DCR: 肌肉和脂肪组织对I期至III期结直肠癌患者长期生存的影响

2019-05-22 不详 MedSci原创

肌肉的质量和脂肪的含量是结直肠癌中新出现的预后因素。本研究旨在确定肌肉减少症,肌肉骨骼增生症和肥胖症在I期至III期结直肠癌中作为独立预测因素的作用。

背景: 
肌肉的质量和脂肪的含量是直肠癌中新出现的预后因素。本研究旨在确定肌肉减少症,肌肉骨骼增生症和肥胖症在I期至III期直肠癌中作为独立预测因素的作用。

方法:
本项研究的数据来自于前瞻性收集数据库。研究人员进行多变量Cox比例风险模型以评估身体成分参数和存活之间的关联。纳入的患者包括从2007年到2009年接受根治性切除的I期至III期结直肠癌的成年患者。使用 计算机断层扫描衍生的骨骼肌和脂肪组织定量来确定肌肉减少症,肌肉骨病和总肥胖的人群特异性截断值。主要观察结局为总体,无复发和癌症特异性生存率。

结果:
在968例患者中,共有254例出现疾病复发,350例死亡。体重指数和肥胖指标并未导致更差的生存结果。肌肉减少症可以独立预测总体恶化(HR,1.45; 95%CI,1.16-1.84),无复发(HR,1.32; 95%CI,1.00-1.75)和癌症特异性生存(HR,1.46; 95%CI,1.09-1.94)。肌肉骨病也可独立预测总生存率(HR,1.53; 95%CI,1.19-1.97)。在考虑肌肉减少症和肌肉骨病的关节影响的模型中,两者的存在预测总体最差(HR,2.23; 95%CI,1.62-3.06),无复发(HR,1.53; 95%CI,1.06-2.21)和癌症特异性生存(HR,2.40;多变量模型中95%CI,1.69-3.42)。

结论:
肌肉减少症和肌肉骨病是I期至III期结直肠癌生存率较低的独立预测因素,其联合作用可高度预测总体,无复发和癌症特异性生存率。

原始出处:

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    2020-05-03 juliusluan78
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