结肠癌中肌肉质量、内脏脂肪和组织学肿瘤间质特征之间的关系。

IF 2.9 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-02-01 DOI:10.1016/j.clnesp.2024.12.012

Cor Ravensbergen , Robert van Kooten , Stijn Crobach , Hein Putter , Willem Grootjans , Ana Navas Cañete , Koen Peeters , Rob Tollenaar , Wilma Mesker

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引用次数: 0

摘要

背景与目的：肌少症和肥胖是结肠癌预后不良的指标。此外，侵袭性的组织病理学肿瘤间质特征，如低肿瘤间质比（TSR）和低肿瘤浸润淋巴细胞（TILs）预测生存和治疗反应。由于它们之间的关系尚不清楚，我们研究了结肠癌患者骨骼肌质量、内脏脂肪组织（VAT）、TSR和TILs之间的关系。方法：194例II/III期结肠癌患者行择期手术。术前计算机断层扫描（CT）根据骨骼肌指数（正常/低）和内脏脂肪组织指数（正常/高）将患者分为四组。评估肿瘤组织的TSR和TILs，并评估5年的疾病复发和相对危害。结果：正常肌、正常增值56例（28.9%），正常肌、高增值26例（13.4%），低肌、正常增值75例（38.7%），低肌、高增值37例（19.1%）。骨骼肌质量低的患者多为男性（62.5%比39%，P = 0.005）。基质-高肿瘤在低肌、正常增值税率患者中较少见（24%），而在正常肌、高增值税率（50%）、低肌、高增值税率（48.6%）和正常肌、正常增值税率（41.1%）患者中较少见（P = 0.020）。低TILs的肿瘤在各组间分布相似（P = 0.679）。低肌、正常增值率患者的复发风险低于低肌、高增值率患者（风险比[HR] 0.34, 95% CI 0.12-0.98, P = 0.048）和正常肌、正常增值率患者（风险比[HR] 0.31, 95% CI 0.11-0.87, P = 0.027）。结论：与低肌、高增值率的结肠癌患者相比，低肌、正常增值率的结肠癌患者表现出更少的侵袭性肿瘤特征和更低的复发风险。这些发现强调了机体成分在肿瘤生物学和预后中的重要性。

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Association between muscle mass, visceral adiposity, and histologic tumor stromal features in colon cancer

Background & aims

Sarcopenia and obesity are indicators for poor outcomes in colon cancer. Additionally, aggressive histopathologic tumor stromal features, such as a low tumor-stroma ratio (TSR) and low tumor-infiltrating lymphocytes (TILs) predict survival and treatment response. As their relationship remains underexplored, we studied the association between skeletal muscle mass, visceral adipose tissue (VAT), TSR, and TILs in patients with colon cancer.

Methods

We studied 194 stage II/III colon carcinoma patients who underwent elective surgery. Preoperative computed tomography (CT) scans classified patients into four groups based on skeletal muscle index (normal/low) and visceral adipose tissue index (normal/high). Tumor tissues were assessed for TSR and TILs, and five-year disease recurrence and relative hazard were evaluated.

Results

Among the patients, 56 (28.9 %) were classified as Normal Muscle, Normal VAT, 26 (13.4 %) as Normal Muscle, High VAT, 75 (38.7 %) as Low Muscle, Normal VAT, and 37 (19.1 %) as Low Muscle, High VAT. Patients with low skeletal muscle mass were more often male (62.5 % vs. 39 %, P = 0.005). Stroma-high tumors were less common in Low Muscle, Normal VAT patients (24 %) compared to Normal Muscle, High VAT (50 %), Low Muscle, High VAT (48.6 %), and Normal Muscle, Normal VAT (41.1 %) patients (P = 0.020). Tumors with low TILs were similarly distributed across groups (P = 0.679). Low Muscle, Normal VAT patients had a lower recurrence hazard compared to both Low Muscle, High VAT (hazard ratio [HR] 0.34, 95 % CI 0.12–0.98, P = 0.048) and Normal Muscle, Normal VAT (HR 0.31, 95 % CI 0.11–0.87, P = 0.027) patients.

Conclusions

Low Muscle, Normal VAT colon cancer patients exhibited fewer aggressive tumor features and a lower recurrence risk compared to Low Muscle, High VAT patients. These findings highlight the importance of body composition in tumor biology and prognosis.

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.