肌内脂肪浸润与老年胃癌根治术后肌少症的相关性

Correlation between intramuscular fatty infiltration and sarcopenia after radical gastrectomy in elderly patients with gastric cancer

目的:探讨老年胃癌根治术后肌少症的因素。方法:采用回顾性研究方法,收集我院2015年01月至2016年07月的124例老年胃癌根治术后患者。根据胃癌根治术后半年骨骼肌数量丢失是否达到术前的10%定义两组患者,比较组间差异。包括性别、体质量指数(body mass index,BMI)、手术史、糖尿病、高血压、其他肿瘤史、T分期、肿瘤位置、血红蛋白、白蛋白、血小板/淋巴细胞比、中性粒细胞/淋巴细胞比、淋巴细胞、中性粒细胞、红细胞、血小板、术前骨骼肌面积和肌内脂肪组织。使用R 3.6.1软件进行t检验分析,临界值根据接收器工作特性曲线计算。结果:术前多裂肌的高肌内脂肪组织浸润与胃癌根治术后骨骼肌大量丢失高度相关(P<0.05,r=0.75),可以筛查术后骨骼肌大量丢失的术前肌内脂肪组织浸润的临界值分别是:女:-0.435[敏感性=100.000%,特异性=93.750%,曲线下面积(area under curve,AUC)=0.956];男:-0.505[敏感性=89.583%,特异性=94.444%,AUC=0.978]。结论:术前多裂肌的高肌内脂肪组织浸润是老年胃癌患者根治术后骨骼肌大量丢失的前提。

Objective:To investigate the factors of sarcopenia after radical resection of gastric cancer in elderly patients.Methods:Using retrospective research methods,124 cases in our hospital were collected from January 2015 to July 2016.Two groups of patients were defined according to whether the loss of skeletal muscle area half a year after radical gastric cancer reached 10%,and the differences between the groups were compared,including gender,BMI,history of surgery,diabetes,hypertension,history of other tumors,T stage,cancer site,anemia,hypoalbuminemia,platelet/lymphocyteradio and neutrophil/lymphocyte radio,lymphocyte,neutrophil,red blood cell,platelet,preoperative skeletal muscle area and intramuscular adipose content.R 3.6.1 software was used for t test analysis,and the cut-off value was calculated according to the receiver's operating characteristic curve.Results:The preoperative high intramuscular adipose content of the multifidus muscle was highly correlated with the massive loss of skeletal muscle after the radical resection of gastric cancer(P<0.05,r=0.75).The cut-off values of intramuscular adipose content were-0.435[sensitivity=100.000%,specificity=93.750%,AUC=0.956]for female and-0.505[sensitivity=89.583%,specificity=94.444%,AUC=0.978]for male.Conclusion:The preoperative high intramuscular adipose content of the multifidus muscle is the precondition of the massive loss of skeletal muscle after radical resection of gastric cancer in elderly patients.