全身性炎症指标对结直肠癌患者肌肉减少症的诊断性研究

Diagnostic study of systemic inflammatory indicators on sarcopenia in patients with colorectal cancer

目的探讨炎症指标对结直肠癌患者肌肉减少症的诊断价值。方法纳入2019年12月至2021年12月在西南医科大学附属医院胃肠外科410例结直肠癌患者进行横断面研究,利用第三腰椎骨骼肌指数(SMI)将患者分为肌肉减少症组和非肌肉减少症组。用血小板与淋巴细胞比值(PLR)、中性粒细胞与淋巴细胞比值(NLR)和全身免疫炎症指数(SII)来评估全身性炎症。多因素logistic回归分析炎症指标对结直肠癌患者肌肉减少症发生风险的影响。受试者操作特征(ROC)曲线确定炎症指标的最佳截断值,并判断其灵敏度和特异度。结果410例结直肠癌患者中,肌肉减少症组和非肌肉减少症组分别有232例(56.60%)和178例(43.40%)。与非肌肉减少症组相比,肌肉减少症组的NLR、PLR、SII较高,体质指数和白蛋白水平更低,住院时间更长,总费用和并发症发生率更高(P<0.05)。回归分析示,PLR≥172.00(OR=1.78,95%CI=1.17~2.72,P=0.007)是结直肠癌患者发生肌肉减少症的独立危险因素。ROC曲线示,PLR预测肌肉减少症风险的最佳截断值为185.12,灵敏度为52.20%,特异度为66.90%。结论在结直肠癌患者中,高PLR使肌肉减少症的发生风险增加,对肌肉减少症具有一定的诊断价值。

Objective To investigate the diagnostic value of inflammatory indicators for sarcopenia in patients with colorectal cancer.Method A cross-sectional study of 410 patients with colorectal cancer who were admitted to the Department of Gastrointestinal Surgery,Affliated Hospital of Southwest Medical University from December 2019 to December 2021 was conducted.The patients were divided into sarcopenia group and non-sarcopenia group by the skeletal muscle index(SMI)of the third lumbar vertebrae.Platelet to lymphocyte ratio(PLR),neutrophil to lymphocyte ratio(NLR)and systemic immune inflammatory index(SII)were used to evaluate systemic inflammation.Multivariate logistic regression analysis was used to analyze the influence of systemic inflammatory indicators on the risk of sarcopenia in colorectal cancer patients.The receiver's operating characteristic(ROC)curve is used to determine the best cut-off value of inflammatory indicators,and to judge its sensitivity and specificity.Result Among 410 patients with colorectal cancer,232(56.60%)were in the sarcopenia group and 178(43.40%)were in the non-sarcopenia group.Compared with the non-sarcopenia group,the sarcopenia group had higher NLR,PLR,and SII,lower body mass index and albumin levels,longer hospitalization time,and higher total costs and complication rates(P<0.05).Regression analysis showed that PLR≥172.00(OR=1.78,95%CI=1.17-2.72,P=0.007)was an independent risk factor for sarcopenia in colorectal cancer patients.The R0C curve showed that the best cut-off value of PLR in predicting the risk of sarcopenia was 185.12,the sensitivity was 52.20%,and the specificity was 66.90%.Conclusion In colorectal cancer patients,high PLR increases the risk of sarcopenia,which has certain diagnostic value for sarcopenia.