在结直肠肝转移患者中,通过结合体积体质成分分析,改善了风险分层
Qiang Wang1, Lei Xu1, Binghua Li2
1Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Medical Imaging and Technology, Karolinska Institutet, Stockholm, Sweden; Department of Radiology, Karolinska University Hospital Huddinge, Stockholm, Sweden.
概括
体积体质成分指标,包括骨肌肉和皮下脂肪组织,显著改善结直肠肝转移患者的风险分层. 将这些与现有分数相结合,可以提高肝切除术后的预后.
科学领域:
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
- 手术瘤学手术瘤学
背景情况:
- 结肠直肠肝转移 (CRLM) 在外科瘤学中构成了重大挑战.
- 传统的评分系统,如临床风险评分 (CRS) 和瘤负担评分 (TBS),有助于风险分层.
- 需要加强预后工具,以指导接受肝切除术的CRLM患者的治疗决策.
研究的目的:
- 评估体积体质成分指标在改善风险分层和预后预测方面的附加值.
- 评估骨肌肉 (SKM) 和皮下脂肪组织 (SAT) 测量的实用性.
- 为了确定与CRS和TBS集成的身体组成签名 (BCS) 是否可以改善CRLM患者的结果.
主要方法:
- 对经过肝切除术的186名CRLM患者的回顾性分析.
- 从CT图像中使用人工智能来自动测量手术前体积组成 (SKM,SAT,内脏脂肪组织,肌内脂肪组织).
- 开发基于规则的身体组成特征 (BCS) 和Kaplan-Meier分析生存结果 (OS,DFS,肝脏特异性DFS).
主要成果:
- SKM和SAT是整体生存时间 (OS) 的重要指标.
- 基于SKM和SAT的身体组成签名 (BCS) 有效地将患者分为高风险,中风险和低风险组.
- 综合评分系统 (CRS-BCS和TBS-BCS) 与独立评分相比,显著改善了风险分层和预后预测,具有更高的时间依赖AUC.
结论:
- 术前体积体构分析,特别是SKM和SAT,提供了有价值的预后信息.
- 将BCS与传统评分系统 (CRS和TBS) 整合起来,显著提高了CRLM患者的风险分层和预后预测.
- 这种方法为经过肝切除术的结直肠肝转移患者的管理提供了更精确的工具.
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