Daitoku Nobuya, Miyamoto Yuji, Hiyoshi Yukiharu, Tokunaga Ryuma, Sakamoto Yuki, Sawayama Hiroshi, Ishimoto Takatsugu, Baba Yoshifumi, Yoshida Naoya, Baba Hideo
Department of Gastroenterological Surgery Graduate School of Medical Sciences Kumamoto University Kumamoto Japan.
International Research Center for Medical Sciences Kumamoto University Kumamoto Japan.
Ann Gastroenterol Surg. 2022 Mar 25;6(5):658-666. doi: 10.1002/ags3.12570. eCollection 2022 Sep.
Sarcopenia is associated with poor prognosis in patients with colorectal cancer (CRC), but the mechanisms contributing to this association remain unclear. We hypothesized that skeletal muscle status is associated with tumor-infiltrating lymphocytes (TILs) in patients with CRC. Therefore, this study investigated the clinical effect of sarcopenia and its relationship with the local immune system in CRC patients.
A total of 256 consecutive patients with CRC who underwent curative resection between 2008 and 2014 were enrolled. Sarcopenia was determined according to the skeletal muscle index (SMI), which was assessed using L3 skeletal muscle mass on axial computed tomography images, and its relationship with patient clinicopathological characteristics and survival was evaluated. Additionally, TILs (CD3, CD8, CD4, and FOXP3 T cells) were assayed by immunohistochemistry. The relationship between TILs and skeletal muscle status was evaluated.
Patients with a lower SMI showed significantly shorter recurrence-free and overall survival compared with those with a higher SMI. Low expression of TILs was associated with significantly shorter recurrence-free survival. SMI was significantly correlated with the number of CD3 and CD8 cells in the ordinal logistic regression analysis. Patients with low skeletal muscle status and low CD3 and CD8 cells had an unfavorable prognosis compared with patients with high skeletal muscle status and high CD3 and CD8 cells.
Our data showed an association between skeletal muscle status and local immune cells, and this association may play a pivotal role in the clinical outcome of patients with CRC.
肌肉减少症与结直肠癌（CRC）患者的不良预后相关，但导致这种关联的机制仍不清楚。我们假设CRC患者的骨骼肌状态与肿瘤浸润淋巴细胞（TILs）相关。因此，本研究调查了肌肉减少症的临床影响及其与CRC患者局部免疫系统的关系。
纳入2008年至2014年间连续接受根治性切除的256例CRC患者。根据骨骼肌指数（SMI）确定肌肉减少症，该指数通过轴向计算机断层扫描图像上的L3骨骼肌质量进行评估，并评估其与患者临床病理特征和生存的关系。此外，通过免疫组织化学检测TILs（CD3、CD8、CD4和FOXP3 T细胞）。评估TILs与骨骼肌状态之间的关系。
与SMI较高的患者相比，SMI较低的患者无复发生存期和总生存期明显缩短。TILs低表达与无复发生存期明显缩短相关。在有序逻辑回归分析中，SMI与CD3和CD8细胞数量显著相关。与骨骼肌状态高且CD3和CD8细胞高的患者相比，骨骼肌状态低且CD3和CD8细胞低的患者预后较差。
我们的数据显示骨骼肌状态与局部免疫细胞之间存在关联，这种关联可能在CRC患者的临床结局中起关键作用。
