摘要
目的报告中国恶性肿瘤患者肌肉减少症的流行病学调查结果。方法纳入中国肿瘤营养队列研究常见恶性肿瘤营养状态与临床结局相关性研究(INSCOC)数据库2013年7月至2023年12月86家三级甲等医院19种恶性肿瘤患者61627例。采用亚洲肌肉减少症工作组(AWGS)2019年肌肉减少症诊断标准诊断肿瘤患者肌肉减少症。χ2检验或Fisher确切概率法分析比较不同特征肿瘤患者肌肉减少症患病情况。结果肿瘤患者中肌肉减少症的患病率为18.1%(11175/61627)。肌肉减少症患病率因肿瘤类型、TNM分期、年龄、性别、地理区域及治疗情况不同而存在差异:消化系统肿瘤患者肌肉减少症患病率较高,其中胰腺癌患者患病率最高[32.4%(311/961)];肌肉减少症患病率随TNM分期增高而增大(P<0.05);70岁以上患者肌肉减少症患病率最高[34.7%(3510/10129)];女性肿瘤患者肌肉减少症患病率高于男性患者[16.1%(5544/34381)比20.7%(5631/27246),P<0.05];东北地区的患者患病率最低[14.7%(2398/16300)],接受手术治疗的患者患病率最高[22.1%(1635/7412)]。此外,在某些肿瘤类型中,不同医疗保险类型、职业、教育水平、民族、居住地的患者肌肉减少症患病率存在显著性差异,文化水平低、农民患者发生肌肉减少症的风险更高。结论本研究首次以大规模数据报告了肿瘤患者肌肉减少症的患病率,消化道系统、老年、农民、低教育水平及进展期肿瘤患者等是发生肌肉减少症的高风险人群。
Objective This study aims to investigate the prevalence of sarcopenia specifically in Chinese patients with malignant tumors.Method A total of 61627 patients with 19 types of malignant tumors from 86 grade-A hospitals from July 2013 to December 2023 were included in the INSCOC database of the Chinese Tumor Nutrition Cohort Study.The diagnostic criteria for sarcopenia provided by the Asian W orking Group on Sarcopenia(AWGS)in 2019 were used.Chi-square test or Fisher exact test was used to compare the prevalence of sarcopenia in patients with different population characteristics.Result The prevalence of sarcopenia in cancer patients was 18.1%.The prevalence of sarcopenia varied with tumor type,TNM stage,age,gender,administrative area and treatment.The prevalence of sarcopenia was higher in patients with digestive system cancers,and the highest prevalence was found in patients with pancreatic cancer[32.4%(311/961)].The prevalence of sarcopenia increased with the increase of TNM stage(P<0.05).The prevalence of sarcopenia was the highest in patients over 70 years old[34.7%(3510/10129)].The prevalence of sarcopenia in female cancer patients was higher than that in male patients[16.1%(5544/34381)us 20.7%(5631/27246),P<0.05].The lowest prevalence was found in the Northeast region[14.7%(2398/16300)].Patients who received surgical treatment had the highest prevalence[22.1%(1635/7412)].In addition,in some tumor types,there were significant differences in the prevalence of sarcopenia among patients with different medical insurance types,occupation,education level,ethnicity,and place of residence.Patients with low education level and farmers had a higher risk of sarcopenia.Conclusion This study is the first to report the incidence of sarcopenia in tumor patients on a large scale,with a prevalence of 18%.Patients with digestive system cancers,elderly,farmers,low education level and advanced tumor are high risk groups for sarcopenia.
作者
宋春花
程好晴
崔久嵬
许红霞
王昆华
翁敏
郭增清
周福祥
林源
巴一
袁凯涛
胡雯
马虎
李苏宜
冯长艳
李增宁
赵青川
李纪鹏
郑瑾
吕全军
李涛
陈俊强
贺英
高茜
吴静
王辉
姚庆华
杨家君
刘明
宋新霞
陈公琰
丛明华
马文君
余亚英
罗素霞
周岚
乔秋阁
王巍
冯永东
罗琪
邱红
施咏梅
姜海平
齐玉梅
管文贤
陈甲信
黄河
余震
方玉
陈子华
付振明
王畅
李薇
石汉平
Song Chunhua;Cheng Haoqing;Cui Jiuwei;Xu Hongxia;Wang Kunhua;Weng Min;Guo Zengqing;Zhou Fuxiang;Lin Yuan;Ba Yi;Yuan Kaitao;Hu Wen;Ma Hu;Li Suyi;Feng Changyan;Li Zengning;Zhao Qingchuan;Li Jipeng;Zheng Jin;Lu Quanjun;Li Tao;Chen Junqiang;He Ying;Gao Qian;Wu Jing;Wang Hui;Yao Qinghua;Yang JiaJun;Liu Ming;Song Xinxia;Chen Gongyan;Cong Minghua;Ma Wenjun;Yu Yaying;Luo Suxia;Zhou Lan;Qiao Qiuge;Wang Wei;Feng Yongdong;Luo Qi;Qiu Hong;Shi Yongmei;Jiang Haiping;Qi Yumei;Guan Wenxian;Chen Jiaxin;Huang He;Yu Zhen;Fang Yu;Chen Zihua;Fu Zhenming;Wang Chang;Li Wei;Shi Hanping(Department of Epidemiology,School of Public Health,Zhengzhou University,Zhengzhou 450001,Henan,China;Cancer Center,the First Bethune Hospital of Jjilin University,Changchun 130021,Jilin,China;Department of Clinical Nutrition,Daping Hospital,Army Medical University,Chongqing 400000,China;Department of Clinical Nutrition,the First Affiliated Hospital of Kunming Medical University,Kunming 650032,Yunnan,China;Department of Medical Oncology,Fuyjian Cancer Hospital,Fyjian Medical University,Fuzhou 350014,Fujian,China;Department of Chemoradiotherapy,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,China;Department of Gastrointestinal Surgery,Affiliated Tumor Hospital of Guangxi Medical University,Nanning 530021,Guangxi,China;Cancer Medicine Center,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Bejing 100730;Department of General Surgery,the First Afiliated Hospital of Sun Yat-sen University,Guangzhou 510080,Guangdong,China;Department of Clinical Nutrition,West China Hospital,Chengdu 610041,Sichuan,China;Department of Oncology,the Second Afiliated Hospital of Zunyi Medical University,Zunyi 