新型身体成分评分可预测 I-III 期结直肠癌患者根治性切除术后的长期生存情况。
Novel body component score predicts long-term survival in patients with stage I-III colorectal cancer following radical resection.
作者信息
Aida Takashi, Kamada Teppei, Hata Taigo, Takahashi Junji, Ito Eisaku, Furukawa Kenei, Yoshida Masashi, Ohdaira Hironori, Ikegami Toru, Suzuki Yutaka
机构信息
Department of Surgery International University of Health and Welfare Hospital Tochigi Japan.
Department of Surgery The Jikei University School of Medicine Tokyo Japan.
出版信息
Ann Gastroenterol Surg. 2024 Nov 26;9(3):529-537. doi: 10.1002/ags3.12890. eCollection 2025 May.
BACKGROUND
In gastrointestinal cancer, the relationship among skeletal muscle, subcutaneous and visceral fat mass, and prognosis is gaining attention. Herein, we developed a body component score (BCS) to comprehensively evaluate total body composition in patients with stage I-III colorectal cancer (CRC) and examined its relationship with long-term prognosis.
METHODS
This retrospective study included 300 patients with CRC who underwent curative colorectal resection in 2010-2019. The BCS included skeletal muscle index (SMI), subcutaneous fat area (SFA), visceral fat area (VFA), fatty liver, and pancreatic fatty replacement, measured by preoperative computed tomography. The BCS was calculated as the sum of each score from 0 to 5; patients were grouped into low (score 0-1), medium (score 2-3), and high (score 4-5) BCS. Multivariate Cox proportional hazard models assessed disease-free (DFS) and cancer-specific survival (CSS) in these patients.
RESULTS
Multivariate analysis showed that T3 or T4 tumors ( = 0.038), pathological stage III ( < 0.001), and low BCS [ = 0.016; hazard ratio (HR), 1.95; 95% confidence interval (CI), 1.13-3.35] were independently associated with DFS, whereas pathological stage III ( < 0.001) and low BCS ( = 0.001; HR, 3.14; 95% CI, 1.57-6.27) were independent prognostic factors for CSS. Patients with a low BCS had significantly worse DFS ( < 0.001) and CSS ( < 0.001), according to the log-rank test for trends.
CONCLUSIONS
The BCS may effectively predict prognosis in patients with CRC.
背景
在胃肠道癌中，骨骼肌、皮下脂肪和内脏脂肪量与预后之间的关系日益受到关注。在此，我们开发了一种身体成分评分（BCS），以全面评估Ⅰ-Ⅲ期结直肠癌（CRC）患者的总体身体组成，并研究其与长期预后的关系。
方法
这项回顾性研究纳入了2010年至2019年接受根治性结直肠切除术的300例CRC患者。BCS包括骨骼肌指数（SMI）、皮下脂肪面积（SFA）、内脏脂肪面积（VFA）、脂肪肝和胰腺脂肪替代，通过术前计算机断层扫描测量。BCS计算为每个评分（从0到5）的总和；患者被分为低（评分0-1）、中（评分2-3）和高（评分4-5）BCS组。多变量Cox比例风险模型评估这些患者的无病生存期（DFS）和癌症特异性生存期（CSS）。
结果
多变量分析显示，T3或T4肿瘤（ = 0.038）、病理Ⅲ期（ < 0.001）和低BCS [ = 0.016；风险比（HR），1.95；95%置信区间（CI），1.13-3.35]与DFS独立相关，而病理Ⅲ期（ < 0.001）和低BCS（ = 0.001；HR，3.14；95%CI，1.57-6.27）是CSS的独立预后因素。根据趋势对数秩检验，低BCS患者的DFS（ < 0.001）和CSS（ < 0.001）明显更差。
结论
BCS可能有效预测CRC患者的预后。
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