肌少症对食管鳞癌围手术期临床结局的影响  

Effect of sarcopenia on the perioperative clinical outcomes of esophageal squamous cell carcinoma

作　　者：田文泽[1] 尤振兵[1] 张明志 陈梦舟 冷雪春 徐达夫[1] 蒋超[2] 徐康[3] 徐克平[1] Tian Wenze;You Zhenbing;Zhang Mingzhi;Chen Mengzhou;Leng Xuechun;Xu Dafu;Jiang Chao;Xu Kang;Xu Keping(Department of Thoracic Surgery,the Affiliated Huaian No.1 People's Hospital of Nanjing Medical University,Huaian 223300,China;Department of Medical Oncology,the Affiliated Huaian No.1 People's Hospital of Nanjing Medical University,Huaian 223300,China;Party Committee Office,the Affiliated Huaian No.1People's Hospital of Nanjing Medical University,Huaian 223300,China)

机构地区：[1]南京医科大学附属淮安第一人民医院胸外科,淮安223300 [2]南京医科大学附属淮安第一人民医院肿瘤内科,淮安223300 [3]南京医科大学附属淮安第一人民医院党委办公室,淮安223300

出　　处：《中华消化外科杂志》2023年第11期1322-1329,共8页Chinese Journal of Digestive Surgery

基　　金：国家自然科学青年基金(82102969);江苏省医学重点学科建设单位(JWDS202233);淮安市自然科学研究计划(HAB202201)。

摘　　要：目的探讨肌少症对食管鳞癌围手术期临床结局的影响.方法采用回顾性病例对照研究方法.收集2020年1月至2021年12月南京医科大学附属淮安第一人民医院收治的1148例食管鳞癌患者的临床病理资料;男789例,女359例;年龄为(67±7)岁.所有患者行胸腹腔镜联合食管癌根治术.观察指标:(1)食管鳞癌患者并发肌少症情况.(2)食管鳞癌并发肌少症患者与食管鳞癌非肌少症患者的一般资料比较.(3)食管鳞癌并发肌少症患者与食管鳞癌非肌少症患者的临床结局比较.(4)食管鳞癌患者并发肌少症的影响因素分析.正态分布的计量资料以(x)±s表示,组间比较采用t检验;计数资料以绝对数表示,组间比较采用χ^(2)检验;等级资料采用Mann-Whitney U检验.单因素分析采用Logistic回归分析,多因素分析采用Logistic逐步回归向后模型.结果(1)食管鳞癌患者并发肌少症情况.1148例食管鳞癌患者中,469例并发肌少症,679例非肌少症,肌少症发生率为40.854%(469/1148).469例并发肌少症患者中,男313例,女156例;年龄<65岁、≥65岁且<70岁、≥70岁且<75岁、≥75岁分别为125、145、106、93例.(2)食管鳞癌并发肌少症患者与食管鳞癌非肌少症患者的一般资料比较.469例食管鳞癌并发肌少症患者的年龄,肿瘤长径,体质量指数,T分期(T1期、T2期、T3期),术前白蛋白,术前血清前白蛋白,腰大肌指数,腰大肌密度分别为(68±7)岁,(3.3±1.5)cm,(22.4±2.9)kg/m^(2),100、105、264例、(43±4)g/L,(193±38)mg/dL.(3.9±0.8)cm^(2)/m^(2),(48±8)HU;679例食管鳞癌非肌少症患者上述指标分别为(66±7)岁,(3.2±1.4)cm,(23.8±3.0)kg/m^(2),173、170、336例,(44±4)g/L,(206±37)mg/dL,(6.0±2.2)cm^(2)/m^(2),(50±7)HU,两者上述指标比较,差异均有统计学意义(t=5.74、2.11、7.57,Z=-2.93,t=2.25、5.52、20.36、4.18,P<0.05).(3)食管鳞癌并发肌少症患者与食管鳞癌非肌少症患者的临床结局比较.469例食管鳞癌并发肌少症患者的�Objective To investigate the effect of sarcopenia on the perioperative clinical outcomes of esophageal squamous cell carcinoma(EscC).Methods The retrospective case-control study was conducted.The clinicopathological data of 1148 ESCC patients who were admitted to the Affiliated Huaian No.1 People's Hospital of Nanjing Medical University from January 2020 to December 2021 were collected.There were 789 males and 359 females,aged(67±7)years.All patients underwent thoracoscopic and laparoscopic radical esophagectomy for esophageal cancer.Observation indicators:(1)incidence of sarcopenia in patients with ESCC;(2)comparison of general data between ESCC patients complicated with sarcopenia and those without sarcopenia;(3)comparison of clinical outcomes between EscC patients complicated with sarcopenia and those without sarcopenia;(4)analysis of influencing factors for sarcopenia in EscC patients.Measurement data of normal distribution were represented by Mean+SD,and comparison between groups was conducted using the t test.Count data were represented as absolute numbers,and comparison between groups was conducted using the chi-square test.Ordinal data was analyzed using the Mann-Whitney U test.Logistic regression analysis was used to conduct univariate analysis.Logistic backward stepwise regression model was used to conduct multivariate analysis.Results(1)Incidence of sarcopenia in patients with ESCC.Among 1148 ESCC patients,469 cases were complicated with sarcopenia,679 were without sarcopenia.The incidence of sarcopenia was 40.854%(469/1148).Among the 469 patients with sarcopenia,there were 313 males and 156 females.There were 125 cases<65 years old,145 cases≥65 years old but<70 years old,106 cases≥70 years old but<75 years old,93 cases≥75 years old,respectively.(2)Comparison of general data between patients with ESCC complicated with sarcopenia and those without sarcopenia.The age,tumor diameter,body mass index,cases in stage T1,T2,T3,preoperative albumin,preoperative serum prealbumin,psoas muscle index,psoas m

关 键 词：食管肿瘤 肌少症 腰大肌指数 食管切除术 并发症 疗效 治疗 手术 

分 类 号：R685[医药卫生—骨科学] R735.1[医药卫生—外科学]