Yan Ou Ying, Teng Hai Bo, Fu Sheng Nan, Chen Yan Zhu, Liu Feng
The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/ Hunan Cancer Hospital, Changsha, Hunan, People's Republic of China.
Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
Cancer Manag Res. 2021 Aug 24;13:6621-6632. doi: 10.2147/CMAR.S326232. eCollection 2021.
Temporal muscle thickness (TMT) has been proposed as a novel surrogate marker for skeletal muscle mass in head and neck malignancies. This study investigated the TMT prognostic relevance with gliomas and evaluated the influence of TMT values on survival in patients with gliomas of different grades and IDH subtypes.
The patients' TMT was measured on contrast-enhanced T1-weighted magnetic resonance images before surgical treatment. Patients were divided into two cohorts based on their median TMT values. The Kaplan-Meier curve was used to compute the overall survival (OS) of different categories and all gliomas. Univariate and multivariate Cox regression analyses were conducted to assess the association between OS and TMT, hematological markers, and other clinical factors in glioma patients. Moreover, the clinical diagnostic efficiency of single and combination biomarkers was evaluated using receiver operating characteristic curve analysis.
We retrospectively analyzed 261 patients with newly diagnosed glioma between November 2016 and May 2020 at Hunan Cancer Hospital. Cox analysis indicated that higher TMT (HR 0.286, P< 0.001) and higher KPS score (HR 0.629, P= 0.012) were protective prognostic factors and IDH wildtype status (HR 2.946, P< 0.001), RDW > 12.6 (HR 1.513, P= 0.036), and NLR > 4 (HR 1.560, P= 0.042) were poor prognostic factors for gliomas. Subsequently, patients with thicker TMT were found to have significantly better overall survival (P<0.001) than patients with thinner TMT among WHO III and WHO IV grade and patients with or without IDH mutation. TMT was considered a better single biomarker than recently prevalent hematological biomarkers for predicting high-grade [0.856 (0.797-0.916)] and IDH- wild-type [0.864 (0.786-0.941)] gliomas.
This study suggests that TMT is a positive biomarker for clinical prognosis in gliomas and that patients with thicker TMT have greater overall survival for gliomas of different grades and IDH subtypes.
颞肌厚度（TMT）已被提议作为头颈部恶性肿瘤骨骼肌质量的一种新型替代标志物。本研究调查了TMT与胶质瘤的预后相关性，并评估了TMT值对不同分级和异柠檬酸脱氢酶（IDH）亚型的胶质瘤患者生存的影响。
在手术治疗前，通过对比增强T1加权磁共振成像测量患者的TMT。根据患者的TMT中位数将其分为两个队列。采用Kaplan-Meier曲线计算不同类别和所有胶质瘤的总生存期（OS）。进行单因素和多因素Cox回归分析，以评估胶质瘤患者的OS与TMT、血液学标志物及其他临床因素之间的关联。此外，使用受试者工作特征曲线分析评估单一和联合生物标志物的临床诊断效率。
我们回顾性分析了2016年11月至2020年5月在湖南省肿瘤医院新诊断的261例胶质瘤患者。Cox分析表明，较高的TMT（风险比[HR]0.286，P<0.001）和较高的KPS评分（HR 0.629，P=0.012）是保护性预后因素，而IDH野生型状态（HR 2.946，P<0.001）、红细胞分布宽度（RDW）>12.6（HR 1.513，P=0.036）和中性粒细胞与淋巴细胞比值（NLR）>4（HR 1.560，P=0.042）是胶质瘤的不良预后因素。随后发现，在世界卫生组织（WHO）III级和IV级以及有或无IDH突变的患者中，TMT较厚的患者总生存期明显优于TMT较薄的患者。对于预测高级别[0.856（0.797 - 0.916）]和IDH野生型[0.864（0.786 - 0.941）]胶质瘤，TMT被认为是比最近流行的血液学生物标志物更好的单一生物标志物。
本研究表明，TMT是胶质瘤临床预后的阳性生物标志物，TMT较厚的不同分级和IDH亚型的胶质瘤患者总生存期更长。
