骨骼肌量预测肝内胆管癌患者的预后。
Skeletal muscle mass predicts the prognosis of patients with intrahepatic cholangiocarcinoma.
机构信息
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan.
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan.
出版信息
Am J Surg. 2019 Nov;218(5):952-958. doi: 10.1016/j.amjsurg.2019.03.010. Epub 2019 Mar 14.
BACKGROUND
We studied the prognostic impact of sarcopenia after hepatic resection for intrahepatic cholangiocarcinoma (ICC).
METHODS
Sixty-one patients who underwent surgery for ICC during 2000-2017 were analyzed retrospectively. Psoas muscle areas were measured on CT scans at the third lumbar vertebra. Areas less than the sex-specific median were deemed low skeletal muscle masses (SMMs).
RESULTS
Low-SMM patients were significantly more often older (p = 0.002) than high-SMM patients, had lower serum albumin (p = 0.004), higher serum C-reactive protein (CRP) (p = 0.002), and higher carbohydrate antigen 19-9 (p < 0.001). Five-year overall survival rates were 72.5% and 17.6% and 5-year recurrence-free survival rates were 58.6% and 21.1%, respectively, in high- and low-SMM patients. Multivariable analysis revealed that low SMM predicted unfavorable prognoses. SMM was associated with immune nutritional status (e.g., prognostic nutritional index, Glasgow prognostic score, CRP/albumin ratio).
CONCLUSION
Low SMM was related to worse surgical outcomes in patients with ICC following hepatic resection.
背景
我们研究了肝内胆管癌（ICC）肝切除术后肌肉减少症对预后的影响。
方法
回顾性分析了 2000 年至 2017 年间接受 ICC 手术的 61 例患者。在 CT 扫描的第三腰椎水平测量腰大肌面积。面积小于性别特异性中位数被认为是低骨骼肌质量（SMM）。
结果
低 SMM 患者明显比高 SMM 患者年龄更大（p=0.002），血清白蛋白水平更低（p=0.004），血清 C 反应蛋白（CRP）更高（p=0.002），碳水化合物抗原 19-9 更高（p<0.001）。高 SMM 组和低 SMM 组患者的 5 年总生存率分别为 72.5%和 17.6%，5 年无复发生存率分别为 58.6%和 21.1%。多变量分析显示，低 SMM 预测预后不良。SMM 与免疫营养状态（如预后营养指数、格拉斯哥预后评分、CRP/白蛋白比值）相关。
结论
低 SMM 与 ICC 患者肝切除术后手术结局较差有关。
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