An exploratory study of serum creatine kinase as a prognostic marker for patients with resectable pancreatic cancer: looking into the relationship with body composition.

IF 4.4 2区医学 Q1 NUTRITION & DIETETICS

Nutrition Journal Pub Date : 2025-02-01 DOI:10.1186/s12937-025-01084-x

Cong Chen, Xin Luo, Xianchao Lin, Ronggui Lin, Yuanyuan Yang, Congfei Wang, Haizong Fang, Tianhong Teng, Heguang Huang, Fengchun Lu

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引用次数: 0

Abstract

Background: Among cancer patients, pancreatic cancer patients have the highest rate of sarcopenia, which is a critical prognostic factor. Serum creatine kinase (CK) is closely related to skeletal muscle mass and has been reported to decline with the progression of cancer. This study investigated whether preoperative serum CK is associated with the survival of patients with pancreatic cancer.

Methods: Data were obtained from patients with pathologically confirmed pancreatic cancer between June 2016 and March 2022. The prognostic significance of CK was analyzed based on sex-stratified groups. The Kaplan-Meier method was used to compare overall survival (OS) and disease-free survival (DFS). Multivariate Cox proportional hazards models were used to determine prognostic factors. Body composition was analyzed based on preoperative abdominal CT images to explore the sex-specific associations between skeletal muscle area (SMA) and serum CK levels.

Results: A total of 166 patients were included in this study. Sarcopenia was presented in 70 patients (42.2%). A low serum CK level showed a significant correlation with the diagnosis of sarcopenia in male patients (P = 0.026). The levels of CK did not predict the outcome in female patients, while a low preoperative CK was notably linked to shorter OS in male patients (median OS: 15 months vs. 33 months, P = 0.011; median DFS: 5 months vs. 14 months, P = 0.007). Multivariate analyses further confirmed the effect of CK in predicting OS (CK>44 IU/L, HR:0.226, 95% CI:0.107-0.478, P < 0.001) and DFS (CK>44 IU/L, HR:0.272, 95% CI:0.139-0.529, P < 0.001) of male patients. Correlation analysis revealed a significant association between SMA and CK levels in male patients (r = 0.225, P = 0.025), and such a correlation was not observed in female patients (r = 0.088, P = 0.478).

Conclusion: The pretherapeutic CK may represent a simple marker for predicting poor survival in male patients with resectable pancreatic cancer, thereby aiding in the selection of therapeutic strategies.

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血清肌酸激酶作为可切除胰腺癌患者预后指标的探索性研究：探讨其与身体成分的关系。

背景：在癌症患者中，胰腺癌患者肌肉减少率最高，是影响预后的重要因素。血清肌酸激酶（CK）与骨骼肌质量密切相关，并随着癌症的进展而下降。本研究探讨术前血清CK是否与胰腺癌患者的生存相关。方法：数据来自2016年6月至2022年3月间病理证实的胰腺癌患者。根据性别分组分析CK的预后意义。Kaplan-Meier法比较总生存期（OS）和无病生存期（DFS）。采用多变量Cox比例风险模型确定预后因素。根据术前腹部CT图像分析身体组成，探讨骨骼肌面积（SMA）与血清CK水平之间的性别特异性关联。结果：本研究共纳入166例患者。70例（42.2%）患者出现肌肉减少症。低血清CK水平与男性患者肌少症的诊断有显著相关性（P = 0.026）。CK水平不能预测女性患者的预后，而术前低CK与男性患者较短的生存期显著相关(中位生存期：15个月vs 33个月，P = 0.011；中位生存期：5个月vs. 14个月，P = 0.007)。多因素分析进一步证实了CK对OS的预测作用（CK bb0 44 IU/L, HR:0.226, 95% CI:0.107 ~ 0.478, P 44 IU/L, HR:0.272, 95% CI:0.139 ~ 0.529， P）。结论：治疗前CK可作为预测男性可切除胰腺癌患者生存不良的简单指标，从而有助于选择治疗策略。

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

Nutrition Journal NUTRITION & DIETETICS-

CiteScore

9.80

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： Nutrition Journal publishes surveillance, epidemiologic, and intervention research that sheds light on i) influences (e.g., familial, environmental) on eating patterns; ii) associations between eating patterns and health, and iii) strategies to improve eating patterns among populations. The journal also welcomes manuscripts reporting on the psychometric properties (e.g., validity, reliability) and feasibility of methods (e.g., for assessing dietary intake) for human nutrition research. In addition, study protocols for controlled trials and cohort studies, with an emphasis on methods for assessing dietary exposures and outcomes as well as intervention components, will be considered. Manuscripts that consider eating patterns holistically, as opposed to solely reductionist approaches that focus on specific dietary components in isolation, are encouraged. Also encouraged are papers that take a holistic or systems perspective in attempting to understand possible compensatory and differential effects of nutrition interventions. The journal does not consider animal studies. In addition to the influence of eating patterns for human health, we also invite research providing insights into the environmental sustainability of dietary practices. Again, a holistic perspective is encouraged, for example, through the consideration of how eating patterns might maximize both human and planetary health.