[1]张 亮,郑 鹏.L3 水平 CT 横截面机体组成改变对结直肠癌病人生存预后的价值分析[J].肠外与肠内营养杂志,2023,(04):226-233.[doi:DOI : 10.16151/j.1007-810x.2023.04.006]
　ZHANG Liang,ZHENG Peng.1.Research Institute of General Surgery, Nanjing Jingling Hospital, Nanjing 210002, Jiangsu, China；2.Department of Gastrointestinal Surgery, Xuzhou Central Hospital, Xuzhou 210009, Jiangsu, China[J].PARENTERAL & ENTERAL NUTRITION,2023,(04):226-233.[doi:DOI : 10.16151/j.1007-810x.2023.04.006]
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L3 水平 CT 横截面机体组成改变对结直肠癌病人生存预后的价值分析()
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《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2023年04期
页码:
226-233
栏目:
论著
出版日期:
2023-08-10

文章信息/Info

Title:
1.Research Institute of General Surgery, Nanjing Jingling Hospital, Nanjing 210002, Jiangsu, China；2.Department of Gastrointestinal Surgery, Xuzhou Central Hospital, Xuzhou 210009, Jiangsu, China
作者:
张 亮 1; 2; 郑 鹏1
1. 中国人民解放军东部战区总医院全军普通外科研究所，江苏南京210002；2. 徐州市中心医院胃肠外科，江苏徐州 221009
Author(s):
ZHANG Liang1; 2;  ZHENG Peng1
1.Research Institute of General Surgery, Nanjing Jingling Hospital, Nanjing 210002, Jiangsu, China；2.Department of Gastrointestinal Surgery, Xuzhou Central Hospital, Xuzhou 210009, Jiangsu, China）
关键词:
结直肠癌 ; 骨骼肌 ; 内脏脂肪 ; 肌少症
Keywords:
Colorectal cancer;  Skeletal muscle;  Visceral adipose tissue;  Sarcopenia
分类号:
R574
DOI:
DOI : 10.16151/j.1007-810x.2023.04.006
文献标志码:
A
摘要:
目的：探究 CT 测算身体成分变化对结直肠癌并行放化疗病人预后的评估价值。 方法：对 142 例结直肠癌(CRC)病人进行回顾性分析。采集病人治疗前后的腹部 CT 第三腰椎层面的图像，得出骨骼肌指数(SMI)，内脏脂肪指数(VATI)及皮下脂肪指数(SATI)。参照文献报道中的截断值定义肌少症，使用 Cox 回归模型分析影响CRC 总生存率(OS)及无病生存率(RFS)的危险因素。 结果：142 例 CRC 并行放化疗的病人中有 49 例(34.5%)在治疗前被诊断为肌少症，多因素分析显示，术前肌少症与 CRC 病人的预后无显著相关性。治疗期间 SMI 丢失> 10%与较差的 OS[HR = 9.46；95% CI：3.49 ~ 25.63；P < 0.001]和 RFS(HR = 11.79；95%CI：4.25 ~ 32.72；P < 0.001)独立相关。治疗期间 VATI 增加>10% 是影响 OS(HR = 3.06；95%CI：1.08 ~ 8.64；P = 0.034)和 RFS(HR = 3.19；95%CI：1.07~ 9.53；P < 0.038)的独立危险因素。 结论：治疗前后 SMI 和 VATI 的变化可评估 CRC 病人的临床结局。在治疗期间准确掌握病人机体成分变化并加以干预，有利于改善 CRC 病人的预后。
Abstract:
Objective: To investigate the role of CT-derived body composition measurement in predicting theprognosis of colorectal cancer (CRC) patients with radiotherapy. Methods: A total of 142 patients with CRC wasincluded in this study. Abdominal CT Images of the patients before and after treatments were obtained from our hospitaldatabase and were retrospectively analyzed. The skeletal muscle index (SMI), visceral adiposity index (VATI) andsubcutaneous adiposity index (SATI) were assessed at the third lumbar vertebra (L3) on abdominal imaging. Sarcopeniawas defined according to the cut-off values reported in the literatures, and the risk factors influencing overall survival(OS) and disease-free survival (RFS) in CRC were analyzed using Cox regression models. Results: Basing on CTderived body composition measurements, 49 (34.5%) of 142 CRC patientswere diagnosed with sarcopeniabeforetreatments which was not significantly associated with the prognosis of CRC patients. Loss of SMI (>10%) duringtreatments was independently associated with poorer OS [HR= 9.46; 95% confidence interval (CI) 3.49 to 25.63; P<0.001] and RFS (HR = 11.79; 95% CI, 4.25 to 32.72; P < 0.001). An increase (>10%) of VATI during treatments was anindependent risk factor for OS (HR = 3.06; 95% CI, 1.08 to 8.64; P = 0.034), whileit was not significantly associatedwith RFS. Conclusions: Changes in of SMI and VATI before and after treatments could be used as predictors forclinical outcomes of CRC patients with radiotherapy. CT-derived body composition measurement at the L3 vertebra level might have potential to guild the clinical managements and is likely helpful for improving the prognosis of CRC patients.

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备注/Memo

备注/Memo:
基金项目 ：彭城英才-医学青年后备人才（XWRCHT2022002）作者简介 ：张 亮，副主任医师，医学博士，从事胃肠外科专业。E-mail：juwimingz@126.com通讯作者 ：郑 鹏，E-mail：45311337@qq.com
更新日期/Last Update: 1900-01-01