在接受治疗的食道癌症患者中,CT定义的身体组成的预后意义
Hannah Götze1, Stefan Niebisch2, Matthias Mehdorn2
1Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, Leipzig, Liebigstr. 20, 04103, Leipzig, Germany.
Surgical oncology
|September 5, 2025
概括
在接受治疗的食道癌症患者中,身体构成,包括肉和内脏肥胖症,显著影响生存率. 结合这些因素提供了比单独评估更强的预后价值.
科学领域:
- 癌症学
- 放射学
- 身体组成分析
背景情况:
- 身体组成,包括低骨肌量 (LSMM) 和脂肪组织 (内脏和皮下),可通过横截图测量.
- 之前的研究表明,在包括食道癌 (EC) 在内的各种癌症中,身体成分具有预后价值.
- 在接受治疗的EC患者中,了解身体成分的作用对于预后评估至关重要.
研究的目的:
- 研究身体组成参数 (LSMM,内脏脂肪组织 (VAT),皮下脂肪组织 (SAT)) 与EC患者的生存率之间的关联.
- 单独和组合地确定萨科佩尼亚和内脏肥胖症对EC总生存的预后意义.
主要方法:
- 在2016年至2023年期间治疗的145名EC患者的回顾性分析.
- 使用计算机断层扫描 (CT) 来计算LSMM (通过骨肌肉指数[SMI]),VAT和SAT.
- 统计分析包括曼- 惠特尼测试,卡普兰- 梅尔曲线和多变量考克斯回归以评估对全因总生存时间的影响.
主要成果:
- 在研究队列中,皮症 (68. 2%) 和内脏肥胖症 (70. 3%) 是普遍存在的.
- 在单独分析中,肉 (HR 2. 05) 和内脏肥胖 (HR 2.47) 与死亡率的增加有关.
- 在多变量分析中,sarcopenic肥胖症与死亡率有显著的关联 (HR 2.47).
结论:
- 对于接受治疗切除的EC患者来说,CT定义的肉症和内脏肥胖症,特别是结合起来,是显著的预后指标.
- 评估人体组成参数一起提供更大的预后相关性,而不是单独评估.
- 基于CT的身体组成分析可以帮助分层EC患者的不良结果风险较高.
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