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可切除食管鳞状细胞癌患者术前肌肉减少症诊断与术后肺炎的关系:一项回顾性队列研究

Association between preoperative diagnosis of sarcopenia and postoperative pneumonia in resectable esophageal squamous cell carcinoma patients: a retrospective cohort study.

作者信息

Xu Zhiyun, Wang Qianwei, Zhang Zhenzhong, Zhu Yaning, Chen Yunyun, Tang Derong, Zhao Jianqiang

机构信息

Department of Thoracic Surgery, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, China.

Department of Pathology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, China.

出版信息

Front Oncol. 2023 May 18;13:1144516. doi: 10.3389/fonc.2023.1144516. eCollection 2023.

Abstract

BACKGROUND

Postoperative outcomes for patients suffering from resectable esophageal squamous cell carcinoma (ESCC) are related to sarcopenia. In patients with resectable ESCC, this study investigated the link between sarcopenia and postoperative pneumonia.

METHODS

The McKewon procedure was the only one used to treat resectable ESCC patients from January 2018 to December 2021 in this retrospective analysis. Sarcopenia was assessed using skeletal muscles at L3 and planning CT scans. It was defined when PMI was below 6.36 cm/m and 3.92 cm/m for men and women, separately. Analyses of multivariate and univariate logistic regression were applied for identifying the risk factors for postoperative pneumonia.

RESULTS

The study included 773 patients with resectable ESCC in total. Sarcopenia was an independent risk factor for postoperative pneumonia in individuals with resectable ESCC based on univariate and multivariate analysis (P < 0.05). The stratified analysis indicated that neither of the clinical outcomes in the logistic regression model were affected by gender, age, BMI, smoking, or pre-albumin (P for interaction > 0.006).

CONCLUSION

Following the McKewon procedure, patients with resectable ESCC who were sarcopenic had a higher postoperative pneumonia rate. To prevent the development of postoperative pneumonia during the perioperative period, it may be important to control the incidence of sarcopenia.

摘要

背景

可切除食管鳞状细胞癌(ESCC)患者的术后结局与肌肉减少症有关。本研究调查了可切除ESCC患者中肌肉减少症与术后肺炎之间的联系。

方法

在这项回顾性分析中,2018年1月至2021年12月期间,仅采用McKewon手术治疗可切除的ESCC患者。使用L3水平的骨骼肌和计划CT扫描评估肌肉减少症。男性和女性的肌肉减少症分别定义为腰大肌指数(PMI)低于6.36 cm/m和3.92 cm/m。采用多因素和单因素逻辑回归分析确定术后肺炎的危险因素。

结果

该研究共纳入773例可切除ESCC患者。基于单因素和多因素分析,肌肉减少症是可切除ESCC患者术后肺炎的独立危险因素(P<0.05)。分层分析表明,逻辑回归模型中的临床结局均未受到性别、年龄、BMI、吸烟或前白蛋白的影响(交互作用P>0.006)。

结论

采用McKewon手术后,存在肌肉减少症的可切除ESCC患者术后肺炎发生率更高。为预防围手术期术后肺炎的发生,控制肌肉减少症的发生率可能很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7931/10233097/2f02c2f087f6/fonc-13-1144516-g001.jpg

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