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

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摘要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。

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	1陈丽
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	1汪敏

关键词 ：结直肠癌, 肌肉减少症, 全身性炎症, 血小板与淋巴细胞比值

Abstract：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 Affiliated 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 ROC 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.

Key words： Colorectal cancer Sarcopenia Systemic inflammation Platelet to lymphocytes ratio

收稿日期: 2022-06-18

基金资助:四川省科技计划项目基金(2021JDTD0003)

通讯作者: 汪敏,电子邮箱:wangmin1605@ 163. com

引用本文:

1陈丽,1张泽宇,1吴优,1倪培萍,2吕沐瀚,1汪敏. 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[J]. 肿瘤代谢与营养电子杂志, 2023, 10(2): 230-235.
1Chen Li,1Zhang Zeyu,1Wu You,1Ni Peiping,2Lyu Muhan,1Wang Min. Diagnostic study of systemic inflammatory indicators on sarcopenia in patients with colorectal cancer. Electron J Metab Nutr Cancer, 2023, 10(2): 230-235.