Nature：结肠癌患者CT衍生的身体成分及与年龄、TNM分期和全身炎症的差异相关性-动脉网

Nature：CT-derived body composition and differential association with age, TNM stage and systemic inflammation in patients with colon cancer

Nature 等信源发布 2024-07-08 20:03

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AbstractLow skeletal muscle index/density (SMI/SMD) is prevalent in cancer, adversely prognostic and associated with tumour stage and the systemic inflammatory response (SIR). Age and SMI/SMD has not been widely studied. The present study analyses the association between age and SMI/SMD after adjustment for other clinicopathological factors.

摘要低骨骼肌指数/密度（SMI/SMD）在癌症中普遍存在，预后不良，并与肿瘤分期和全身炎症反应（SIR）相关。年龄和SMI/SMD尚未得到广泛研究。本研究分析了调整其他临床病理因素后年龄与SMI/SMD之间的关系。

Patients undergoing resectional surgery for TNM Stage I-III disease within the West of Scotland between 2011 and 2014 were identified. A single CT slice was obtained from each patients staging CT scan. SMI and SMD were stratified normal/abnormal. The SIR was stratified using Systemic Inflammatory Grade (SIG).

确定了2011年至2014年间在苏格兰西部接受TNM I-III期疾病切除手术的患者。从每个分期CT扫描的患者获得单个CT切片。SMI和SMD分层正常/异常。SIR使用全身炎症分级（SIG）进行分层。

When stratified by age (< 50/50s/60s/70s/80+), 39%/38%/48%/62%/74% and 27%/48%/64%/82%/92% of patients had a low SMI and SMD respectively (both p < 0.001). Older age (OR 1.47, p < 0.001), female sex (OR 1.32, p = 0.032), lower socioeconomic deprivation (OR 1.15, p = 0.004), higher ASA (OR 1.30, p = 0.019), emergency presentation (OR 1.82, p = 0.003), lower BMI (OR 0.67, p < 0.002) and higher SIG (OR 1.23, p < 0.001) were independently associated with low SMI.

当按年龄（50/50/60/70/80+）分层时，分别有39%/38%/48%/62%/74%和27%/48%/64%/82%/92%的患者SMI和SMD较低（均p<0.001）。年龄较大（OR 1.47，p0.001），女性（OR 1.32，p0.032），社会经济剥夺程度较低（OR 1.15，p0.004），ASA较高（OR 1.30，p0.019），急诊（OR 1.82，p0.003），BMI较低（OR 0.67，p0.002），SIG较高（OR 1.23，p<0.001）与低SMI独立相关。

Older age (OR 2.28, p < 0.001), female sex (OR 1.38, p = 0.038), higher ASA (OR 1.92, p < 0.001), emergency presentation (OR 1.71, p = 0.023), and higher SIG (OR 1.37, p < 0.001) were independently associated with lower SMD. Tumour factors were not independently associated with either SMI/SMD. Age was a major factor associated with low SMI/SMD in patients with colon cancer.

年龄较大（OR 2.28，p<0.001），女性（OR 1.38，p<0.038），ASA较高（OR 1.92，p<0.001），紧急情况（OR 1.71，p<0.023）和较高的SIG（OR 1.37，p<0.001）与较低的SMD独立相关。肿瘤因素与SMI/SMD均无独立相关性。年龄是结肠癌患者SMI/SMD低的主要因素。

Therefore, in these patients it is likely that this represents largely constitutional body composition as opposed to being a disease mediated effect. Adjustment for age is required when considering the cancer mediated effect on SMI/SMD in patients with colon cancer..

因此，在这些患者中，这很可能在很大程度上代表了体质成分，而不是疾病介导的作用。考虑到癌症介导的结肠癌患者SMI/SMD的影响时，需要调整年龄。。

IntroductionSarcopenia, coined by Irwin Rosenbeg in 19891 for an age-related reduction in lean muscle mass, until recently, had no widely accepted definition or diagnostic criteria. In 2009 (and subsequently updated in 20192, the Sarcopenia Working Group defined sarcopenia as “progressive and generalized loss of skeletal muscle mass and strength” that may be primary (aging) or secondary (including disease, nutrition or activity related).

