食管鳞状细胞癌内镜切除患者骨骼肌受损的计算机断层成像评估预后影响。

IF 3.6 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Digestion Pub Date : 2025-09-19 DOI:10.1159/000548090
Naotaro Tanno, Waku Hatta, Yohei Ogata, Kimiko Kayada, Makoto Kawabe, Yutaka Hatayama, Masahiro Saito, Akira Imatani, Tomoyuki Koike, Tomohiro Nakamura, Naoki Nakaya, Atsushi Masamune
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引用次数: 0

摘要

导言:没有研究调查骨骼肌质量和脂肪组织分布对食管鳞状细胞癌(ESCC)行内镜切除(ER)患者预后的影响。因此,本研究旨在评估其相关性。方法:回顾性收集我院2005年至2020年间因ESCC接受ER治疗的患者资料。采用多变量Cox分析来研究17个候选因素与预后的关系,包括骨骼肌质量和脂肪组织分布指标(通过计算机断层扫描(CT)图像评估)。此外,我们评估了以低骨骼质量指数(SMI)和高肌内脂肪组织含量(IMAC)为特征的骨骼肌受损与预后和早期和晚期死亡率的关系。结果:450例患者中,116例(25.8%)在中位随访111.6个月期间死亡。多因素分析显示,低SMI(风险比[HR]为1.65)和高内脏脂肪指数(HR为0.48)与死亡率、男性、体能状况、Charlson合病指数、美国麻醉医师协会身体状况和预后营养指数均有显著相关性。相反,其他指标无显著相关性。骨骼肌受损是死亡率的危险因素(HR, 2.87),但低SMI和低IMAC的组合不是危险因素。它与晚期死亡率显著相关(HR, 4.53),但与早期死亡率无关。结论:CT图像评估的骨骼肌受损是ESCC患者接受ER治疗晚期死亡的危险因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prognostic Effect of Impaired Skeletal Muscle Assessed with Computed Tomography Images in Patients with Endoscopic Resection for Esophageal Squamous Cell Carcinoma.

Introduction: No studies have investigated the prognostic effect of skeletal muscle mass and quality and adipose tissue distribution in patients who undergo endoscopic resection (ER) for esophageal squamous cell carcinoma (ESCC). Thus, this study aimed to evaluate their association.

Methods: We retrospectively collected data from patients who underwent ER for ESCC at our institution between 2005 and 2020. Multivariate Cox analysis was performed to investigate the association of 17 candidate factors, including indices for skeletal muscle mass and quality and adipose tissue distribution assessed with computed tomography (CT) images, with prognosis. Further, we evaluated the association of impaired skeletal muscle, characterized by the combination of low skeletal mass index (SMI) and high intramuscular adipose tissue content (IMAC), with prognosis and early and late mortality.

Results: Among 450 patients, 116 (25.8%) died during the median follow-up of 111.6 months. Multivariate analyses revealed low SMI (hazard ratio [HR], 1.65) and high visceral adipose index (HR, 0.48) showed significant association with mortality, in addition to male sex, performance status, Charlson comorbidity index, American Society of Anesthesiologists physical status, and prognostic nutrition index. Conversely, no significant association was revealed in other indices. Impaired skeletal muscle was a risk factor for mortality (HR, 2.87) but not the combination of low SMI and low IMAC. It was significantly associated with late mortality (HR, 4.53) but not with early mortality.

Conclusion: Impaired skeletal muscle assessed with CT images was a risk factor for late mortality in patients who underwent ER for ESCC.

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来源期刊
Digestion
Digestion 医学-胃肠肝病学
CiteScore
7.90
自引率
0.00%
发文量
39
审稿时长
6-12 weeks
期刊介绍: ''Digestion'' concentrates on clinical research reports: in addition to editorials and reviews, the journal features sections on Stomach/Esophagus, Bowel, Neuro-Gastroenterology, Liver/Bile, Pancreas, Metabolism/Nutrition and Gastrointestinal Oncology. Papers cover physiology in humans, metabolic studies and clinical work on the etiology, diagnosis, and therapy of human diseases. It is thus especially cut out for gastroenterologists employed in hospitals and outpatient units. Moreover, the journal''s coverage of studies on the metabolism and effects of therapeutic drugs carries considerable value for clinicians and investigators beyond the immediate field of gastroenterology.
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