How different body compositions affect the prognosis of HCC undergoing immunotherapy: the paradoxical phenomenon of BMI.

IF 9.7 1区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Radiologia Medica Pub Date : 2025-02-01 Epub Date: 2024-12-13 DOI:10.1007/s11547-024-01933-5
Jingzhong Ouyang, Yi Yang, Ying Xu, Zhengzheng Wang, Yanzhao Zhou, Haitao Zhao, Hong Zhao, Jianqiang Cai, Feng Ye, Jinxue Zhou
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引用次数: 0

Abstract

Purpose: Body mass index (BMI) is associated with the prognosis of hepatocellular carcinoma (HCC) receiving immunotherapy. Body compositions are considered to account for this association, but this hypothesis has yet to be verified conclusively.

Material and methods: Our study included 305 patients received immunotherapy at 3 centers between August 2018 and February 2022. We calculated skeletal muscle index (SMI), mean skeletal muscle density (SMD), subcutaneous adipose tissue index (SATI), visceral adipose tissue index (VATI), and visceral to subcutaneous adipose tissue area ratio (VSR) at lumbar 3 level. The influences of BMI and body compositions on overall survival (OS) were comprehensively described.

Results: Sarcopenia (Low SMI, HR = 2.203, 95% CI:1.425-3.405, P < 0.001), myosteatosis (low SMD, HR = 2.013, 95% CI:1.246-3.252, P = 0.004) and visceral adipose deposition (high VATI, HR = 0.658, 95% CI:0.453-0.957, P = 0.028) were independent predictors of OS, while BMI was not. The prognosis of underweight (BMI < 20.0 kg/m2, P = 0.009) and obesity (BMI ≥ 25.0 kg/m2, P = 0.003) were significantly worse than normal weight (20.0 ≤ BMI ≤ 24.9 kg/m2), which might attribute to the differences in body compositions. High VATI had significantly improved OS than low VATI (P = 0.002), and the difference remained significant after propensity score matching (P = 0.017).

Conclusion: In HCC receiving immunotherapy, sarcopenia, myosteatosis, and visceral adipose deposition independently predicted OS, and visceral adipose was protective in OS. The effects of BMI on OS depended on body compositions.

不同体成分如何影响肝癌免疫治疗的预后:BMI的矛盾现象。
目的:体重指数(BMI)与接受免疫疗法的肝细胞癌(HCC)的预后有关。身体成分被认为是造成这种关联的原因,但这一假设还有待最终验证:我们的研究纳入了2018年8月至2022年2月期间在3个中心接受免疫治疗的305名患者。我们计算了骨骼肌指数(SMI)、平均骨骼肌密度(SMD)、皮下脂肪组织指数(SATI)、内脏脂肪组织指数(VATI)以及腰3水平的内脏与皮下脂肪组织面积比(VSR)。结果表明:肉质疏松症(低SMI)患者的总生存率(OS)较高:肌少症(Low SMI,HR = 2.203,95% CI:1.425-3.405,P 2,P = 0.009)和肥胖症(BMI ≥ 25.0 kg/m2,P = 0.003)明显差于正常体重(20.0 ≤ BMI ≤ 24.9 kg/m2),这可能归因于身体成分的差异。与低VATI相比,高VATI患者的OS明显改善(P = 0.002),倾向得分匹配后差异仍然显著(P = 0.017):结论:在接受免疫治疗的HCC患者中,肌肉疏松症、肌骨质疏松症和内脏脂肪沉积可独立预测OS,而内脏脂肪对OS具有保护作用。体重指数对OS的影响取决于身体组成。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Radiologia Medica
Radiologia Medica 医学-核医学
CiteScore
14.10
自引率
7.90%
发文量
133
审稿时长
4-8 weeks
期刊介绍: Felice Perussia founded La radiologia medica in 1914. It is a peer-reviewed journal and serves as the official journal of the Italian Society of Medical and Interventional Radiology (SIRM). The primary purpose of the journal is to disseminate information related to Radiology, especially advancements in diagnostic imaging and related disciplines. La radiologia medica welcomes original research on both fundamental and clinical aspects of modern radiology, with a particular focus on diagnostic and interventional imaging techniques. It also covers topics such as radiotherapy, nuclear medicine, radiobiology, health physics, and artificial intelligence in the context of clinical implications. The journal includes various types of contributions such as original articles, review articles, editorials, short reports, and letters to the editor. With an esteemed Editorial Board and a selection of insightful reports, the journal is an indispensable resource for radiologists and professionals in related fields. Ultimately, La radiologia medica aims to serve as a platform for international collaboration and knowledge sharing within the radiological community.
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