Diagnostic utility of the preoperative cachexia index for malnutrition in colorectal cancer: A prospective cohort study.

IF 2.4 4区医学 Q3 ONCOLOGY

Surgical Oncology-Oxford Pub Date : 2025-10-01 Epub Date: 2025-08-06 DOI:10.1016/j.suronc.2025.102275

Katarzyna Chawrylak, Wojciech Górski, Katarzyna Sędłak, Radoslaw Mlak, Marta Kaus, Agnieszka Hotloś, Zuzanna Chilimoniuk, Konrad Gładysz, Katarzyna Mielniczek, Magdalena Leśniewska, Zuzanna Pelc, Michał Bednarz, Wiktor Grela, Natalia Gniaź, Aleksandra Górska, Karolina Kasprzak, Damian Wach, Albert Chomątowski, Jakub Stawikowski, S Vincent Grasso, Marcin Kubiak, Andrew Gumbs, Timothy M Pawlik, Wojciech P Polkowski, Karol Rawicz- Pruszyński

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引用次数: 0

Abstract

Background: Cachexia is a multifactorial syndrome characterized by weight and muscle loss, often linked to malnutrition and inflammation. Malnutrition affects almost 40 % of colorectal cancer (CRC) patients, contributing to worse surgical outcomes, higher morbidity, and increased mortality. This study evaluates the Cachexia Index (CXI) for malnutrition detection in CRC patients.

Patients and methods: Seventy patients (54.3 % men; median age 65) underwent bioelectrical impedance analysis, blood tests, and nutritional assessments before surgery. Patients were recruited between November 1, 2023, and October 30, 2024. CXI, calculated as [Skeletal Mass Index × Serum Albumin]/Neutrophil-to-Lymphocyte-Ratio, was compared with the Subjective Global Assessment.

Results: The median CXI was 13.7 (range: 1.9-53.8), with malnourished or at-risk patients exhibiting significantly lower median CXI values (9.5 vs. 14.9; p = 0.0262) than well-nourished individuals. Tumor location also influenced CXI; patients with sigmoid colon tumors had the highest median CXI, while those with caecum tumors had the lowest (22.2 vs. 8.2; p = 0.0202). CXI demonstrated 100 % sensitivity and 60 % specificity for malnutrition detection, with a cutoff of ≤12.09 (AUC = 0.80; 95 % CI: 0.69-0.89; p < 0.0001). Malnourished patients had a significantly lower median CXI (9.5 vs. 14.9; p = 0.0262).

Conclusions: These findings support CXI as a reliable, non-invasive biomarker for malnutrition in CRC patients, with potential applications in personalized nutritional and therapeutic care.

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术前恶病质指数对结直肠癌患者营养不良的诊断价值：一项前瞻性队列研究。

背景：恶病质是一种以体重和肌肉减少为特征的多因素综合征，通常与营养不良和炎症有关。几乎40%的结直肠癌（CRC）患者营养不良，导致手术结果更差、发病率更高和死亡率增加。本研究评价恶病质指数（Cachexia Index， CXI）在CRC患者营养不良检测中的应用价值。患者和方法：70例(男性54.3%；中位年龄65岁)在手术前进行了生物电阻抗分析、血液检查和营养评估。患者于2023年11月1日至2024年10月30日期间招募。CXI计算方法为[骨量指数×血清白蛋白]/中性粒细胞与淋巴细胞比值，与主观总体评价进行比较。结果：中位CXI为13.7（范围：1.9-53.8），营养不良或高危患者的中位CXI值明显较低(9.5 vs. 14.9；P = 0.0262)。肿瘤位置也影响CXI；乙状结肠肿瘤患者的中位CXI最高，盲肠肿瘤患者的中位CXI最低(22.2 vs 8.2；p = 0.0202)。CXI检测营养不良的灵敏度为100%，特异性为60%，截止值≤12.09 (AUC = 0.80；95% ci: 0.69-0.89；结论：这些发现支持CXI作为CRC患者营养不良的可靠、无创生物标志物，在个性化营养和治疗护理中具有潜在的应用前景。

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

Surgical Oncology-Oxford 医学-外科

CiteScore

4.50

自引率

0.00%

发文量

169

审稿时长

38 days

期刊介绍： Surgical Oncology is a peer reviewed journal publishing review articles that contribute to the advancement of knowledge in surgical oncology and related fields of interest. Articles represent a spectrum of current technology in oncology research as well as those concerning clinical trials, surgical technique, methods of investigation and patient evaluation. Surgical Oncology publishes comprehensive Reviews that examine individual topics in considerable detail, in addition to editorials and commentaries which focus on selected papers. The journal also publishes special issues which explore topics of interest to surgical oncologists in great detail - outlining recent advancements and providing readers with the most up to date information.