计算机断层扫描测量的骨骼肌消耗对非转移性乳腺癌患者总生存期的预后价值
Prognostic Value of Skeletal Muscle Depletion Measured on Computed Tomography for Overall Survival in Patients with Non-Metastatic Breast Cancer.
作者信息
Huh Jimi, Park Bumhee, Lee Heirim, An Young-Sil, Jung Yongsik, Kim Ji Young, Kang Doo Kyoung, Kim Kyung Won, Kim Tae Hee
机构信息
Department of Radiology, Ajou University School of Medicine, Suwon, Korea.
Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Korea.
出版信息
J Breast Cancer. 2020 Feb;23(1):80-92. doi: 10.4048/jbc.2020.23.e8.
PURPOSE
The purpose of this study was to evaluate the prognostic value of skeletal muscle depletion measured on computed tomography (CT) in patients with non-metastatic invasive breast cancer.
METHODS
This retrospective study included 577 consecutive women (mean age ± standard deviation: 48.9 ± 10.2 years with breast cancer who underwent a preoperative positron-emission tomography (PET)/CT scan and curative surgery between January 2012 and August 2014. The total abdominal muscle area (TAMA), subcutaneous fat area (SFA), and visceral fat area (VFA) were measured on CT images at the L3 vertebral level. Univariate and multivariate Cox proportional-hazard regression analyses were performed to evaluate whether there was an association between sarcopenia and overall survival (OS) outcome.
RESULTS
Of the 577 women, 49 (8.5%) died after a mean of 46 months. The best TAMA threshold for predicting OS was 83.7 cm. The multivariate Cox proportional-hazard analysis revealed that sarcopenia (TAMA ≤ 83.70 cm) was a strong prognostic biomarker (hazard ratio [HR], 1.951; 95% confidence interval [CI], 1.061-3.586), along with large tumor size, axillary lymph node metastasis, high nuclear grade, estrogen receptor status, and adjuvant radiation therapy. In the subgroup analysis of patients aged ≥ 50 years, TAMA (≤ 77.14 cm) was a significant independent factor (HR, 2.856; 95% CI, 1.218-6.695).
CONCLUSION
Skeletal muscle depletion measured on CT was associated with worse OS outcome in patients with non-metastatic breast cancer.
目的
本研究旨在评估计算机断层扫描（CT）测量的骨骼肌消耗对非转移性浸润性乳腺癌患者的预后价值。
方法
这项回顾性研究纳入了2012年1月至2014年8月期间连续577例接受术前正电子发射断层扫描（PET）/CT扫描及根治性手术的乳腺癌女性患者（平均年龄±标准差：48.9±10.2岁）。在L3椎体水平的CT图像上测量总腹部肌肉面积（TAMA）、皮下脂肪面积（SFA）和内脏脂肪面积（VFA）。进行单因素和多因素Cox比例风险回归分析，以评估肌肉减少症与总生存期（OS）结局之间是否存在关联。
结果
577例女性患者中，49例（8.5%）在平均46个月后死亡。预测OS的最佳TAMA阈值为83.7 cm²。多因素Cox比例风险分析显示，肌肉减少症（TAMA≤83.70 cm²）是一个强有力的预后生物标志物（风险比[HR]，1.951；95%置信区间[CI]，1.061 - 3.586），此外还有肿瘤体积大、腋窝淋巴结转移、高核分级、雌激素受体状态和辅助放疗。在年龄≥50岁患者的亚组分析中，TAMA（≤77.14 cm²）是一个显著的独立因素（HR，2.856；95% CI，1.218 - 6.695）。
结论
CT测量的骨骼肌消耗与非转移性乳腺癌患者较差的OS结局相关。
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