Big Data Center, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
BMC Cancer. 2022 Jul 6;22(1):737. doi: 10.1186/s12885-022-09823-7.
Immune checkpoint inhibitors (ICIs) have been used to successfully treat primary liver cancer (PLC); however, identifying modifiable patient factors associated with therapeutic benefits is challenging. Obesity is known to be associated with increased survival after ICI treatment; however, the relationship between body composition (muscle, fat) and outcomes is unclear. This study aimed to evaluate the association between sarcopenia and CT-derived fat content and the prognosis of ICIs for the treatment of PLC.
In this retrospective cohort study of 172 patients with PLC, we measured the skeletal muscle index (SMI), skeletal muscle density, visceral adipose tissue index, subcutaneous adipose tissue index, total adipose tissue index (TATI), and visceral-to-subcutaneous adipose tissue area ratio using CT. In addition, we analyzed the impact of body composition on the prognosis of the patients. Multivariate Cox regression analysis was used to screen for influencing factors.
Among the seven body composition components, low SMI (sarcopenia) and low TATI were significantly associated with poor clinical outcomes. Multivariate analysis revealed that sarcopenia (hazard ratio [HR], 5.39; 95% confidence interval [CI], 1.74-16.74; p = 0.004) was a significant predictor of overall survival (OS). Kaplan-Meier curves showed that sarcopenia and TATI were significant predictors of OS. Body mass index was not associated with survival outcomes.
Sarcopenia and fat tissue content appear to be independently associated with reduced survival rates in patients with PLC treated with ICIs.
免疫检查点抑制剂（ICIs）已成功用于治疗原发性肝癌（PLC）；然而，确定与治疗获益相关的可改变的患者因素具有挑战性。肥胖与 ICI 治疗后生存率增加有关；然而，身体成分（肌肉、脂肪）与结局之间的关系尚不清楚。本研究旨在评估肌肉减少症和 CT 衍生的脂肪含量与 ICI 治疗 PLC 预后之间的关系。
在这项对 172 名 PLC 患者的回顾性队列研究中，我们使用 CT 测量了骨骼肌指数（SMI）、骨骼肌密度、内脏脂肪组织指数、皮下脂肪组织指数、总脂肪组织指数（TATI）和内脏-皮下脂肪组织面积比。此外，我们分析了身体成分对患者预后的影响。多变量 Cox 回归分析用于筛选影响因素。
在这七种身体成分成分中，低 SMI（肌肉减少症）和低 TATI 与不良临床结局显著相关。多变量分析显示，肌肉减少症（危险比 [HR]，5.39；95%置信区间 [CI]，1.74-16.74；p=0.004）是总生存期（OS）的显著预测因素。Kaplan-Meier 曲线显示，肌肉减少症和 TATI 是 OS 的显著预测因素。体质指数与生存结局无关。
肌肉减少症和脂肪组织含量似乎与接受 ICI 治疗的 PLC 患者生存率降低独立相关。
