骨骼肌指数对老年非小细胞肺癌手术患者预后的评估价值

Prognostic value of skeletal muscle index on postoperative outcome of elderly patients with non-small cell lung cancer

目的:探讨胸部CT获得的骨骼肌指数(SMI)对老年非小细胞肺癌(NSCLC)手术患者预后的评估价值。方法:回顾性分析140例老年NSCLC手术患者的临床及影像资料。在术前进行的胸部CT平扫或增强扫描图像上,选择胸8椎体中心层面,通过半自动化分割CT值在-29~150 HU范围内的肌肉组织获得SMI(cm^(2)/m^(2))。SMI低于性别特异性下四分位数时归为肌少症组,高于性别特异性下四分位数时归为非肌少症组。通过随访生存时间,比较两组患者的预后。结果:男性下四分位数SMI为20.45 cm^(2)/m^(2),女性下四分位数SMI为15.44 cm^(2)/m^(2)。在肌少症NSCLC手术患者中,男性总生存时间为(50.0±24.0)个月,女性总生存时间为(56.2±31.6)个月。在非肌少症NSCLC手术患者中,男性总生存时间为(57.7±26.3)个月,女性总生存时间为(61.9±19.6)个月。肌少症的男性和女性患者的总生存时间明显低于非肌少症患者,但差异无统计学意义(P>0.05)。结论:SMI对预测老年NSCLC手术患者的预后有一定价值。

Objective:To investigate the prognostic value of skeletal muscle index(SMI)in prediction of elderly patients with non-small cell lung cancer(NSCLC).Methods:A total of 140 patients who underwent lung resection surgery for NSCLC were prospectively included.Skeletal muscle index was assessed by the sum of cross-sectional areas of skeletal muscles in the region of the eighth thoracic vertebra(T8)on preoperative CT using semi-automated segmentation with Hounsfield unit thresholds of-29~150HU.SMI lower than the sex-specific lower quartile was classified as sarcopenia group,and higher than the sex-specific lower quartile was classified as non-sarcopenia group.The prognosis of the two groups was compared by follow-up survival time.Results:The cut-off value according to lower quartile number was 20.45cm^(2)/m^(2) for men and 15.44cm^(2)/m^(2) for women,and during the follow-up period,the overall survival time of sarcopenic patients(50.0±24.0)months for men and(56.2±31.6)months for women was lower than that of non-sarcopenic patients(57.7±26.3)months for men and(61.9±19.6)months for women with no significant difference(P>0.05).Conclusions:SMI can be used in predicting postoperative outcomes of patients with NSCLC.