肌肉减少症与肿瘤预后的研究进展

Research progress on sarcopenia and tumor prognosis

肌肉减少症是一种以进行性的、广泛性骨骼肌含量减少和功能减退为主要特点的综合征,肌肉减少症常见于老年人,不但会导致机体功能障碍,还会增加骨折、跌倒、并发症的发生甚至死亡风险。然而越来越多的研究发现,肌肉减少症高发于肿瘤患者,与恶性肿瘤相关的肌肉减少症,称为肿瘤相关性肌肉减少症。在消化道肿瘤、头颈部肿瘤、乳腺癌及肺癌等多种肿瘤中,肿瘤相关性肌肉减少症发生率高,不仅与化疗、放疗不良反应以及术后并发症相关,更严重影响患者的远期生存。目前对于肿瘤相关性肌肉减少症的研究处于探索阶段,尚需开展多中心、大样本、前瞻性循证研究,以进一步减少相关不良反应的发生,提高患者的生存质量。本文对肿瘤相关肌肉减少症的定义、评估及诊断标准,以及肿瘤相关肌肉减少症在不同肿瘤中,与肿瘤患者的治疗不良反应、术后并发症以及生存预后的相关性进行综述,旨在明确肌肉减少症在肿瘤患者预后中的重要临床价值,为进一步开展大规模临床研究提供依据。

Sarcopenia is a progressive,generalized syndrome characterized by decreased skeletal muscle content and decreased function,which is common in the elderly.It not only causes dysfunction,but also increases the risk of fractures,falls,complications and even death.However,more and more studies have found that sarcopenia is more common in patients with tumors,and that sarcopenia associated with malignant tumors is called tumor-associated sarcopenia.In a variety of tumors such as gastrointestinal tumors,head and neck tumors,breast cancer and lung cancer,the high incidence of tumor-related sarcopenia is not only related to the toxic side effects of chemotherapy and radiotherapy and postoperative complications,but also seriously affects the long-term survival of patients.At present,the research on tumor-related sarcopenia is in the exploratory stage,and multi-center,large-sample,prospective evidence-based research is still needed to further reduce the occurrence of related adverse reactions and improve the quality of life of patients.This article reviews the definition,evaluation and diagnostic criteria of tumor-associated sarcopenia,as well as the correlation between tumor-related sarcopenia and the treatment of toxic side effects,postoperative complications and survival prognosis in tumor patients in different tumors,aiming to clarify the important clinical value of sarcopenia in the prognosis of tumor patients and provide a basis for further large-scale clinical research.