Department of General Surgery, The Second People's Hospital of Hefei Affiliated to Bengbu Medical University, Hefei, 230011, China.
Department of General Surgery, The Second People's Hospital of Hefei, Hefei, 230011, China.
Eur Radiol. 2024 Dec;34(12):7596-7608. doi: 10.1007/s00330-024-10849-7. Epub 2024 Jun 24.
To investigate the prognostic value of preoperative body composition and serum tumor markers (STM) in patients undergoing surgical treatment for colorectal cancer (CRC) and to establish the prognostic score for patients with CRC.
This study enrolled 365 patients (training set 245, validation set 120) with CRC who underwent surgical resection. The predictive value of various body composition features and STM for determining CRC prognosis were compared. A novel index score based on the independent risk factors from Cox regression for CRC patients was established and evaluated for its usefulness.
Multivariate Cox regression showed that low skeletal muscle radiodensity (SMD) (p = 0.020), low subcutaneous fat area (SFA) (p = 0.029), high carcinoembryonic antigen (CEA) (p = 0.008), and high alpha-fetoprotein (AFP) (p = 0.039) were all independent prognostic factors for poor overall survival (OS). The multifactorial analysis indicated that high intermuscular fat area (IMFA) (p = 0.033) and high CEA (p = 0.009) were independent prognostic factors for poor disease-free survival (DFS). Based on these findings, two scoring systems for OS and DFS were established in the training datasets. CRC patients who scored higher on the new scoring systems had lower OS and DFS (both p < 0.001) as shown in the Kaplan-Meier survival curves in the training and validation datasets.
In predicting the prognosis of CRC patients, SFA and SMD are superior to other body composition measurements. A scoring system based on body composition and STM can have prognostic value and clinical applicability.
This scoring system, combining body composition and serum tumor markers, may help predict postoperative survival of CRC patients and help clinicians make well-informed decisions regarding the treatment of patients.
Colorectal cancer prognosis can be related to body composition. High intermuscular fat area and CEA were independent prognostic factors for poor disease-free survival. This scoring system, based on body composition and tumor markers, can prognosticate for colorectal cancer patients.
探讨术前人体成分和血清肿瘤标志物（STM）对结直肠癌（CRC）患者手术治疗预后的预测价值，并建立 CRC 患者的预后评分。
本研究纳入了 365 例接受手术切除的 CRC 患者（训练集 245 例，验证集 120 例）。比较了各种人体成分特征和 STM 对确定 CRC 预后的预测价值。基于 COX 回归的独立风险因素建立了一种新的 CRC 患者指数评分，并对其有效性进行了评估。
多变量 COX 回归显示，低骨骼肌辐射密度（SMD）（p=0.020）、低皮下脂肪面积（SFA）（p=0.029）、高癌胚抗原（CEA）（p=0.008）和高甲胎蛋白（AFP）（p=0.039）均为总生存期（OS）不良的独立预后因素。多因素分析表明，高肌间脂肪面积（IMFA）（p=0.033）和高 CEA（p=0.009）是无病生存期（DFS）不良的独立预后因素。基于这些发现，在训练数据集建立了两个用于 OS 和 DFS 的评分系统。新评分系统中得分较高的 CRC 患者 OS 和 DFS 较低（均 p<0.001），在训练和验证数据集的 Kaplan-Meier 生存曲线中也有体现。
在预测 CRC 患者的预后方面，SFA 和 SMD 优于其他人体成分测量。基于人体成分和 STM 的评分系统具有预后价值和临床适用性。
该评分系统结合了人体成分和血清肿瘤标志物，可能有助于预测 CRC 患者的术后生存，并帮助临床医生做出明智的治疗决策。
结直肠癌的预后与人体成分有关。高肌间脂肪面积和 CEA 是无病生存期不良的独立预后因素。基于人体成分和肿瘤标志物的评分系统可预测结直肠癌患者的预后。
