Adipose tissue and muscle attenuation as novel biomarkers predicting mortality in patients with extremity sarcomas
Adipose tissue and muscle attenuation as novel biomarkers predicting mortality in patients with extremity sarcomas
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DOI：
10.1007/s00330-016-4306-6
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发表时间：
2016-12-01
影响因子：
5.9
通讯作者：
Bredella, Miriam A.
中科院分区：
文献类型：
--
作者：
Veld, Joyce;Vossen, Josephina A.;Bredella, Miriam A.
评估腹部脂肪组织和腰大肌的CT衰减作为四肢肉瘤患者死亡率的预测因子。我们的研究是IRB批准的，符合HIPAA。研究组包括135例有肢体肉瘤病史的患者（平均年龄：53 ± 17岁），他们接受了全身PET/CT。腹部皮下脂肪组织（SAT），内脏脂肪组织（VAT），腰大肌衰减（HU）进行了评估，非造影剂，衰减校正CT。记录临床信息，包括生存率、肿瘤分期、肉瘤类型、治疗和预先存在的合并症。考克斯比例风险模型被用来确定脂肪组织和肌肉衰减与死亡率之间的纵向关系。在平均20 +/-17个月的随访期内，有47例死亡。较高的SAT和较低的腰大肌衰减与死亡率增加相关（分别为p = 0.03和p = 0.005），在调整年龄、BMI、性别、肿瘤分期、治疗和合并症后，死亡率仍然显著（分别为p = 0.002和p = 0.02）。VAT衰减与死亡率无关。非增强CT评估的SAT和腰大肌衰减是肢体肉瘤患者死亡率的预测因子，独立于其他既定的预后因素，这表明脂肪组织和肌肉衰减可以作为肉瘤患者死亡率的新生物标志物。衰减预测死亡率，与已确定的预后因素无关。肉瘤患者经常接受CT分期或监测。脂肪组织和肌肉衰减可作为死亡率的生物标志物。
To assess CT-attenuation of abdominal adipose tissue and psoas muscle as predictors of mortality in patients with sarcomas of the extremities.Our study was IRB approved and HIPAA compliant. The study group comprised 135 patients with history of extremity sarcoma (mean age: 53 +/- 17 years) who underwent whole body PET/CT. Abdominal subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), and psoas muscle attenuation (HU) was assessed on non-contrast, attenuation-correction CT. Clinical information including survival, tumour stage, sarcoma type, therapy and pre-existing comorbidities were recorded. Cox proportional hazard models were used to determine longitudinal associations between adipose tissue and muscle attenuation and mortality.There were 47 deaths over a mean follow-up period of 20 +/- 17 months. Higher SAT and lower psoas attenuation were associated with increased mortality (p = 0.03 and p = 0.005, respectively), which remained significant after adjustment for age, BMI, sex, tumor stage, therapy, and comorbidities (p = 0.002 and p = 0.02, respectively). VAT attenuation was not associated with mortality.Attenuation of SAT and psoas muscle, assessed on non-contrast CT, are predictors of mortality in patients with extremity sarcomas, independent of other established prognostic factors, suggesting that adipose tissue and muscle attenuation could serve as novel biomarkers for mortality in patients with sarcomas.aEuro cent CT-attenuation of adipose tissue and muscle predict mortality in sarcoma patientsaEuro cent CT-attenuation predicts mortality independent of established prognostic factorsaEuro cent Patients with sarcomas often undergo CT for staging or surveillanceaEuro cent Adipose tissue and muscle attenuation could serve as biomarkers for mortality.