Kohara Yuichiro, Yasuda Satoshi, Nagai Minako, Nakamura Kota, Matsuo Yasuko, Terai Taichi, Doi Shunsuke, Sakata Takeshi, Sho Masayuki
Department of Surgery, Nara Medical University, Nara, Japan.
J Hepatobiliary Pancreat Sci. 2024 Dec;31(12):906-916. doi: 10.1002/jhbp.12081. Epub 2024 Nov 3.
Creatine kinase (CK) levels decrease with cancer progression and muscle wasting, but its association with pancreatic ductal adenocarcinoma (PDAC) remains unclear. The aim of this study was to investigate CK as a prognostic biomarker and surrogate marker for muscle mass in patients with PDAC.
A retrospective analysis of 476 patients with PDAC was conducted. CK levels were categorized into low and high groups using receiver-operating characteristic (ROC) curve analysis.
Among the 476 patients, 200 (42.0%) and 276 (58.0%) were classified into the low and high CK groups, respectively. The low CK group had significantly poorer overall survival (p < .001) and recurrence-free survival (p < .001) compared to the high CK group. Multivariate analysis identified low CK as an independent poor prognostic factor (p < .001). The low CK group had significantly lower skeletal muscle index (p = .048) than the high CK group; however, the difference was slight and not significantly associated with sarcopenia. Additionally, combined risk assessment incorporating CK and resectability facilitated a more nuanced prognostic stratification.
CK served as a reliable prognostic marker independent from resectability but was less effective as a marker for sarcopenia in PDAC.
肌酸激酶（CK）水平会随着癌症进展和肌肉萎缩而降低，但其与胰腺导管腺癌（PDAC）的关联仍不明确。本研究的目的是探讨CK作为PDAC患者预后生物标志物以及肌肉量替代标志物的作用。
对476例PDAC患者进行回顾性分析。使用受试者工作特征（ROC）曲线分析将CK水平分为低水平组和高水平组。
在476例患者中，分别有200例（42.0%）和276例（58.0%）被归入低CK组和高CK组。与高CK组相比，低CK组的总生存期（p <.001）和无复发生存期（p <.001）显著更差。多因素分析确定低CK是一个独立的不良预后因素（p <.001）。低CK组的骨骼肌指数显著低于高CK组（p = 0.
