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使用连续 CT 测量骨骼肌减少和内脏肥胖对亚洲可手术乳腺癌患者预后的影响。

Impact of Skeletal Muscle Loss and Visceral Obesity Measured Using Serial CT on the Prognosis of Operable Breast Cancers in Asian Patients.

机构信息

Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

Korean J Radiol. 2022 Feb;23(2):159-171. doi: 10.3348/kjr.2020.1475. Epub 2022 Jan 6.

Abstract

OBJECTIVE

This study aimed to investigate the impact of baseline values and temporal changes in body composition parameters, including skeletal muscle index (SMI) and visceral adipose tissue area (VAT), measured using serial computed tomography (CT) imaging on the prognosis of operable breast cancers in Asian patients.

MATERIALS AND METHODS

This study retrospectively included 627 Asian female (mean age ± standard deviation [SD], 53.6 ± 8.3 years) who underwent surgery for stage I-III breast cancer between January 2011 and September 2012. Body composition parameters, including SMI and VAT, were semi-automatically calculated on baseline abdominal CT at the time of diagnosis and follow-up CT for post-treatment surveillance. Serial changes in SMI and VAT were calculated as the delta values. Multivariable Cox regression analysis was used to evaluate the association of baseline and delta SMI and VAT values with disease-free survival.

RESULTS

Among 627 patients, 56 patients (9.2%) had breast cancer recurrence after a median of 40.5 months. The mean value ± SD of the baseline SMI and baseline VAT were 43.7 ± 5.8 cm²/m² and 72.0 ± 46.0 cm², respectively. The mean value of the delta SMI was -0.9 cm²/m² and the delta VAT was 0.5 cm². The baseline SMI and VAT were not significantly associated with disease-free survival (adjusted hazard ratio [HR], 0.983; 95% confidence interval [CI], 0.937-1.031; = 0.475 and adjusted HR, 1.001; 95% CI, 0.995-1.006; = 0.751, respectively). The delta SMI and VAT were also not significantly associated with disease-free survival (adjusted HR, 0.894; 95% CI, 0.766-1.043; = 0.155 and adjusted HR, 1.001; 95% CI, 0.989-1.014; = 0.848, respectively).

CONCLUSION

Our study revealed that baseline and early temporal changes in SMI and VAT were not independent prognostic factors regarding disease-free survival in Asian patients undergoing surgery for breast cancer.

摘要

目的

本研究旨在探讨使用连续计算机断层扫描(CT)成像测量的体成分参数(包括骨骼肌指数[SMI]和内脏脂肪组织面积[VAT])的基线值和时间变化对亚洲可手术乳腺癌患者预后的影响。

材料与方法

本研究回顾性纳入了 2011 年 1 月至 2012 年 9 月期间接受 I-III 期乳腺癌手术的 627 名亚洲女性患者(平均年龄 ± 标准差[SD],53.6 ± 8.3 岁)。在诊断时和术后治疗监测的随访 CT 上,半自动计算体成分参数,包括 SMI 和 VAT。SMI 和 VAT 的连续变化值计算为差值。多变量 Cox 回归分析用于评估基线和 delta SMI 和 VAT 值与无病生存的相关性。

结果

在 627 例患者中,56 例(9.2%)在中位 40.5 个月后出现乳腺癌复发。基线 SMI 和基线 VAT 的平均值 ± SD 分别为 43.7 ± 5.8 cm²/m²和 72.0 ± 46.0 cm²。delta SMI 的平均值为-0.9 cm²/m²,delta VAT 为 0.5 cm²。基线 SMI 和 VAT 与无病生存无显著相关性(调整后的危险比[HR],0.983;95%置信区间[CI],0.937-1.031;=0.475 和调整后的 HR,1.001;95%CI,0.995-1.006;=0.751,分别)。delta SMI 和 VAT 也与无病生存无显著相关性(调整后的 HR,0.894;95%CI,0.766-1.043;=0.155 和调整后的 HR,1.001;95%CI,0.989-1.014;=0.848,分别)。

结论

我们的研究表明,亚洲乳腺癌患者手术后,SMI 和 VAT 的基线和早期时间变化不是无病生存的独立预后因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a792/8814696/6cb83bd1e01f/kjr-23-159-g001.jpg

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