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Background <p>Vitamin deficiency may be associated with cancer development and poor prognosis. Data on vitamin levels in patients with cancer are lacking owing to the limitations of traditional analytical methods. This study assessed the serum levels of vitamins and the prevalence of vitamin deficiency in patients with cancer using liquid chromatography-tandem mass spectrometry (LC–MS/MS). The study also analysed the association between vitamin deficiency and clinical outcomes in patients with cancer.</p> Methods <p>Patients diagnosed with malignant diseases at the largest cancer centre in China were prospectively enrolled. Nutritional risk and status were evaluated using standardised evaluation tools. Blood samples were collected upon entry and analysed for vitamin concentrations using LC–MS/MS. Survival analysis was conducted for patients with stage IV disease (<i>N</i> = 510). The primary endpoint was overall survival (OS), and the secondary endpoints included a 1-year OS rate and cancer-specific survival.</p> Results <p>A total of 1257 patients were included. Vitamin deficiency was common in the study, with deficiencies in vitamin D (89.4%), vitamin B1 (80.9%), folic acid (53.5%), and vitamin C (VC, 41.4%). Vitamin deficiency was more prevalent in the cancer cohort than in the healthy controls. Vitamin status was not directly related to the tumour, node, metastasis stage, or nutritional status. Patients with VC deficiency had a significantly shorter OS than those with normal VC levels (hazard ratio [HR] = 1.410, 95% confidence interval [CI] 1.008–1.972, <i>p</i> = 0.044). After adjusting for covariates, VC status was an independent prognostic factor for patients with stage IV disease (HR = 1.451, 95% CI 1.037–2.033, <i>p</i> = 0.030). No significant association was found for the other measured vitamins.</p> Conclusions <p>Screening for micronutrient deficiency is crucial in hospitalised patients with cancer. VC deficiency is associated with increased mortality risk in metastatic malignancies. A prospective interventional study is warranted to confirm the effects of VC on clinical outcomes in patients with cancer.</p>

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Micronutrient deficiency detected by liquid chromatography-tandem mass spectrometry and its association with clinical outcome of cancer patients—a prospective cohort study

  • 期刊论文

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  • 发表日期：

    2025年10月8日

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  • Wenjie Zhu,
  • Chenan Liu,
  • Keqing Yao,
  • Xi Zhang,
  • Jiaxin Huang,
  • Maoliang Cheng,
  • Xinyi Wang,
  • Wei Wei,
  • Minghua Cong

摘要

Background

Vitamin deficiency may be associated with cancer development and poor prognosis. Data on vitamin levels in patients with cancer are lacking owing to the limitations of traditional analytical methods. This study assessed the serum levels of vitamins and the prevalence of vitamin deficiency in patients with cancer using liquid chromatography-tandem mass spectrometry (LC–MS/MS). The study also analysed the association between vitamin deficiency and clinical outcomes in patients with cancer.

Methods

Patients diagnosed with malignant diseases at the largest cancer centre in China were prospectively enrolled. Nutritional risk and status were evaluated using standardised evaluation tools. Blood samples were collected upon entry and analysed for vitamin concentrations using LC–MS/MS. Survival analysis was conducted for patients with stage IV disease (N = 510). The primary endpoint was overall survival (OS), and the secondary endpoints included a 1-year OS rate and cancer-specific survival.

Results

A total of 1257 patients were included. Vitamin deficiency was common in the study, with deficiencies in vitamin D (89.4%), vitamin B1 (80.9%), folic acid (53.5%), and vitamin C (VC, 41.4%). Vitamin deficiency was more prevalent in the cancer cohort than in the healthy controls. Vitamin status was not directly related to the tumour, node, metastasis stage, or nutritional status. Patients with VC deficiency had a significantly shorter OS than those with normal VC levels (hazard ratio [HR] = 1.410, 95% confidence interval [CI] 1.008–1.972, p = 0.044). After adjusting for covariates, VC status was an independent prognostic factor for patients with stage IV disease (HR = 1.451, 95% CI 1.037–2.033, p = 0.030). No significant association was found for the other measured vitamins.

Conclusions

Screening for micronutrient deficiency is crucial in hospitalised patients with cancer. VC deficiency is associated with increased mortality risk in metastatic malignancies. A prospective interventional study is warranted to confirm the effects of VC on clinical outcomes in patients with cancer.