Lu Xinyan, Tian Ying, Huang Jiaxin, Li Fei, Shao Tingru, Huang Guangzhao, Lv Xiaozhi
Department of Oral & Maxillofacial Surgery, Southern Medical University NanFang Hospital, Guangzhou, China.
NanFang PET Center, Southern Medical University NanFang Hospital, Guangzhou, China.
Oral Dis. 2023 Apr;29(3):923-932. doi: 10.1111/odi.14074. Epub 2021 Nov 24.
This study aimed to construct a formula to predict L3 skeletal muscle cross-sectional area (CSA) from C3 CSA and to select the cutoff values to evaluate the nutritional status in OSCC.
A total of 220 OSCC patients in Nanfang Hospital were divided into two groups: the training set (n = 100) and the validation set (n = 120). Patients in the training set were performed the preoperative whole-body positron emission tomography-computed tomography (PET/CT) scans, and patients in the validation set received preoperative head-and-neck computed tomography (CT) scans. C3 CSA and L3 CSA were delineated. The predictive formula was established, and the gender-specific thresholds of malnutrition were obtained by X-tile software in training set. Finally, the formula and cutoff values were validated.
The predictive formula was successfully established. The gender-specific cutoff values for L3 SMI were 55.0 cm /m for men and 36.6 cm /m for women. There were no differences between the overall survival (OS) of patients diagnosed with malnutrition and that of patients who are not malnutrition.
Our studies reveal that the L3 CSA could be calculated by C3 CSA conveniently with our formula in OSCC, which allowed us to assess malnutrition with head-and-neck CT image. However, there is no direct connection found between malnutrition and OS in OSCC. Hence, further studies with a larger sample size may be required.
本研究旨在构建一个根据C3横截面积预测L3骨骼肌横截面积（CSA）的公式，并选择临界值以评估口腔鳞状细胞癌（OSCC）患者的营养状况。
南方医院的220例OSCC患者被分为两组：训练集（n = 100）和验证集（n = 120）。训练集患者进行术前全身正电子发射断层扫描-计算机断层扫描（PET/CT），验证集患者接受术前头颈部计算机断层扫描（CT）。勾勒出C3 CSA和L3 CSA。建立预测公式，并通过X-tile软件在训练集中获得按性别划分的营养不良阈值。最后，对公式和临界值进行验证。
成功建立了预测公式。L3骨骼肌指数（SMI）的按性别划分的临界值男性为55.0 cm²/m²，女性为36.6 cm²/m²。诊断为营养不良的患者与未患营养不良的患者的总生存期（OS）之间无差异。
我们的研究表明，在OSCC中，利用我们的公式可以通过C3 CSA方便地计算出L3 CSA，这使我们能够通过头颈部CT图像评估营养不良情况。然而，在OSCC中未发现营养不良与OS之间存在直接联系。因此，可能需要进一步开展更大样本量的研究。
