Skeletal Muscle Index, Tumor and Systemic Immunity, and Survival in Advanced Pancreatic Ductal Adenocarcinoma.

IF 3.5 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2026-10-01 DOI:10.1002/cam4.72378

Yue Ma, Ru Jia, Mengjiao Fan, Guochao Deng, Tieqiang Liu, Yanrong Wang, Yue Li, Nan Zhang, Fang Pang, Yue Shi, Yaoyue Zhang, Yuting Pan, Qi Wang, Zhikuan Wang, Guanghai Dai

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引用次数: 0

Abstract

Background: This study investigated relationships between the skeletal muscle index (SMI) and the tumor immune microenvironment (TIME), peripheral immune phenotypes, and serum biomarkers in advanced pancreatic ductal adenocarcinoma (PDAC) and evaluated the prognostic significance of these parameters.

Methods: A retrospective analysis of 119 advanced PDAC patients was performed. Sarcopenia was diagnosed using sex-specific SMI cut-offs from baseline L3-level computed tomography (CT) images. The TIME was characterized by multiplex immunofluorescence (mIF; n = 31), peripheral immunity by flow cytometry, and serum biomarkers by routine testing. Associations with SMI were examined using Spearman correlation; prognostic relevance was assessed using Cox proportional hazards models.

Results: Sarcopenia (56/119, 47.1%) was associated with shorter progression-free survival (PFS) (8.83 vs. 12.03 months, p = 0.016) and overall survival (OS) (10.20 vs. 17.33 months, p = 0.014). SMI correlated most strongly with stromal CD8⁺ T cells (ρ = 0.52), stromal total T cells (ρ = 0.52), and stromal M2 macrophages (ρ = 0.50) in the TIME; with circulating Th2-like cells (ρ = -0.58) and CD4⁺ memory T cells (ρ = 0.45) peripherally; and with hemoglobin (ρ = 0.32) among serum markers. In multivariable Cox regression, stromal CD4⁺ Treg percentage independently predicted OS (hazard ratio [HR] = 7.60, 95% confidence interval [CI] 1.60-36.22, p = 0.011), stromal CD56dim natural killer (NK)-cell density predicted PFS (HR = 1.015, 95% CI 1.001-1.028, p = 0.031), and the lymphocyte-to-monocyte ratio (LMR) predicted both PFS (HR = 0.86, p = 0.023) and OS (HR = 0.83, p = 0.009). No peripheral lymphocyte subset reached prognostic significance.

Conclusion: SMI is broadly associated with local and systemic immune phenotypes in advanced PDAC. Stromal CD4⁺ regulatory T cells (Tregs), CD56dim NK cells, and LMR carry independent prognostic information and may complement body-composition assessment.

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晚期胰腺导管腺癌的骨骼肌指数、肿瘤和全身免疫以及生存。

背景：本研究探讨了晚期胰腺导管腺癌（PDAC）骨骼肌指数（SMI）与肿瘤免疫微环境（TIME）、外周免疫表型和血清生物标志物之间的关系，并评估了这些参数的预后意义。方法：对119例晚期PDAC患者进行回顾性分析。骨骼肌减少症的诊断使用基线l3级计算机断层扫描（CT）图像的性别特异性SMI截断值。采用多重免疫荧光（mIF; n = 31）、流式细胞术检测外周免疫、常规检测血清生物标志物对TIME进行表征。使用Spearman相关检验与重度精神分裂症的关系；采用Cox比例风险模型评估预后相关性。结果：肌肉减少症（56/119,47.1%）与较短的无进展生存期（PFS）（8.83 vs 12.03个月，p = 0.016）和总生存期（OS）（10.20 vs 17.33个月，p = 0.014）相关。SMI与基质CD8+ T细胞（ρ = 0.52）、基质总T细胞（ρ = 0.52）、基质M2巨噬细胞（ρ = 0.50）相关性最强；外周血有循环th2样细胞（ρ = -0.58）和CD4+记忆T细胞（ρ = 0.45）；血清指标与血红蛋白（ρ = 0.32）一致。在多变量Cox回归中，基质CD4+ Treg百分比独立预测OS（风险比[HR] = 7.60, 95%可信区间[CI] 1.60 ~ 36.22, p = 0.011），基质CD56dim自然杀伤细胞（NK）细胞密度预测PFS (HR = 1.015, 95% CI 1.001 ~ 1.028, p = 0.031)，淋巴细胞/单核细胞比率（LMR）预测PFS （HR = 0.86, p = 0.023）和OS （HR = 0.83, p = 0.009）。外周淋巴细胞亚群无预后意义。结论：SMI与晚期PDAC的局部和全身免疫表型广泛相关。基质CD4+调节性T细胞（Tregs）、CD56dim NK细胞和LMR携带独立的预后信息，可以补充机体成分评估。

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

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.