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在结直肠癌中作为CT衍生的营养预后标记的手术前骨髓炎和肌肉间脂肪:多中心发展验证研究

Yinghao Cao¹, Yixin Heng², Mingming Song³

¹Department of Digestive Surgical Oncology, Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China; Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China.

Clinical nutrition (Edinburgh, Scotland)

|August 22, 2025

概括

低骨肌肉辐射密度 (SMD) 和高肌肉间脂肪区域 (IMFA) 预测结直肠癌 (CRC) 患者的结果不佳. 使用CT评估的身体组成的联合临床放射学 (CRAD) 模型提高了预后准确性.

科学领域:

癌症学
放射学
身体组成分析

背景情况:

在结肠直肠癌 (CRC) 中,常规的术前成像可以评估身体组成.
这些评估可以加强风险分层,并指导营养干预措施.
需要确定CT评估的肌肉质量和子宫外脂肪的预后值.

研究的目的:

确定CT量化的肌肉质量和子宫外脂肪沉积的预后意义.
评估联合临床放射学 (CRAD) 模型对CRC存活率的预测能力.

主要方法:

对850名 (武汉联合医院) 和647名 (石河大学医院) CRC 患者的回顾性分析.
治疗前腹部CT在L3量化脂肪指标 (VFA,SFA,IMFA) 和肌肉指标 (SMI,SMD).
按性别分类患者;主要终点是总生存率 (OS) 和无病生存率 (DFS).

主要成果:

低骨肌肉辐射密度 (SMD) 和高肌肉间脂肪区域 (IMFA) 是OS的独立预后因素.
较高的IMFA和IMFA/VFA比率与较差的生存状况相关;较高的IMFA和IMFA/SFA比率与DFS相关.
与单独使用TNM或与身体组成相比,CRAD模型对OS和DFS具有更好的预测能力.

结论:

低SMD和高IMFA独立预测CRC的不良结果.
该CRAD模型将CT衍生的身体组成与临床数据整合起来,使得个性化的预后分层成为可能.
这种方法支持有针对性的营养策略,以应对肌肉质量下降和子宫外脂肪积累.

关键词:

大肠直肠癌计算机断层扫描营养风险预测模式麻症肥胖症

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