| 肌内脂肪浸润与食管癌术后肌肉减少症的相关性分析 |
| 投稿时间：2025-02-13 修订日期：2025-03-01 点此下载全文 |
| 引用本文：郑世铭,张勐,王成,班冰冰,李隆乾,秦卓霖,菅启航,杨建宝.肌内脂肪浸润与食管癌术后肌肉减少症的相关性分析[J].医学研究杂志,2025,54(7):145-151 |
| DOI：
10.11969/j.issn.1673-548X.2025.07.026 |
| 摘要点击次数: 4 |
| 全文下载次数: 7 |
|
| 基金项目:甘肃省兰州市科技计划项目(2023-4-38) |
|
| 中文摘要:目的 探究影响食管癌术后发生肌肉减少症的相关因素,分析骨骼肌脂肪浸润与食管癌术后发生肌肉减少症的相关性。方法 回顾性分析在2020年1月～2022年12月在兰州大学第二医院胸外科接受食管癌根治性切除术的患者的临床资料,根据术后骨骼肌面积丢失率是否大于10%,将患者分为肌肉减少症组(n=50)和非肌肉减少症组(n=69)。收集患者的一般资料、围术期相关资料及影像学资料。使用R.3.1.4软件进行统计学分析,临界值根据受试者工作特征(receiver operating characteristic, ROC)曲线计算。结果 肌肉减少症组和非肌肉减少症组患者术后是否化疗、淋巴细胞、骨骼肌面积、骨骼肌指数、预后营养指数和肌内脂肪组织含量比较,差异有统计学意义(P＜0.05)。第3腰椎骨骼肌肌内脂肪含量与术后发生肌肉减少症存在相关性(r=0.21,P<0.05),但与术前骨骼肌面积无相关性(r=-0.07,P=0.45)。多因素Logistic回归分析显示,术前肌内脂肪含量、骨骼肌指数及术后接受化疗是术后肌肉减少症发生的独立预测因素。ROC曲线分析提示,术前第3腰椎骨骼肌肌内脂肪组织含量临界值为-0.647时,对食管癌术后发生肌肉减少症的预测效能最佳(曲线下面积为0.630,敏感度为80.00%,特异性为47.80%)。结论 食管癌患者第3腰椎层面骨骼肌脂肪浸润程度与术后肌肉减少症相关,对高脂肪浸润的食管癌患者早期实施营养支持和康复训练,可以预防术后肌肉减少症的发生。 |
| 中文关键词:食管癌 肌肉减少症 骨骼肌脂肪浸润 |
| |
| Association between Intramuscular Fat Infiltration and Postoperative Sarcopenia in Esophageal Cancer. |
|
|
| Abstract:Objective To explore the factors influencing the occurrence of sarcopenia following esophageal cancer surgery and to assess the association between skeletal muscle fat infiltration and postoperative sarcopenia. Methods The retrospective study analyzed clinical data from patients who underwent radical esophagectomy in the Department of Thoracic Surgery at the Second Hospital of Lanzhou University between January 2020 and December 2022. Based on whether the postoperative loss of skeletal muscle area exceeded 10%, patients were categorized into a sarcopenia group (n=50) and a non-sarcopenia group (n=69). General clinical information, perioperative data, and imaging findings were collected. Statistical analyses were performed using R version 3.1.4, and cutoff values were determined by receiver operating characteristic (ROC) curve analysis. Results There were statistically significant differences between the sarcopenia and non-sarcopenia groups in terms of postoperative chemotherapy, lymphocyte count, skeletal muscle area, skeletal muscle index, prognostic nutritional index, and intramuscular fat content (P ＜ 0.05). At the level of the third lumbar vertebra, intramuscular fat content was significantly correlated with the rate of postoperative skeletal muscle loss (r=0.21, P ＜ 0.05), but showed no correlation with the preoperative skeletal muscle area (r=-0.07, P=0.45). Multivariate Logistic regression analysis revealed that preoperative intramuscular fat content, skeletal muscle index, and postoperative chemotherapy were independent predictors of postoperative sarcopenia. ROC curve analysis indicated that a cutoff value of -0.647 for preoperative intramuscular fat content at the third lumbar vertebra provided the optimal predictive efficacy for postoperative sarcopenia in esophageal cancer patients [area under the curve (AUC)=0.630, sensitivity=80.00%, specificity=47.80%]. Conclusions The degree of skeletal muscle fat infiltration at the L3 level is significantly associated with the development of postoperative sarcopenia in patients with esophageal cancer. Early nutritional support and rehabilitation training in patients with high fat infiltration may help prevent the occurrence of postoperative sarcopenia. |
| keywords:Esophageal cancer Sarcopenia Myosteatosis |
| 查看全文 查看/发表评论 下载PDF阅读器 |
|
|
|
