首页|L3椎体骨骼肌密度变化对食管鳞状细胞癌放化疗患者的预后预测价值

L3椎体骨骼肌密度变化对食管鳞状细胞癌放化疗患者的预后预测价值

扫码查看
目的 探讨放疗前后L3 椎体骨骼肌密度(SMD)变化与食管鳞状细胞癌(ESCC)患者预后之间相关性.方法 本研究对 2012 年3 月至2018 年11 月于四川省肿瘤医院诊断为ESCC的患者进行回顾性病例研究,所有研究对象均测量了放疗前后L3 椎体SMD、L3 椎体骨骼肌面积、L3 椎体皮下脂肪面积、L3 椎体内脏脂肪面积的变化.根据放疗后L3-SMD相较于放疗前改变情况,将L3-SMD>0 定义为增加组,L3-SMD<0 定义为降低组.使用风险比评估放疗前后SMD变化与总生存(OS)期之间的关系.生存分析采用Kaplan-Meier曲线和Cox比例风险模型.结果 258 例ESCC患者中,放疗后L3 椎体SMD增加为 162例,中位随访时间为 22.4 个月(从 3.3 到 92.4 个月不等).通过单、多因素Cox比例风险分析,发现放疗后SMD变化、年龄≥60 岁和肿瘤长度是影响OS期的独立预后因素(P<0.05).结论 放疗前后SMD的变化可作为ESCC患者OS期的预后生物标志物.
Prognostic value of skeletal muscle density change of L3 vertebra in patients with esophageal squamous cell carcinoma treated with radiotherapy and chemotherapy
Objective To investigate the correlation between skeletal muscle density(SMD)of L3 vertebra before and after radiotherapy and prognosis of esophageal squamous cell carcinoma(ESCC).Method This study was a retrospective case study of patients diagnosed with esophageal squamous cell carcinoma between March 2012 and November 2018.The skeletal muscle density of L3 cone,skeletal muscle area of L3 cone,subcutaneous fat area of L3 cone and visceral fat area of L3 cone were measured before and after radiotherapy.Hazard ratios were used to assess the association between changes in SMD and overall survival(OS)before and after radiotherapy.Kaplan-Meier curve and Cox proportional risk model were used for survival analysis.Result Among 258 patients with esophageal squamous cell carcinoma,162 patients in the L3 pyramidal subcutaneous skeletal muscle density increase group after radiotherapy were followed for a median of 22.4 months(ranging from 3.3 to 92.4 months).Through univariate Cox proportional risk analysis,we found that changes in SMD,age≥60 years and tumor length after radiotherapy were independent prognostic factors affecting overall survival(P<0.05).Conclusion Changes in subcutaneous skeletal muscle density before and after radiotherapy can be used as a prognostic biomarker for overall survival in ESCC patients.

Esophageal squamous cell carcinomaSkeletal muscle density of third lumbar vertebraPrognostic model

聂昕宇、阳宁静、吕家华、刘宇笛、李涛

展开 >

西南医科大学临床医学院肿瘤科,四川 泸州 646000

四川省肿瘤医院·研究所,四川省癌症防治中心,电子科技大学附属肿瘤医院,四川 成都 610000

食管鳞状细胞癌 第三腰椎骨骼肌密度 预后模型

2024

肿瘤代谢与营养电子杂志

肿瘤代谢与营养电子杂志

CSTPCD
ISSN:
年,卷(期):2024.11(3)