Hirase Yuki, Arigami Takaaki, Matsushita Daisuke, Shimonosono Masataka, Tsuruda Yusuke, Sasaki Ken, Baba Kenji, Kawasaki Yota, Ohtsuka Takao
Department of Digestive Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
Cancer Immunol Immunother. 2025 May 30;74(7):230. doi: 10.1007/s00262-025-04084-2.
Osteosarcopenia, characterized by muscle loss and osteoporosis, has emerged as a prognostic marker for various malignancies. However, its impact on the immune response in gastric cancer remains unclear. This study aimed to assess the clinical significance of osteosarcopenia and its relationship with the immune microenvironment in patients with advanced gastric cancer.
This study included 105 patients with pathological stage II/III gastric cancer who underwent gastrectomy between 2018 and 2022. Preoperative computed tomography was used to measure muscle mass and bone density, with sarcopenia and osteoporosis defined as values below the respective standard thresholds. Sarcopenia and osteoporosis were identified when both conditions were present. We explored the relationships between osteosarcopenia, clinicopathological factors, and prognoses. Additionally, immune marker expression was evaluated via immunohistochemistry.
Among the 105 patients, 37 (35%) were diagnosed with osteosarcopenia. This condition significantly correlated with performance status, body mass index, and disease recurrence (all p < 0.05). Overall survival and relapse-free survival were significantly lower in the osteosarcopenia group than those in the non-osteosarcopenia group (all p < 0.05). Moreover, the osteosarcopenia group had significantly fewer CD8-positive, programmed cell death protein 1-positive, and programmed death-ligand 1-positive cells than that of the control group (all p < 0.05).
Our findings suggest that osteosarcopenia is associated with the tumor microenvironment and might serve as a prognostic indicator in patients with advanced gastric cancer.
以肌肉减少和骨质疏松为特征的骨肌减少症已成为多种恶性肿瘤的预后标志物。然而，其对胃癌免疫反应的影响仍不清楚。本研究旨在评估骨肌减少症在晚期胃癌患者中的临床意义及其与免疫微环境的关系。
本研究纳入了2018年至2022年间接受胃切除术的105例病理分期为II/III期的胃癌患者。术前使用计算机断层扫描测量肌肉量和骨密度，肌肉减少症和骨质疏松症定义为低于各自标准阈值的值。当两种情况都存在时，即可诊断为骨肌减少症。我们探讨了骨肌减少症、临床病理因素和预后之间的关系。此外，通过免疫组织化学评估免疫标志物的表达。
在105例患者中，37例（35%）被诊断为骨肌减少症。这种情况与体能状态、体重指数和疾病复发显著相关（所有p<0.05）。骨肌减少症组的总生存期和无复发生存期显著低于非骨肌减少症组（所有p<0.05）。此外，骨肌减少症组的CD8阳性、程序性细胞死亡蛋白1阳性和程序性死亡配体1阳性细胞明显少于对照组（所有p<0.05）。
我们的研究结果表明，骨肌减少症与肿瘤微环境相关，可能是晚期胃癌患者的预后指标。
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