Relationship between presarcopenia and event occurrence in patients with primary hepatocellular carcinoma
Relationship between presarcopenia and event occurrence in patients with primary hepatocellular carcinoma
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DOI：
10.1038/s41598-020-67147-7
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发表时间：
2020-06-23
影响因子：
4.6
通讯作者：
Enomoto, Nobuyuki
中科院分区：
文献类型：
--
作者：
Takada, Hitomi;Amemiya, Fumitake;Enomoto, Nobuyuki
动脉前减少症是肝细胞癌（HCC）患者的一个预后因素。日本综合分期（JIS）评分是一种结合Child-Turcotte-Pugh分类和HCC肿瘤淋巴结转移（TNM）分期的预后方法。我们研究了原发性肝癌患者术前动脉减少症、JIS评分和预后之间的关系。这项回顾性研究包括2011年10月至2018年3月在甲府市立医院住院的153例原发性肝癌患者。使用基于CT成像的简化腰大肌质量指数（PMI）测量骨骼肌质量，并使用体积分析仪SYNAPSE VINCENT ver3.0测量PMI。我们根据日本肝病学会定义的肝脏疾病中肌肉减少症的评估标准，基于截止值诊断肌肉减少症前。43例患者（28%）被诊断为前驱减少症。中位无事件生存率在伴有动脉前减少的患者中显著低于无动脉前减少的患者（P=0.016）。在多因素分析中，存在动脉硬化前减少症、JIS评分>= 3、甲胎蛋白>= 200 ng/ml和维生素K缺乏诱导的凝血酶原-II>= 200 mAU/ml是显著的预后因素。在JIS评分>= 3的患者中，存在前驱减少症的事件发生率无差异（P=0.96）。在JIS评分的患者中
Presarcopenia is a prognostic factor in patients with hepatocellular carcinoma (HCC). The Japan integrated staging (JIS) score is a prognostic method that combines the Child-Turcotte-Pugh classification and the tumor-node-metastasis (TNM) staging for HCC. We investigated the relationship between presarcopenia, the JIS score, and prognosis in patients with primary HCC. This retrospective study included 153 patients with primary HCC who were hospitalized from October 2011 to March 2018 at Municipal Hospital of Kofu. The skeletal muscle mass was measured using simplified psoas muscle mass index (PMI) based on CT imaging, and PMI using the volume analyzer SYNAPSE VINCENT ver3.0. We diagnosed presarcopenia based on the cut off value according to the assessment criteria for sarcopenia in liver disease defined by the Japan Society of Hepatology. Forty-three patients (28%) were diagnosed with presarcopenia. The median event-free survival was significantly worse in patients with presarcopenia than those without presarcopenia (P=0.016). In multivariate analysis, presence of presarcopenia, JIS score >= 3, alpha-fetoprotein >= 200ng/ml, and prothrombin induced by vitamin K absence-II >= 200 mAU/ml were significant prognostic factors. Among the patients with JIS scores >= 3, there was no difference in the event occurrence rate with presence of presarcopenia (P=0.96). Among the patients with JIS scores