7种筛查肺癌患者肌少症评估工具的诊断效能比较

Comparison of diagnostic efficacy of 7 assessment tools for screening sarcopenia in lung cancer patients

目的:肺癌患者肌少症发病率高,对预后影响大。选择一种精确可行的肌少症筛查工具有助于普及临床肌少症的评估。本研究验证并比较7种肌少症评估工具在肺癌人群中的筛查效能,为早期筛查肺癌肌少症提供科学可行的评估工具。方法:便利选取2022年9月至2023年4月广州市某三级甲等综合性医院收治的252例肺癌患者作为调查对象,分别使用体重指数、小腿围、肌少症五条目(Strength,Assistance in Walk,Rise From Chair,Climb Stairs,Fall,SARC-F)量表、肌少症五条目联合小腿围(SARC-F Combined with Calf Circumference,SARC-CalF)量表、SARC-F联合老龄和体重指数(SARC-F Adding Elderly and Body Mass Index Information,SARC-F+EBM)量表、Ishii评分以及营养风险指数对肺癌患者进行肌少症风险筛查,分别使用敏感度、特异度、约登指数以及受试者操作特征曲线下面积(area under the curve,AUC)对上述7种评估工具进行诊断效能评价。结果:肺癌患者肌少症发生率为24.21%(61/252)。在最优截断值下,体重指数、小腿围、SARC-F量表、SARC-CalF量表、SARC-F+EBM量表、Ishii评分以及营养风险指数的AUC值分别为0.843、0.850、0.747、0.824、0.854、0.923、0.784,约登指数分别为0.550、0.583、0.429、0.489、0.534、0.721、0.506。结论:7种肌少症评估工具中,Ishii评分的筛查效能最佳,推荐使用Ishii评分对肺癌患者进行肌少症的快速筛查。

Objective:The incidence of sarcopenia is high in lung cancer patients,and it significantly impacts prognosis.Selecting an accurate and feasible sarcopenia screening tool can help promote clinical assessment of sarcopenia.This study validates and compares the screening efficacy of seven sarcopenia assessment tools in the lung cancer population,aiming to provide a scientifically feasible assessment tool for early screening of sarcopenia in lung cancer.Methods:A convenience sample of 252 lung cancer patients admitted to a tertiary-grade comprehensive hospital in Guangzhou from September 2022 to April 2023 was selected as the investigation population.The following 7 assessment tools were used for sarcopenia risk screening:body mass index,calf circumference,the Five-Item Sarcopenia(Strength,Assistance in Walk,Rise from Chair,Climb Stairs,Fall,SARC-F)Scale,SARC-F Combined with Calf Circumference(SARC-CalF)Scale,SARC-F Adding Elderly and Body Mass Index Information(SARC-F+EBM)Scale,Ishii score,and geriatric nutritional risk index.Sensitivity,specificity,Youden index,and area under the curve(AUC)were used to evaluate the diagnostic performance of these tools.Results:The incidence of sarcopenia in lung cancer patients was 24.21%(61/252).At the optimal cutoff values,the AUC values for body mass index,calf circumference,SARC-F Scale,SARC-CalF Scale,SARC-F+EBM Scale,Ishii score,and geriatric nutritional risk index were 0.843,0.850,0.747,0.824,0.854,0.923,and 0.784.The Youden index was 0.550,0.583,0.429,0.583,0.429,0.489,0.534,0.721,and 0.506,respectively.Conclusion:Among the 7 assessment tools for sarcopenia,the Ishii score demonstrates the best screening efficacy,suggesting the recommendation of Ishii score for rapid screening of sarcopenia in lung cancer patients.