Clinical Nutrition:身体成分参数可以预测接受新辅助治疗后局部晚期胃癌患者预后

2021-07-03 MedSci原创 MedSci原创

胃肠道肿瘤手术患者常出现肌肉减少症和内脏脂肪肥胖,而身体成分特征影响多种癌症的预后。

       胃肠道肿瘤手术患者常出现肌肉减少症和内脏脂肪肥胖,而身体成分特征影响多种癌症的预后;身体成分在新辅助治疗 (NT) 后局部晚期胃癌 (LAGC) 患者中的作用尚未得到很好地研究,因此,本项研究旨在对接受新辅助治疗后局部晚期胃癌患者进行身体成分的测量以预测其疾病预后。

 

       研究人员对213名在中国南方的患者进行了相关检查,所有患者都是接受 NT 后胃切除术的 LAGC 患者。此外,分别对来自中国西部170 名和意大利的77 名患者进行了外部验证。骨骼肌指数 (SMI)、骨骼肌放射密度 (SMD) 以及皮下和内脏肥胖指数在诊断时和术前通过临床CT扫描获得。

 

      总体而言,所有患者接受NT后没有任何身体成分参数发生显着变化。NT前骨骼肌放射密度(SMD)和SMI变化(ΔSMI)在反应不佳的患者中均显着降低,根据约登指数计算的临界值SMD为 43.7 而ΔSMI为1.2。基于这两个参数,提出了一种新模型骨骼肌评分 (SMS) 来预测病理反应。此外,SMI 损失 >1.2 的患者的引流管移除时间显着延长(平均值:10.0 VS  8.2,P = 0. 003)和术后住院时间(11.1 vs 9.8,P = 0.048),以及术后并发症发生率显着升高(30.9% vs 16.7%,P = 0.015)。在多变量分析中,SMI 损失 >1.2 独立预测较差的总生存期(HR:1.677,95% CI 1.040-2.704,P = 0.034)和无复发生存期(HR:1.924,95% CI 1.165-3.175,P = 0.011)相关。

 

       本项研究证实对于 LAGC患者,接受NT治疗前 SMD 和 ΔSMI 水平可以准确预测 NT 后的病理反应。SMI 损失 >1.2 与较差的结果密切相关。

 

 

原始出处:

Jian-Xian Lin. Et al. Body composition parameters predict pathological response and outcomes in locally advanced gastric cancer after neoadjuvant treatment: A multicenter, international study. Clinical Nutrition.2021.

 

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  5. 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  6. 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  7. 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    2021-07-05 chg122
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    2021-07-04 词小调

    谢谢分享

    0

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