肌肉减少症影像学测量在肝细胞癌预后评价中的应用

Application of sarcopenia imaging measurement in prognosis evaluation of hepatocellular carcinoma

肝细胞癌(HCC)是全球最常见的恶性肿瘤之一,是导致肿瘤相关死亡的重要原因。尽管目前针对HCC的治疗手段众多,包括手术切除、经导管肝动脉化疗栓塞(TACE)、消融治疗、肝移植和药物治疗等,已经很大程度上地改善了患者的生存情况,但相同分期且接受相同治疗的患者对治疗的反应及预后有很大差异,这不仅与肿瘤本身的异质性有关系,还与患者机体不同的体力状态、营养状态及对治疗耐受性的差异密切相关。肌肉减少症是影响HCC患者生存的独立预测因子,而骨骼肌的定量测量是肌肉减少症诊断和评价其严重程度的关键因素,影像学测量技术也飞速发展,大大提高了评估的精准性,对临床决策更具指导意义,成为了新的研究热点。因此,本文将对HCC患者肌肉减少症的影像学测量的研究进展做一总结,并探讨其在HCC预后评价中发挥的作用。

Hepatocellular carcinoma(HCC)is one of the most common malignancy tumors worldwide and an important reason of cancer-related death.Various options for HCC treatment,including surgery resection,transcatheter arterial chemoembolization(TACE),ablation therapy,liver transplantation,and drug therapy,have greatly improved the survival of patients.However,the patients with the same stage and the same treatment have a great difference in response to treatment and prognosis.It is not only related to the heterogeneity of the tumor itself,but also closely related to the different physical state,nutrition status and tolerance to treatment of patients.In recent years,multiple studies have shown that sarcopenia is an independent predictor of survival in HCC patients,and the quantitative measurement of skeletal muscle is a key factor in the diagnosis of sarcopenia and the evaluation of its severity.Moreover,the rapid development of imaging measurement technology has greatly improved the accuracy of evaluation and has more guiding significance for clinical decision-making,which has become a new research focus.Therefore,this review will summarize the research progress of imaging measurement of sarcopenia in HCC patients and explore their roles in the prognostic evaluation of HCC.