Chen Cong, Luo Xin, Lin Xianchao, Lin Ronggui, Yang Yuanyuan, Wang Congfei, Fang Haizong, Teng Tianhong, Huang Heguang, Lu Fengchun
Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, 350001, China.
Nutr J. 2025 Feb 1;24(1):22. doi: 10.1186/s12937-025-01084-x.
Among cancer patients, pancreatic cancer patients have the highest rate of sarcopenia, which is a critical prognostic factor. Serum creatine kinase (CK) is closely related to skeletal muscle mass and has been reported to decline with the progression of cancer. This study investigated whether preoperative serum CK is associated with the survival of patients with pancreatic cancer.
Data were obtained from patients with pathologically confirmed pancreatic cancer between June 2016 and March 2022. The prognostic significance of CK was analyzed based on sex-stratified groups. The Kaplan-Meier method was used to compare overall survival (OS) and disease-free survival (DFS). Multivariate Cox proportional hazards models were used to determine prognostic factors. Body composition was analyzed based on preoperative abdominal CT images to explore the sex-specific associations between skeletal muscle area (SMA) and serum CK levels.
A total of 166 patients were included in this study. Sarcopenia was presented in 70 patients (42.2%). A low serum CK level showed a significant correlation with the diagnosis of sarcopenia in male patients (P = 0.026). The levels of CK did not predict the outcome in female patients, while a low preoperative CK was notably linked to shorter OS in male patients (median OS: 15 months vs. 33 months, P = 0.011; median DFS: 5 months vs. 14 months, P = 0.007). Multivariate analyses further confirmed the effect of CK in predicting OS (CK>44 IU/L, HR:0.226, 95% CI:0.107-0.478, P < 0.001) and DFS (CK>44 IU/L, HR:0.272, 95% CI:0.139-0.529, P < 0.001) of male patients. Correlation analysis revealed a significant association between SMA and CK levels in male patients (r = 0.225, P = 0.025), and such a correlation was not observed in female patients (r = 0.088, P = 0.478).
The pretherapeutic CK may represent a simple marker for predicting poor survival in male patients with resectable pancreatic cancer, thereby aiding in the selection of therapeutic strategies.
在癌症患者中，胰腺癌患者的肌肉减少症发生率最高，而肌肉减少症是一个关键的预后因素。血清肌酸激酶（CK）与骨骼肌质量密切相关，据报道其会随着癌症进展而下降。本研究调查了术前血清CK是否与胰腺癌患者的生存情况相关。
数据来源于2016年6月至2022年3月间病理确诊的胰腺癌患者。基于性别分层组分析CK的预后意义。采用Kaplan-Meier法比较总生存期（OS）和无病生存期（DFS）。使用多变量Cox比例风险模型确定预后因素。基于术前腹部CT图像分析身体成分，以探索骨骼肌面积（SMA）与血清CK水平之间的性别特异性关联。
本研究共纳入166例患者。70例患者（42.2%）存在肌肉减少症。低血清CK水平与男性患者肌肉减少症的诊断显著相关（P = 0.026）。CK水平不能预测女性患者的预后，而术前低CK水平与男性患者较短的OS显著相关（中位OS：15个月对33个月，P = 0.011；中位DFS：5个月对14个月，P = 0.007）。多变量分析进一步证实了CK对男性患者OS（CK>44 IU/L，HR：0.226，95%CI：0.107 - 0.478，P < 0. = 0.001）和DFS（CK>44 IU/L，HR：0.272，95%CI：0.139 - 0.529，P < 0.001）的预测作用。相关性分析显示男性患者SMA与CK水平之间存在显著关联（r = 0.225，P = 0.025），而女性患者未观察到这种相关性（r = 0.088，P = 0.478）。
治疗前CK可能是预测可切除胰腺癌男性患者生存不良的一个简单标志物，从而有助于治疗策略的选择。
