背景及重要性：女性癌症中，乳癌和婦癌皆是台灣前十大常見癌症，而隨著醫療技術進步，5年存活率提升，但相關的副作用也伴隨出現，例如淋巴水腫。目前常使用來評估或診斷淋巴水腫的工具皆為客觀性，但淋巴水腫長期持續影響病人的生、心理健康，卻甚少將病人之主觀感受納入考量。
研究目的：探討病人對於癌症所致之續發性肢體淋巴水腫的主觀報告結果測量與客觀診斷工具之間以及客觀診斷工具之間的相關性。
研究方法：為相關性、描述性研究，採次級資料分析，資料來自於台灣南部某醫學中心，個案納入標準為，1)癌症所致之續發性上肢或下肢淋巴水腫；2)該個案在同一時間點有主觀Lymph-ICF問卷資料和相對應之客觀診斷工具評估紀錄。排除標準則為原發性淋巴水腫和非癌症所致之續發性淋巴水腫。客觀診斷工具包含肢體周長測量、圓錐體幾何體積法、臨床淋巴水腫分期(ISL)和生物電阻抗分析，而主觀報告結果測量則為Lymph-ICF問卷。將採用Pearson correlation、Spearman’s rank correlation或Kruskal-Wallis來進行分析。
結果：本研究納入138位個案，其中女性佔86.2%，平均年齡為60.8歲(SD=11.7)，乳癌佔38%，婦癌佔48%。結果顯示，1)80%個案的Lymph-ICF問卷表達出淋巴水腫為中等程度到嚴重程度的困擾；2) Lymph-ICF問卷與本研究所納入的客觀診斷工具-肢體周長測量(r=0.21-0.4, p<0.05)、圓錐體幾何體積法(r=0.28-0.31, p<0.05)呈現弱到輕度顯著正相關；與生物電阻抗分析亦有相關。3)生物電阻抗分析與其他的客觀診斷工具-肢體周長測量(r=0.4-0.51, p<0.005)、圓錐體幾何體積法(r=0.41-0.49, p<0.005)、淋巴水腫分期(ISL)(r=0.29, p=0.014)呈現弱到中度顯著正相關。
結論與實務應用：Lymph-ICF主觀報告測量與目前常見的淋巴水腫診斷工具的相關性弱，但主觀報告結果測量能忠實反映個案感受，在客觀診斷方法不足以全面性評估癌症相關之續發性淋巴水腫的情況下，結合主觀的報告結果測量一起評估、考量能對病情進展提供更完整的視野。

Several objective measures have been used to evaluate or diagnose lymphedema. However, lymphedema continuously affects the patient's quality of life, rarely taking the patient’s feelings into account. The study aimed to investigate the relationships between patient-reported outcomes and the objective measures of cancer-related lymphedema.
The study was a correlational, descriptive study with secondary data analysis. Data were retrieved from the participants with cancer-related limb lymphedema in a medical center in southern Taiwan. Data included the objective medical records such as limb circumference measurement, geometric volume, the International Society of Lymphology (ISL) clinical stages, and bio-impedance analysis, as well as patient-reported outcomes, the Lymph-ICF questionnaire. Pearson correlations, Spearman’s rank correlations, and Kruskal-Wallis were used to assess the relationship between patient-reported outcomes and the objective measures of cancer-related lymphedema.
The study contained 138 subjects who were aged range of 36-97 years old, with 86% females, 40% (n=53) breast cancer and 55% (n=66) gynecological cancer. Of the subjects, 55 participants with cancer-related upper limb lymphedema and 83 participants with cancer-related lower limb lymphedema participated in the study. The results showed that 1) 80% of the subjects reported lymphedema caused moderate to severe disturbance of daily life; 2) the Lymph-ICF questionnaire had a poor to fair significantly positive correlation with the limb circumference measurement (r = 0.21-0.4, p<0.05) and geometric volume (r = 0.28-0.31, p<0.05). As well as significantly correlated with bio-impedance; 3) bio-impedance had a fair to moderate significantly positive correlation with circumference measurement (r = 0.4-0.51, p<0.005), geometric volume (r = 0.41-0.49, p<0.005) and ISL clinical stages (r =0.29, p=0.014).
Patient-reported lymphedema questionnaires were partially consistent with the objective measures in patients with cancer-related secondary lymphedema. Patient-reported outcomes should be incorporated with the objective measures for a comprehensive evaluation of the cancer-related limb lymphedema.

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