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经腔内减压后行根治性手术治疗梗阻性结直肠癌患者中 Ishii 肌肉减少症筛查评分的预后意义。

Prognostic significance of Ishii's sarcopenia screening score for patients undergoing curative surgery for obstructive colorectal cancer after intraluminal decompression.

机构信息

Department of Gastroenterological Surgery, Sendai City Medical Center Sendai Open Hospital, 5-22-1 Tsurugaya, Miyagino-Ku, Sendai, 983-0824, Japan.

Department of Surgery, Japanese Red Cross Sendai Hospital, 2-43-3Yagiyama Hon-Cho, Taihaku-Ku, Sendai, 982-8501, Japan.

出版信息

Surg Today. 2024 Jul;54(7):683-691. doi: 10.1007/s00595-023-02774-x. Epub 2023 Dec 13.

Abstract

PURPOSE

Sarcopenia influences the short- and long-term outcomes of various medical conditions including malignancy. Ishii's screening test estimates the probability of sarcopenia based on a score calculated by three simple variables: age, grip strength, and calf circumference. We investigated the clinical significance of Ishii's score for patients with non-metastatic obstructive colorectal cancer (OCRC) who underwent curative surgery after intraluminal decompression.

METHODS

Ishii's score was calculated in 79 patients with OCRC. Muscle volume loss and decreased muscle quality were evaluated by computed tomography (CT) images as skeletal muscle index (SMI) and intramuscular adipose tissue content (IMAC), respectively.

RESULTS

There were 46 men and 33 women, with a median age of 70 years old. The cutoff value for Ishii's score was 155.1 and 15 patients were in the high-score group. The high-score group was significantly associated with worse time to recurrence (TTR) and overall survival (OS), and a high Ishii's score was an independent negative prognostic factor for TTR (hazard ratio = 2.93, P = 0.015). A high Ishii's score was significantly associated with a low SMI value but not with the IMAC value.

CONCLUSION

A high Ishii's score was independently associated with poorer TTR in patients with non-metastatic OCRC.

摘要

目的

肌肉减少症影响多种医学病症的短期和长期预后,包括恶性肿瘤。石井氏筛查试验根据三个简单变量(年龄、握力和小腿围)计算的评分来估计肌肉减少症的概率。我们研究了石井氏评分对接受腔内减压后接受根治性手术的非转移性阻塞性结直肠癌(OCRC)患者的临床意义。

方法

对 79 例 OCRC 患者计算了石井氏评分。通过计算机断层扫描(CT)图像评估肌肉体积损失和肌肉质量下降,分别评估骨骼肌指数(SMI)和肌内脂肪组织含量(IMAC)。

结果

患者中有 46 名男性和 33 名女性,中位年龄为 70 岁。石井氏评分的截断值为 155.1,15 名患者为高分组。高分组与复发时间(TTR)和总生存(OS)更差显著相关,高石井氏评分是 TTR 的独立负预后因素(风险比=2.93,P=0.015)。高石井氏评分与低 SMI 值显著相关,但与 IMAC 值无关。

结论

高石井氏评分与非转移性 OCRC 患者 TTR 更差独立相关。

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