比（0.19±0.01）g/L，n t=1.987，n P=0.049］。血清的IL-6水平明显增高［（3.73±0.32）ng/L比（5.26±0.77）ng/L，n t=2.214，n P=0.036］，游离脂肪酸明显升高［（0.40±0.02）mmol/L比（0.51±0.06）mmol/L，n t=2.393，n P=0.018］，总胆固醇明显降低［（4.09±0.09）mmol/L比（3.74±0.15）mmol/L，n t=2.393，n P=0.046］。皮下脂肪面积明显较少［（151.6±8.73）cmn 2比（112.4±15.9）cmn 2，n t=2.192，n P=0.042］。但是TNF-α浓度，两组无明显差异［（8.51±0.51）ng/L比（7.98±0.72）ng/L，n t=0.551，n P=0.583］。n 结论:IL-6可能比TNF-α在胃癌癌症恶病质患者脂肪丢失过程中发挥了更重要的作用。胃癌癌症恶病质患者脂肪分解增强并且以皮下脂肪丢失为主。“,”Objective:To investigate the clinical features of preoperative gastric cancer cachexia patients, with the focus on changes of abdominal fat distribution and serum inflammatory factors.Methods:128 gastric cancer patients admitted to General Surgery Department of Zhongshan Hospital, Fudan University from January 2018 to December 2018 were included. Relevant clinical information was collected, including age, gender, height, weight, hematological test results and blood lipid profiles (including free fatty acids ,FFA). Concurrent serum IL-6 and TNF-α levels were examined using enzyme-linked immunosorbent assay. Areas of subcutaneous and visceral fat were both measured at umbilical level on CT. Data mentioned above were compared between gastric cancer patients with cachexia and pre-cachexia.Results:The 128 patients were divided into stable pre-cachexia group (97 patients) and cachexia group (31 patients). Compared with pre-cachexia group, patients in the cachexia group showed significant decline in BMIs (23.4±0.3 n vs 21.9±0.6,n t=2.359,n P=0.019), apparent elevation in serum IL-6 levels [(3.73±0.32) ng/L n vs(5.26±0.77) ng/L,n t=2.214,n P=0.036], significant decrease in lymphocyte counts [(1.67±0.05)×10n 9/L n vs (1.42±0.12)×10n 9/L,n t=2.251, n P=0.026], as well as predominant decrease in total protein levels, [(64.9 ± 0.8) g/L n vs (61.5±1.1) g/L,n t=2.208,n P=0.029], total cholesterol levels [(4.09±0.09) mmol/L n vs (3.74±0.15) mmol/L, n t=2.393,n P=0.046] and pre-albumin levels [(0.22±0.01) g/L n vs (0.19±0.01) g/L,n t=1.987,n P=0.049]. Additionally, there was a noticeable decrease in subcutaneous fat area [(151.6±8.73) cmn 2vs (112.4±15.9) cmn 2,n t=2.192,n P=0.042]. The other markers displayed no remarkable differences.n Conclusion:Based on our investigation, it\'s highly suspected that IL-6 plays a more important role than TNF-α in the fat loss of gastric cancer cachexia patients, and these patients have increased lipid catabolism predominated by subcutaneous fat loss.