基线肌肉减少症与肝癌患者对治疗无反应、肝功能失代偿和高死亡率相关。
Baseline Sarcopenia is Associated with Lack of Response to Therapy, Liver Decompensation and High Mortality in Hepatocellular Carcinoma Patients.
机构信息
Department of Hepatology and Gastroenterology, National Liver Institute, Menoufia University, Shebeen El-Koom, Egypt.
Department of Diagnostic Medical Imaging and Interventional Radiology; National Liver Institute, Menoufia University, Shebeen El-Koom, Egypt.
出版信息
Asian Pac J Cancer Prev. 2020 Nov 1;21(11):3285-3290. doi: 10.31557/APJCP.2020.21.11.3285.
OBJECTIVE
hepatocellular carcinoma (HCC) is a dreadful complication of liver cirrhosis. Aim was to study the effect of sarcopenia on the survival in patients with HCC.
METHODS
we included 262 patients and were followed up for 12 months. Sarcopenia was calculated by skeletal muscle index (SMI). Sarcopenia was defined by SMI ≤39 cm2/m2 for women and ≤50 cm2/m2 for men.
RESULTS
patients with sarcopenia (n= 113, 43.1%) were older, mainly males, Child-Pugh class B and smokers. Patients with sarcopenia had lower survival than those without (10.09 vs. 11.72 months). Survival was also lower in Barcelona clinic liver cancer stage C than B and A (9.02 vs. 11.21 vs. 11.89 months). Age and sarcopenia were hazardous of mortality (p <0.05). There was statistically significant difference of serial SMI in patients without baseline sarcopenia unlike patients with baseline sarcopenia. On follow up patients with sarcopenia had higher incidence of ascites (45% vs. 20.4%), spontaneous bacterial peritonitis (21.7% vs. 11.6%), hepatic encephalopathy (28% vs. 11.5%) and bleeding (22.9% vs. 12.7%). Totally patients with sarcopenia had higher incidence of progressive HCC (39% vs. 25.5%).
CONCLUSION
Sarcopenia is associated with lack of response to therapy, liver decompensation and higher mortality in hepatocellular carcinoma patients.
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目的
肝细胞癌（HCC）是肝硬化的一种严重并发症。本研究旨在探讨肌肉减少症对 HCC 患者生存的影响。
方法
我们纳入了 262 例患者，并进行了 12 个月的随访。通过骨骼肌指数（SMI）计算肌肉减少症。女性肌肉减少症定义为 SMI≤39cm2/m2，男性为 SMI≤50cm2/m2。
结果
肌肉减少症患者（n=113，43.1%）年龄较大，主要为男性，Child-Pugh 分级为 B 级和吸烟者。与无肌肉减少症患者相比，有肌肉减少症患者的生存率较低（10.09 个月比 11.72 个月）。巴塞罗那临床肝癌分期 C 期患者的生存率低于 B 期和 A 期（9.02 个月比 11.21 个月比 11.89 个月）。年龄和肌肉减少症是死亡的危险因素（p<0.05）。与无基线肌肉减少症的患者相比，基线无肌肉减少症的患者的 SMI 连续值存在统计学差异。在随访中，有肌肉减少症的患者腹水（45%比 20.4%）、自发性细菌性腹膜炎（21.7%比 11.6%）、肝性脑病（28%比 11.5%）和出血（22.9%比 12.7%）的发生率更高。总的来说，有肌肉减少症的患者进展性 HCC 的发生率更高（39%比 25.5%）。
结论
肌肉减少症与 HCC 患者对治疗无反应、肝功能失代偿和更高的死亡率有关。
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