肿瘤预防与治疗2024，Vol.37Issue(4)：301-311,11.DOI:10.3969/j.issn.1674-0904.2024.04.005
骨骼肌退化与食管癌患者根治性放疗后总生存期的相关性研究
Correlation between Skeletal Muscle Degeneration and Overall Survival of Patients with Esophageal Cancer after Radiotherapy
摘要
Abstract
Objective:To investigate the relationship be-tween skeletal muscle degeneration,including sarcopenia(SAR)and myosteatosis(MYO),and overall survival(OS)of patients with esophageal cancer after radiotherapy.Meth-ods:249 eligible esophageal cancer patients in our hospital from January 2013 to December 2017 were retrospectively collect-ed.Body composition parameters of the 3rd lumbar vertebrae,including skeletal muscle area,skeletal muscle index(SMI),skeletal muscle density(SMD),and subcutaneous,visceral and total fat areas,on computed tomography(CT)images were measured;and skeletal muscle quantity and quality,and skeletal muscle deterioration including quantitative(SAR)and qualitative(MYO)deterioration were assessed according to SMI and SMD.The patients were categorized into four groups,Normal,SAR,MYO and combined muscle types,according to muscle type with or without SAR and MYO.Kaplan-Meier method was used to plot the survival curves.Body composition parameters,clinical data,and nutrition and inflammation in-dicators were analyzed by Cox regression models.Results:Univariate analysis showed that Karnofsky Performance Scale in-dex,tumor length,TIVa stage,total cholesterol(TC),triglyceride,systemic immune-inflammation index,neutrophil-to-lymphocyte ratio,platelet-to-lymphocyte ratio(PLR),SAR,and MYO were significant factors influencing patients'OS(P＜0.05).Multivariate analysis showed that tumor length,TⅢ stage,TIVa stage,TC,PLR,SAR and MYO were independ-ent factors affecting patients'OS(P＜0.05).High TC among nutritional indicators was a protective factor for the prognosis of esophageal cancer patients treated with radiotherapy.In addition,high PLR in inflammation indicators was a risk factor for prognosis.When muscle type was used as a categorical variable for COX regression analysis,univariate analysis showed that SAR,MYO and combined muscle types were factors influencing OS,and multivariate analysis showed that only MYO and combined muscle types were independent factors influencing OS.Conclusion:Skeletal muscle degeneration(SAR and MYO)before radiotherapy is an independent risk factor for reduced OS of esophageal cancer patients after radiotherapy.关键词
食管肿瘤/放疗/肌肉减少症/肌肉脂肪浸润/预后Key words
Esophageal neoplasm/Radiotherapy/Sarcopenia/Myosteatosis/Prognosis分类
医药卫生引用本文复制引用
叶怡宏,周鹏,任静,吕家华,聂昕宇,阳宁静..骨骼肌退化与食管癌患者根治性放疗后总生存期的相关性研究[J].肿瘤预防与治疗,2024,37(4):301-311,11.基金项目
This study was supported by grants from Wu Jieping Medical Foundation(No.320·6750·2022-01-1).吴阶平医学基金会临床研究课题(编号:320 ·6750·2022-01-1) （No.320·6750·2022-01-1）
