Nishiyama Tsuyoshi, Shibutani Masatsune, Tanda Hideki, Seki Yuki, Kashiwagi Shinichiro, Kasashima Hiroaki, Fukuoka Tatsunari, Maeda Kiyoshi
Department of Gastroenterological Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
Department of Breast Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
Cancer Diagn Progn. 2025 Jan 3;5(1):89-94. doi: 10.21873/cdp.10416. eCollection 2025 Jan-Feb.
BACKGROUND/AIM: The cachexia index (CXI) has been reported to be a useful indicator for predicting the prognosis of cancer patients. However, CXI calculation requires skeletal muscle index (SMI) measurements, which involves an analysis of computed tomography images using an imaging software program, which makes the calculation process highly complex and time-consuming. Recently, the modified cachexia index (mCXI), calculated using the urea-to-creatinine ratio (UCR) instead of SMI, has been reported to be a useful marker that is easier to calculate than CXI. This study aimed to evaluate the correlation between mCXI and the prognosis of patients with colorectal cancer (CRC).
A total of 291 patients who underwent curative surgery for stage I-III CRC were enrolled. mCXI was calculated as the serum albumin concentration/neutrophil-to-lymphocyte ratio (NLR)/UCR. A receiver operating characteristic (ROC) curve analysis was used to determine the optimal cutoff value of the mCXI for predicting prognosis.
The median mCXI was 0.089 (range=0.012-0.354). The ROC curve analysis revealed that the appropriate cut-off value for mCXI was 0.113. The low mCXI group had significantly shorter relapse-free and overall survival rates than the high mCXI group (p=0.030 and p=0.014, respectively).
mCXI, which does not require an image analysis, may be closely associated with prognosis in patients undergoing curative surgery for CRC.
背景/目的：据报道，恶病质指数（CXI）是预测癌症患者预后的有用指标。然而，计算CXI需要测量骨骼肌指数（SMI），这涉及使用成像软件程序对计算机断层扫描图像进行分析，使得计算过程非常复杂且耗时。最近，据报道，使用尿素与肌酐比值（UCR）而非SMI计算的改良恶病质指数（mCXI）是一种比CXI更易于计算的有用标志物。本研究旨在评估mCXI与结直肠癌（CRC）患者预后之间的相关性。
共纳入291例接受I-III期CRC根治性手术的患者。mCXI的计算方法为血清白蛋白浓度/中性粒细胞与淋巴细胞比值（NLR）/UCR。采用受试者工作特征（ROC）曲线分析来确定预测预后的mCXI最佳临界值。
mCXI中位数为0.089（范围=0.012-0.354）。ROC曲线分析显示，mCXI的合适临界值为0.113。低mCXI组的无复发生存率和总生存率显著低于高mCXI组（分别为p=0.030和p=0.014）。
不需要图像分析的mCXI可能与接受CRC根治性手术患者的预后密切相关。
