定量CT在肿瘤恶液质定量诊断及疗效评估中的研究进展

Research progress of QCT in quantitative diagnosis of cancer cachexia syndrome and evaluation of curative effect

肿瘤患者在治疗过程中身体组分的变化受多种因素影响,并与患者的预后不良密切相关。晚期恶性肿瘤患者常伴有恶液质,其发病机理尚未阐明,严重影响了患者的生活质量及预后。肿瘤恶液质患者身体组分的变化常对临床有一定提示和预警意义,既往通过体质指数对恶液质进行评估,忽略了肌肉脂肪含量的变化及异常脂肪浸润,无法准确对身体组分进行定量分析。定量CT(QCT)能够全面、准确、高效的定量测定患者身体组分的信息,包括肌肉密度、骨密度(BMD)以及体部脂肪含量等,这些参数可作为评估患者营养状态参考指标,在评估肿瘤恶液质具有较大优势。本文就近年来国内外学者对QCT在恶性肿瘤恶液质定量诊断及QCT基于身体组分变化进行肿瘤治疗后的疗效评估的应用进展进行综述,旨在提高QCT在肿瘤恶液质诊断与疗效评估中的应用价值。

The changes in body composition of cancer patients during treatment are affected by many factors and are closely related to the poor prognosis of patients.Patients with advanced malignant tumors are often accompanied by cachexia,which seriously affects the patient's quality of life and prognosis.The pathogenesis of cancer cachexia has not been elucidated.Changes in the body composition of patients with early cancer cachexia often have certain hints and early warning significance for the clinicians.In the past,the BMI was used to assess cachexia,ignoring changes in muscle fat content and abnormal fat infiltration,and it was impossible to accurately quantify body components.Quantitative computed tomography(QCT)can comprehensively,accurately and efficiently quantify the patient's muscle density,bone mineral density(BMD)and body fat content,etc.which can be used as relevant indicators for evaluating the patient's nutritional status,and those relevant information has great advantages in evaluating cancer cachexia.The author summarizes quantitative diagnosis of cachexia and the application progress of QCT in evaluating the efficacy of cancer treatment based on changes in body composition are reviewed,aiming to improve the application value of QCT in the diagnosis and efficacy evaluation of cancer cachexia.