Abbass Tanvir, Dolan Ross D, Laird Barry J, McMillan Donald C
Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow Royal Infirmary, Glasgow G4 0SF, UK.
Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, EH4 2XR, UK.
Cancers (Basel). 2019 Sep 4;11(9):1304. doi: 10.3390/cancers11091304.
Cancer is the second leading cause of death globally. Nutritional status (cachexia) and systemic inflammation play a significant role in predicting cancer outcome. The aim of the present review was to examine the relationship between imaging-based body composition and systemic inflammation in patients with cancer. Methods: MEDLINE, EMBASE, Cochrane Library and Google Scholar were searched up to 31 March 2019 for published articles using MESH terms cancer, body composition, systemic inflammation, Dual energy X-ray absorptiometry (DEXA), magnetic resonance imaging (MRI), ultrasound sonography (USS) and computed tomography (CT). Studies performed in adult patients with cancer describing the relationship between imaging-based body composition and measures of the systemic inflammatory response were included in this review. The literature search retrieved 807 studies and 23 met the final eligibility criteria and consisted of prospective and retrospective cohort studies comprising 11,474 patients. CT was the most common imaging modality used (20 studies) and primary operable (16 studies) and colorectal cancer (10 studies) were the most commonly studied cancers. Low skeletal muscle index (SMI) and systemic inflammation were consistently associated; both had a prognostic value and this relationship between low SMI and systemic inflammation was confirmed in four longitudinal studies. There was also evidence that skeletal muscle density (SMD) and systemic inflammation were associated (9 studies). The majority of studies examining the relationship between CT based body composition and systemic inflammation were in primary operable diseases and in patients with colorectal cancer. These studies showed that there was a consistent association between low skeletal muscle mass and the presence of a systemic inflammatory response. These findings have important implications for the definition of cancer cachexia and its treatment.
癌症是全球第二大致死原因。营养状况（恶病质）和全身炎症在预测癌症预后方面起着重要作用。本综述的目的是研究癌症患者基于影像学的身体成分与全身炎症之间的关系。方法：截至2019年3月31日，在MEDLINE、EMBASE、Cochrane图书馆和谷歌学术上搜索已发表的文章，使用医学主题词“癌症”“身体成分”“全身炎症”“双能X线吸收法（DEXA）”“磁共振成像（MRI）”“超声检查（USS）”和“计算机断层扫描（CT）”。本综述纳入了针对成年癌症患者进行的研究，这些研究描述了基于影像学的身体成分与全身炎症反应指标之间的关系。文献检索共找到807项研究，其中23项符合最终纳入标准，包括前瞻性和回顾性队列研究，共11474例患者。CT是最常用的成像方式（20项研究），原发性可手术癌症（16项研究）和结直肠癌（10项研究）是最常研究类型。低骨骼肌指数（SMI）与全身炎症始终相关；两者均具有预后价值，并且低SMI与全身炎症之间的这种关系在四项纵向研究中得到了证实。也有证据表明骨骼肌密度（SMD）与全身炎症相关（9项研究）。大多数研究基于CT的身体成分与全身炎症之间关系的研究都集中在原发性可手术疾病和结直肠癌患者中。这些研究表明，低骨骼肌质量与全身炎症反应的存在之间存在一致的关联。这些发现对癌症恶病质的定义及其治疗具有重要意义。
