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骨骼肌减少症、肌内脂肪增多症和预后营养指数对 2 期和 3 期胃癌患者生存的影响。

Effects of Sarcopenia, Myosteatosis, and the Prognostic Nutritional Index on Survival in Stage 2 and 3 Gastric Cancer Patients.

机构信息

Department of Medical Oncology, Gazi University, Ankara, Turkey.

Department of Radiology, Gazi University, Ankara, Turkey.

出版信息

Nutr Cancer. 2023;75(1):368-375. doi: 10.1080/01635581.2022.2121845. Epub 2022 Sep 10.

Abstract

BACKGROUND

We aimed to evaluate the relationship between sarcopenia, myosteatosis, and systemic inflammatory response biomarkers and their prognostic role in stage 2 and 3 gastric cancer patients.

METHODS

This study included 84 patients with stage 2 or 3 gastric cancer who underwent a gastrectomy. Computed tomography scans were used to determine the skeletal muscle index (SMI) at the third lumbar vertebra level for sarcopenia and myosteatosis.

RESULTS

Based on the Asian Working Group of Sarcopenia (AWGS2019) criteria, the sarcopenia incidence was 36.9% and that of myosteatosis 46.4%. Univariate analysis showed that sarcopenia (48 vs. 14 mo,  < 0.001), myosteatosis (45 vs. 16 mo,  = 0.016), a low prognostic nutritional index (60 vs. 15 mo,  = 0.003), stage 3 (104 vs. 21 mo,  = 0.013), and old age (45 vs. 16 mo,  = 0.015) were poor prognostic markers. Multivariate analysis revealed that sarcopenia (AWGS2019), age, and stage significantly affected overall survival (hazard ratio: 3.31, 95% CI: 1.85-5.1; 1.96, 95% CI: 1.06-6.63; 2.5, 95% CI: 1.2-5.1, respectively).

CONCLUSION

We showed that sarcopenia directly affects overall gastric cancer survival.

摘要

背景

本研究旨在评估骨骼肌减少症、肌内脂肪增多症与全身炎症反应生物标志物之间的关系,并探讨其在 2 期和 3 期胃癌患者中的预后作用。

方法

本研究纳入了 84 例接受胃切除术的 2 期或 3 期胃癌患者。通过计算机断层扫描确定第三腰椎水平的骨骼肌指数(SMI)以评估骨骼肌减少症和肌内脂肪增多症。

结果

根据亚洲肌肉减少症工作组(AWGS2019)标准,骨骼肌减少症的发生率为 36.9%,肌内脂肪增多症的发生率为 46.4%。单因素分析显示,骨骼肌减少症(48 个月与 14 个月,  < 0.001)、肌内脂肪增多症(45 个月与 16 个月,  = 0.016)、预后营养指数低(60 个月与 15 个月,  = 0.003)、Ⅲ期(104 个月与 21 个月,  = 0.013)和高龄(45 个月与 16 个月,  = 0.015)是不良预后标志物。多因素分析显示,骨骼肌减少症(AWGS2019)、年龄和分期显著影响总生存(风险比:3.31,95%CI:1.85-5.1;1.96,95%CI:1.06-6.63;2.5,95%CI:1.2-5.1)。

结论

本研究表明,骨骼肌减少症直接影响胃癌患者的总生存。

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