Sarcopenia Impairs Prognosis of Patients with Hepatocellular Carcinoma: The Role of Liver Functional Reserve and Tumor-Related Factors in Loss of Skeletal Muscle Volume.
Sarcopenia Impairs Prognosis of Patients with Hepatocellular Carcinoma: The Role of Liver Functional Reserve and Tumor-Related Factors in Loss of Skeletal Muscle Volume.
复制标题
DOI：
10.3390/nu9101054
复制
发表时间：
2017-09-22
期刊：
影响因子：
5.9
通讯作者：
Shimizu M
中科院分区：
文献类型：
--
作者：
Imai K;Takai K;Watanabe S;Hanai T;Suetsugu A;Shiraki M;Shimizu M
肌肉减少症损害肝细胞癌（HCC）患者的生存。本研究旨在阐明导致HCC患者骨骼肌体积减少的因素。计算351例连续HCC患者的第三腰椎骨骼肌指数（L3 SMI）以识别肌肉减少症。骨骼肌减少症定义为L3 SMI值≤29.0 cm2/m2的女性和≤36.0 cm2/m2的男性。采用多元线性回归分析和基于树的模型分析了L3级SMI的影响因素。在351例HCC患者中，33例被诊断为肌肉减少，与非肌肉减少患者相比预后较差（p = 0.007）。然而，通过倾向评分匹配分析调整年龄、性别、Child-Pugh评分、最大肿瘤大小、肿瘤数量、门静脉侵犯程度后，这种显著性差异消失。多元线性回归分析显示，年龄（p = 0.015）和性别（p < 0.0001）与L3级SMI下降有显著相关。基于树的模型显示，性别（女性）是影响L3级SMI的最重要因素。在男性患者中，L3级SMI因年龄增大、Child-Pugh评分升高（≥56岁）和肿瘤大小增大（<56岁）而降低。维持肝功能储备，早期诊断和治疗HCC对于预防骨骼肌衰竭和改善HCC患者预后至关重要。
Sarcopenia impairs survival in patients with hepatocellular carcinoma (HCC). This study aimed to clarify the factors that contribute to decreased skeletal muscle volume in patients with HCC. The third lumbar vertebra skeletal muscle index (L3 SMI) in 351 consecutive patients with HCC was calculated to identify sarcopenia. Sarcopenia was defined as an L3 SMI value ≤ 29.0 cm2/m2 for women and ≤ 36.0 cm2/m2 for men. The factors affecting L3 SMI were analyzed by multiple linear regression analysis and tree-based models. Of the 351 HCC patients, 33 were diagnosed as having sarcopenia and showed poor prognosis compared with non-sarcopenia patients (p = 0.007). However, this significant difference disappeared after the adjustments for age, sex, Child–Pugh score, maximum tumor size, tumor number, and the degree of portal vein invasion by propensity score matching analysis. Multiple linear regression analysis showed that age (p = 0.015) and sex (p < 0.0001) were significantly correlated with a decrease in L3 SMI. Tree-based models revealed that sex (female) is the most significant factor that affects L3 SMI. In male patients, L3 SMI was decreased by aging, increased Child–Pugh score (≥56 years), and enlarged tumor size (<56 years). Maintaining liver functional reserve and early diagnosis and therapy for HCC are vital to prevent skeletal muscle depletion and improve the prognosis of patients with HCC.
登录
查看更多内容
影响因子：
12.6
作者：
Muto, Y;Sato, S;Kumada, H
通讯作者：
Kumada, H
影响因子：
11.5
作者：
Tan, Benjamin H. L.;Birdsell, Laura A.;Fearon, Kenneth C. H.
通讯作者：
Fearon, Kenneth C. H.
影响因子：
5.8
作者：
Banerjee, Mousumi;Muenz, Daniel G.;Haymart, Megan R.
通讯作者：
Haymart, Megan R.
影响因子：
3.2
作者：
Grossmann, Mathis;Hoermann, Rudolf;Angus, Peter
通讯作者：
Angus, Peter
影响因子：
3.7
作者：
Mir, Olivier;Coriat, Romain;Goldwasser, Francois
通讯作者：
Goldwasser, Francois