Lin Ji, Zhang Weiteng, Huang Yunshi, Chen Weisheng, Wu Ruisen, Chen Xiaodong, Lou Neng, Wang Pengfei
Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China,
Department of General Surgery, Zhejiang University Huzhou Hospital, Huzhou, Zhejiang, China,
Cancer Manag Res. 2018 Oct 25;10:4935-4944. doi: 10.2147/CMAR.S175421. eCollection 2018.
Sarcopenia is distinguished by decreased skeletal muscle plus low muscle strength and/or physical performance. This study was designed to demonstrate the relationship between sarcopenia and systemic inflammatory response (neutrophil/lymphocyte ratio [NLR], platelet/lymphocyte ratio [PLR], and large platelet/lymphocyte ratio [LPLR]) prior to radical gastrectomy for gastric cancer.
We conducted a prospective study of gastric cancer patients who underwent radical gastrectomy. The clinical utility of the NLR, PLR, and LPLR was evaluated by receiver operating characteristic curves. Sarcopenia components including skeletal muscle index, handgrip strength, and 6 m usual gait speed were measured. Logistic analysis was used to identify the independent indices associated with sarcopenia.
A total of 670 patients were included, representing 504 men and 166 women. Of these, 104 patients (15.5%) were diagnosed with sarcopenia and 567 (84.5%) were non-sarcopenia. PLR has a diagnostic sensitivity of 91.3% for sarcopenia. In addition to the indicators of preoperative age, nutritional risk screening, body mass index, preoperative albumin, and diabetes, the NLR and PLR were independent predictors for sarcopenia (<0.05).
The present study showed that at-diagnosis sarcopenia was associated with inflammation in patients with operable gastric cancer. Due to the complex assessment of muscle condition, PLR may be used as a primary screening test for sarcopenia. How systemic inflammatory response influences changes in sarcopenia may provide new therapeutic perception toward improving outcomes.
肌肉减少症的特征是骨骼肌减少以及肌肉力量和/或身体机能下降。本研究旨在阐明胃癌根治性胃切除术前肌肉减少症与全身炎症反应（中性粒细胞/淋巴细胞比值[NLR]、血小板/淋巴细胞比值[PLR]和大血小板/淋巴细胞比值[LPLR]）之间的关系。
我们对接受根治性胃切除的胃癌患者进行了一项前瞻性研究。通过受试者工作特征曲线评估NLR、PLR和LPLR的临床效用。测量了包括骨骼肌指数、握力和6米常规步速在内的肌肉减少症相关指标。采用逻辑分析来确定与肌肉减少症相关的独立指标。
共纳入670例患者，其中男性504例，女性166例。这些患者中，104例（15.5%）被诊断为肌肉减少症，567例（84.5%）为非肌肉减少症患者。PLR对肌肉减少症的诊断敏感性为91.3%。除了术前年龄、营养风险筛查、体重指数、术前白蛋白和糖尿病等指标外，NLR和PLR是肌肉减少症的独立预测因素（<0.05）。
本研究表明，可手术胃癌患者确诊时的肌肉减少症与炎症相关。由于肌肉状况评估复杂，PLR可用作肌肉减少症的初步筛查检测。全身炎症反应如何影响肌肉减少症的变化可能为改善治疗结果提供新的治疗思路。
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