Osteopenia is associated with wasting in pancreatic adenocarcinoma and predicts survival after surgery.
Osteopenia is associated with wasting in pancreatic adenocarcinoma and predicts survival after surgery.
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DOI：
10.1002/cam4.4416
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发表时间：
2022-01
期刊：
影响因子：
4
通讯作者：
Judge AR
中科院分区：
文献类型：
--
作者：
Cameron ME;Underwood PW;Williams IE;George TJ;Judge SM;Yarrow JF;Trevino JG;Judge AR
胰腺导管腺癌（PDAC）是所有常见恶性肿瘤中最致命的一种。治疗是困难的，并往往复杂的恶病质的存在。恶病质的临床特征导致PDAC患者的预后不良，并影响治疗结果。我们提出低骨密度是恶病质的一个组成部分，我们在本文中通过回顾性审查2011年至2018年期间在我们机构接受PDAC手术的所有患者，并与性别，年龄和合并症匹配的对照个体进行比较进行了探讨。从病历和术前计算机断层扫描中提取数据。在L3水平测量肌肉质量和质量，并测量骨矿物质密度作为腰椎椎体的辐射衰减。PDAC患者表现出典型的恶病质体征，如体重减轻和骨骼肌放射学明显恶化。重要的是，PDAC患者的骨密度显著低于对照组，61.2%的PDAC患者被归类为骨质减少，而对照组为36.8%。与无骨质减少的患者（2.77年）相比，骨质减少的PDAC患者的生存率（1.01年）显著降低。骨质减少的存在是1年和2年疾病特异性死亡率的最强临床预测因子，分别使死亡风险增加107%和80%。骨质减少作为2年死亡率的测试，灵敏度为76%，特异性为58%。因此，这些数据确定受损的骨矿物质密度作为恶病质的关键组成部分和PDAC患者术后生存的预测因子。导致荷瘤宿主骨消耗的机制值得进一步研究。胰腺癌患者骨密度降低伴随骨骼肌萎缩。骨质减少是治疗性手术后2年生存率的单一最强预测因素。
Pancreatic ductal adenocarcinoma (PDAC) is among the deadliest of all common malignancies. Treatment is difficult and often complicated by the presence of cachexia. The clinical portrait of cachexia contributes to the poor prognosis experienced by PDAC patients and worsens therapeutic outcomes. We propose that low bone mineral density is a component of cachexia, which we explore herein through a retrospective review of all patients at our facility that underwent surgery for PDAC between 2011 and 2018 and compared to sex‐, age‐ and comorbidity‐matched control individuals. Data were abstracted from the medical record and pre‐operative computed tomography scans. Muscle mass and quality were measured at the L3 level and bone mineral density was measured as the radiation attenuation of the lumbar vertebral bodies. Patients with PDAC displayed typical signs of cachexia such as weight loss and radiologically appreciable deterioration of skeletal muscle. Critically, PDAC patients had significantly lower bone mineral density than controls, with 61.2% of PDAC patients categorized as osteopenic compared to 36.8% of controls. PDAC patients classified as osteopenic had significantly reduced survival (1.01 years) compared to patients without osteopenia (2.77 years). The presence of osteopenia was the strongest clinical predictor of 1‐ and 2‐year disease‐specific mortality, increasing the risk of death by 107% and 80%, respectively. Osteopenia serves as a test of 2‐year mortality with sensitivity of 76% and specificity of 58%. These data therefore identify impaired bone mineral density as a key component of cachexia and predictor of postoperative survival in patients with PDAC. The mechanisms that lead to bone wasting in tumor‐bearing hosts deserve further study. Bone density loss accompanies skeletal muscle atrophy in pancreatic cancer. Osteopenia is the single strongest predictor of 2‐year survival following curative surgery.
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影响因子：
2
作者：
Fu, Shengling;Lin, Jiayuh
通讯作者：
Lin, Jiayuh
DOI：
10.1111/apha.12224
发表时间：
2014-03
期刊：
Acta physiologica (Oxford, England)
影响因子：
--
作者：
Aubrey J;Esfandiari N;Baracos VE;Buteau FA;Frenette J;Putman CT;Mazurak VC
通讯作者：
Mazurak VC
影响因子：
5.2
作者：
Callaway, Chandler S.;Delitto, Andrea E.;Judge, Andrew R.
通讯作者：
Judge, Andrew R.
影响因子：
4.1
作者：
Laurent, Michael R.;Dubois, Vanessa;Jardi, Ferran
通讯作者：
Jardi, Ferran
DOI：
10.1002/jcsm.12311
发表时间：
2018-08
期刊：
Journal of cachexia, sarcopenia and muscle
影响因子：
--
作者：
Pin F;Barreto R;Kitase Y;Mitra S;Erne CE;Novinger LJ;Zimmers TA;Couch ME;Bonewald LF;Bonetto A
通讯作者：
Bonetto A