563000,Guizhou,China;Department of Oncology,Nutrition and Metabolism,Anhui Provincial Hospital Affiliated to Anhui Medical University/Anhui Provincial Cancer Hospital,Hefei 230031,Anhui,China;Department of Clinical Nutrition,Chongqing Cancer Hospital,Chongqing 40000,China;Department of Clinical Nutrition,the First Hospital of Hebei Medical University,Shijiazhuang 050031,Hebei,China;Department of Digestive Surgery,the First Affiliated Hospital of Air Force Medical University,Xi'an 710032,Shaanxi,China;Department of Traditional Chinese Medicine,the Second Affiliated Hospital of Air Force Medical University,Xi'an 710000,Shaanxi,China;Department of Nutition,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450001,Henan,China;Department of Radiotherapy,Sichuan Cancer Center/Sichuan Cancer Hospital,School of Medicine,University of Electronic Science and Technology of China,Chengdu 610041,Sichuan,China;Department of Gastrointestinal Gland Surgery,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,Guangxi,China;Department of Clinical Nutrition,Chongqing Third People's Hospital,Chongqing 400014,China;Department of Oncology,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan,China;Department of Clinical Nutrition,the First Afiliated Hospital of Zhejiang University of Chinese Medicine,Hangzhou 310053,Zhejiang,China;Department of Oncology,Dujiangyan People s Hospital,Dujiangyan 611800,Sichuan,China;Department of Integrated Traditional Chinese and Western Medicine,Zhejiang Cancer Hospital,Hangzhou 310000,Zhejiang,China;Department of Anorectal Surgery,Huizhou Central People's Hospital,Huizhou 516001,Guangdong,China;Department of General Surgery,the Fourth Affiliated Hospital of Harbin Medical University,Harbin 150000,Heilongjiang,China;Department of Oncology,Affiliated Hospital of Hebei Medical University,Xingtai People's Hospital,Xingtai 054031,Hubei,China;Department of Respiratory Oncology,Harbin Medical University Cancer Hospital,Harbin 150085,Heilongjiang,China;Department of General Surgery,Cancer Hospital,Chinese Academy of Medical Sciences,Bejing 100021,China;Department of Nutrition,Guangdong Academy of Medical Sciences/Guangdong Provincial People's Hospital,Guangzhou 510080,Guangdong,China;Department of Nutrition,the First Affiliated Hospital of Henan University,Kaifeng 475000,Henan,China;Department of Oncology,Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital,Zhengzhou 450008,Henan,China;Department of Nutrition,Yunnan Cancer Hospital/The Third Affiliated Hospital of Kunming Medical College,Kunming 650118,Yunnan,China;Department of General Surgery,the Second Hospital(East Hospital)of Hebei Medical University,Shijiazhuang 050000,Hebei,China;Cancer Center,the First People's Hospital of Foshan,Foshan 528000,Guangdong,China;Cancer Center,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei,China;Department of Gastrointestinal Cancer Surgery,the First Affiliated Hospital of Xiamen University,Xiamen 361003,Fujian,China;Department of Oncology,Wuhan Tongji Hospital,Wuhan 430000,Hubei,China;Department of Nutrition,School of Medicine,Shanghai Jiaotong University/Shanghai Ruijin Hospital,Shanghai 200025,China;Department of Surgery,the First Affiliated Hospital of Jinan University,Guangzhou 510632,Guangdong,China;Department of Nutrition,Tianjin Third Central Hospital,Tianjin 300170,China;Department of General Surgery,Nanjing Drum Tower Hospital,Nanjing University Medical School,Nanjing 210008,Jiangsu,China;Department of Radiology and Oncology,People's Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,Guangxi,China;Department of General Surgery,the First Hospital of Shanxi Medical University,Taiyuan 030000,Shanxi,China;Department of Gastrointestinal Surgery,Shanghai Tenth People's Hospital,Shanghai 200000,China;Department of Clinical Nutrition,Peking University Cancer Hospital,Bejing 100142,China;Department of General Surgery,Xiangya Hospital,Central South University,Changsha 410008,Hunan,China;Cancer Center,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China;Cancer Nutition and Metabolism Center,Beijing Shijitan Hospital,Capital Medical University,Bejing 100038,China)
出处
《肿瘤代谢与营养电子杂志》
2024年第5期638-650,共13页
Electronic Journal of Metabolism and Nutrition of Cancer
基金
国家重点研发计划项目(2022YFC2009600)
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关键词
恶性肿瘤
肌肉减少症
四肢骨骼肌指数
现况调查
患病率
影响因素
老年
消化道系统
Malignant tumor
Sarcopenia
Appendicular skeletal muscle mass index
Current investigation
Prevalence
Influencing factors
Aged
Digestive system