Shoji Fumihiro, Matsubara Taichi, Kozuma Yuka, Haratake Naoki, Akamine Takaki, Takamori Shinkichi, Katsura Masakazu, Toyokawa Gouji, Okamoto Tatsuro, Maehara Yoshihiko
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Anticancer Res. 2017 Dec;37(12):6997-7003. doi: 10.21873/anticanres.12168.
Although the skeletal muscle in the region of the third lumbar vertebra (L3) is generally assessed in order to judge sarcopenia, not every patient with non-small cell lung cancer (NSCLC) undergoes computed tomography including the L3 region. We hypothesized that immuno-nutritional parameters could predict the existence of sarcopenia in patients with NSCLC.
The aim of this study was to retrospectively investigate the correlation between preoperative sarcopenia and immuno-nutritional parameters in patients with early-stage NSCLC.
We selected 147 of patients with pathological stage I NSCLC who underwent preoperative measurement of immuno-nutritional parameters and CT including the L3 region.
Preoperative sarcopenia was significantly associated with female gender (p=0.0003) and poor prognosis (p=0.0322). In Kaplan-Meier analysis of overall survival (OS) by preoperative sarcopenia status, the sarcopenic group had significantly shorter OS than the non-sarcopenic group (5-year OS: 87.27% vs. 77.37%, p=0.0131, log-rank test). In multivariate analysis, the preoperative sarcopenia status (hazard ratio=5.138; 95% confidence interval=2.305-11.676; p<0.0001) was an independent prognostic factor. Preoperative sarcopenia status was significantly related to controlling nutritional status score (p=0.0071) and Geriatric Nutritional Risk Index (GNRI) (p<0.0001). Spearman's correlation test showed good significant correlation between preoperative sarcopenia status and GNRI (r=0.348, p<0.0001).
The preoperative GNRI is a simple and useful predictor for existence of preoperative sarcopenia which was associated with poor outcome in patients with early-stage NSCLC.
尽管通常通过评估第三腰椎（L3）区域的骨骼肌来判断肌肉减少症，但并非每位非小细胞肺癌（NSCLC）患者都接受包括L3区域在内的计算机断层扫描。我们推测免疫营养参数可以预测NSCLC患者肌肉减少症的存在。
本研究的目的是回顾性调查早期NSCLC患者术前肌肉减少症与免疫营养参数之间的相关性。
我们选择了147例接受了免疫营养参数术前测量以及包括L3区域在内的CT检查的病理I期NSCLC患者。
术前肌肉减少症与女性性别（p = 0.0003）和预后不良（p = 0.0322）显著相关。在通过术前肌肉减少症状态进行的总体生存（OS）的Kaplan-Meier分析中，肌肉减少症组的OS明显短于非肌肉减少症组（5年OS：87.27% 对77.37%，p = 0.0131，对数秩检验）。在多变量分析中，术前肌肉减少症状态（风险比=5.138；95%置信区间=2.305 - 11.676；p < 0.0001）是一个独立的预后因素。术前肌肉减少症状态与控制营养状态评分（p = 0.0071）和老年营养风险指数（GNRI）（p < 0.0001）显著相关。Spearman相关性检验显示术前肌肉减少症状态与GNRI之间存在良好的显著相关性（r = 0.348，p < 0.0001）。
术前GNRI是术前肌肉减少症存在的一个简单且有用的预测指标，而术前肌肉减少症与早期NSCLC患者的不良预后相关。