引言肌肉减少症，由欧文·罗森贝格（IrwinRosenbeg）于19891年创造，用于与年龄相关的瘦肌肉质量减少，直到最近，还没有被广泛接受的定义或诊断标准。2009年（随后于20192年更新），肌肉减少症工作组将肌肉减少症定义为“进行性和全身性骨骼肌质量和力量丧失”，可能是原发性（衰老）或继发性（包括疾病，营养或活动相关）。

Low muscle mass combined with impairment of muscle function, has been recognized for decades however was only defined as an independent disease entity within the ICD-10 classification in 20163. This has corresponded with an increased research output around body composition, in particular low skeletal muscle mass/strength (sarcopenia) and low skeletal muscle density within a number of areas of clinical practice, including cancer.Multiple modalities of stratifying body composition including dual energy x-ray absorptiometry (DXA), computed tomography (CT) and magnetic resonance imaging (MRI) techniques have been described4.

几十年来，人们已经认识到低肌肉质量与肌肉功能受损相结合，但仅在20163年的ICD-10分类中被定义为独立的疾病实体。这与围绕身体成分的研究成果增加相对应，特别是在包括癌症在内的许多临床实践领域内，骨骼肌质量/强度低（肌肉减少症）和骨骼肌密度低。已经描述了多种分层身体成分的方式，包括双能x射线吸收测定法（DXA），计算机断层扫描（CT）和磁共振成像（MRI）技术4。

Within oncology, the use of CT imaging for stratification of skeletal muscle mass/density dominates the literature, due to the widespread availability of CT imaging routinely carried out for cancer staging5. Predominantly, a single CT slice obtained at the level of the third lumbar vertebrae is analyzed with muscle area and density being stratified as previously described by Martin and colleagues6.

在肿瘤学中，由于常规用于癌症分期的CT成像的广泛可用性，使用CT成像对骨骼肌质量/密度进行分层在文献中占主导地位5。主要是，如Martin及其同事先前所述，分析在第三腰椎水平获得的单个CT切片，并对肌肉面积和密度进行分层6。

Low skeletal muscle mass (based on CT image analysis) is typically used as a surrogate for sarcopenia.In patients with cancer, low skeletal muscle mass has been reported to be highly prevalent. A recent meta-analysis by Surov and colleagues7 including approximately 80,000 patients with solid organ tumours reported an overall .

低骨骼肌质量（基于CT图像分析）通常用作肌肉减少症的替代指标。据报道，在癌症患者中，低骨骼肌质量非常普遍。Surov及其同事最近进行的一项荟萃分析[7]包括约80000例实体器官肿瘤患者，总体报告。

Data availability

数据可用性

Data is available on request. The corresponding author (Allan Golder) should be contacted for such requests.

数据可根据要求提供。应联系通讯作者（Allan Golder）以获取此类请求。

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Download referencesAuthor informationAuthors and AffiliationsAcademic Unit of Surgery, University of Glasgow, Level 2, New Lister Building, Glasgow Royal Infirmary, Glasgow, G31 2ER, UKAllan M. Golder, Michael Ferguson, Paul McMillan, David Mansouri, Paul G. Horgan, Campbell S. Roxburgh, Ross D.

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Reprints and permissionsAbout this articleCite this articleGolder, A.M., Ferguson, M., McMillan, P. et al. CT-derived body composition and differential association with age, TNM stage and systemic inflammation in patients with colon cancer.

转载和许可本文引用本文Golder，A.M.，Ferguson，M.，McMillan，P。等人。结肠癌患者CT衍生的身体成分以及与年龄，TNM分期和全身炎症的差异关联。

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KeywordsAgeSarcopeniaBody compositionCTCancerColorectal

关键词sagesarcopeniabody compositionctcancercolorectal

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BiomarkersCancer epidemiologyCancer imagingCancer metabolismColorectal cancerGastrointestinal cancer

生物标志物癌症流行病学癌症成像癌症代谢直肠癌胃肠道癌

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