人体测量学指标在胃癌中的预后意义：一项多中心队列研究
Prognostic significance of anthropometric measurements in gastric cancer: a multicenter cohort study.
作者信息
Xie Hailun, Wei Lishuang, Wang Shuyao, Shi Hanping, Chen Junqiang
机构信息
Department of Gastrointestinal and Gland Surgery, the First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China.
Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China.
出版信息
Support Care Cancer. 2025 Aug 13;33(9):783. doi: 10.1007/s00520-025-09849-0.
PURPOSE
Anthropometric measurements are practical tools for nutritional assessment, yet their prognostic value in gastric cancer remains understudied. This multicenter cohort study aimed to evaluate the association of multidimensional anthropometric parameters with overall survival (OS), metastasis, malnutrition, and cachexia in gastric cancer patients.
METHODS
This multicenter cohort study enrolled 2,343 patients with gastric cancer. Baseline anthropometric measurements, including body mass index (BMI), mid-arm circumference (MAC), triceps skinfold thickness (TSF), mid-arm muscle circumference (MAMC), mid-arm muscle area (MAMA), calf circumference (CC), and handgrip strength (HGS), were collected. Survival outcomes were evaluated using Kaplan-Meier analysis and Cox regression analysis. Receiver operating characteristic (ROC) curves and C-index were used to compare the prognostic accuracy of anthropometric measurements. Logistic regression analysis assessed associations with metastasis, severe malnutrition, and cachexia.
RESULTS
Cox regression analysis revealed that higher anthropometric measurements were significantly associated with improved OS. Specifically, higher CC (HR = 0.658, 95% CI 0.581-0.746, p < 0.001) demonstrated the strongest protective effects against survival. ROC curves showed that CC had the best predictive performance in both males (AUC = 0.712) and females (AUC = 0.689), followed by BMI (males AUC = 0.698, females AUC = 0.673). C-index comparison further validated the advantage of CC, with slightly higher predictive accuracy in males (C-index = 0.574) and females (C-index = 0.576) compared to BMI (males 0.571, females 0.545). Logistic regression analysis indicated that higher anthropometric measurements were associated with lower odds of metastasis, severe malnutrition, and cachexia. Notably, MAC performed best in assessing malnutrition, followed by CC.
CONCLUSION
Anthropometric measurements, particularly CC, are robust predictors of OS, metastasis, malnutrition, and cachexia in gastric cancer patients.
目的
人体测量是营养评估的实用工具，但其在胃癌中的预后价值仍研究不足。这项多中心队列研究旨在评估多维人体测量参数与胃癌患者总生存期（OS）、转移、营养不良和恶病质之间的关联。
方法
这项多中心队列研究纳入了2343例胃癌患者。收集了基线人体测量数据，包括体重指数（BMI）、上臂中部周长（MAC）、三头肌皮褶厚度（TSF）、上臂中部肌肉周长（MAMC）、上臂中部肌肉面积（MAMA）、小腿周长（CC）和握力（HGS）。使用Kaplan-Meier分析和Cox回归分析评估生存结局。采用受试者工作特征（ROC）曲线和C指数比较人体测量的预后准确性。逻辑回归分析评估与转移、严重营养不良和恶病质的关联。
结果
Cox回归分析显示，较高的人体测量值与改善的总生存期显著相关。具体而言，较高的小腿周长（HR = 0.658，95%CI 0.581 - 0.746，p < 0.001）对生存具有最强的保护作用。ROC曲线显示，小腿周长在男性（AUC = 0.712）和女性（AUC = 0.689）中具有最佳预测性能，其次是体重指数（男性AUC = 0.698，女性AUC = 0.673）。C指数比较进一步验证了小腿周长的优势，与体重指数相比，其在男性（C指数 = 0.574）和女性（C指数 = 0.576）中的预测准确性略高（男性体重指数0.571，女性体重指数0.545）。逻辑回归分析表明，较高的人体测量值与转移、严重营养不良和恶病质的较低几率相关。值得注意的是，上臂中部周长在评估营养不良方面表现最佳，其次是小腿周长。
结论
人体测量，尤其是小腿周长，是胃癌患者总生存期、转移、营养不良和恶病质的有力预测指标。
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