Serum tumor marker and CT body composition scoring system predicts outcomes in colorectal cancer surgical patients.

IF 4.7 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING European Radiology Pub Date : 2024-12-01 Epub Date: 2024-06-24 DOI:10.1007/s00330-024-10849-7

Mingming Song, Zhihao Liu, Feihong Wu, Tong Nie, Yixin Heng, Jiaxin Xu, Ning Huang, Xiaoyu Wu, Yinghao Cao, Gang Hu

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Abstract

Objective: To investigate the prognostic value of preoperative body composition and serum tumor markers (STM) in patients undergoing surgical treatment for colorectal cancer (CRC) and to establish the prognostic score for patients with CRC.

Methods: This study enrolled 365 patients (training set 245, validation set 120) with CRC who underwent surgical resection. The predictive value of various body composition features and STM for determining CRC prognosis were compared. A novel index score based on the independent risk factors from Cox regression for CRC patients was established and evaluated for its usefulness.

Results: Multivariate Cox regression showed that low skeletal muscle radiodensity (SMD) (p = 0.020), low subcutaneous fat area (SFA) (p = 0.029), high carcinoembryonic antigen (CEA) (p = 0.008), and high alpha-fetoprotein (AFP) (p = 0.039) were all independent prognostic factors for poor overall survival (OS). The multifactorial analysis indicated that high intermuscular fat area (IMFA) (p = 0.033) and high CEA (p = 0.009) were independent prognostic factors for poor disease-free survival (DFS). Based on these findings, two scoring systems for OS and DFS were established in the training datasets. CRC patients who scored higher on the new scoring systems had lower OS and DFS (both p < 0.001) as shown in the Kaplan-Meier survival curves in the training and validation datasets.

Conclusion: In predicting the prognosis of CRC patients, SFA and SMD are superior to other body composition measurements. A scoring system based on body composition and STM can have prognostic value and clinical applicability.

Clinical relevance statement: This scoring system, combining body composition and serum tumor markers, may help predict postoperative survival of CRC patients and help clinicians make well-informed decisions regarding the treatment of patients.

Key points: Colorectal cancer prognosis can be related to body composition. High intermuscular fat area and CEA were independent prognostic factors for poor disease-free survival. This scoring system, based on body composition and tumor markers, can prognosticate for colorectal cancer patients.

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血清肿瘤标记物和 CT 身体成分评分系统预测结直肠癌手术患者的预后。

目的研究接受手术治疗的结直肠癌（CRC）患者术前身体成分和血清肿瘤标志物（STM）的预后价值，并建立 CRC 患者的预后评分：本研究招募了365名接受手术切除的CRC患者（训练集245名，验证集120名）。比较了各种身体成分特征和 STM 对确定 CRC 预后的预测价值。结果发现，多变量 Cox 回归得出的独立风险因素对 CRC 患者的预后具有预测价值：结果：多变量 Cox 回归显示，低骨骼肌放射密度 (SMD) (p = 0.020)、低皮下脂肪面积 (SFA) (p = 0.029)、高癌胚抗原 (CEA) (p = 0.008) 和高甲胎蛋白 (AFP) (p = 0.039) 都是总生存率 (OS) 低的独立预后因素。多因素分析表明，高肌间脂肪面积（IMFA）（p = 0.033）和高 CEA（p = 0.009）是无病生存期（DFS）较差的独立预后因素。根据这些发现，在训练数据集中建立了两种 OS 和 DFS 评分系统。在新评分系统中得分较高的 CRC 患者的 OS 和 DFS 都较低（均为 p）：在预测 CRC 患者的预后方面，SFA 和 SMD 优于其他身体成分测量方法。基于身体成分和 STM 的评分系统具有预后价值和临床适用性：该评分系统结合了身体成分和血清肿瘤标志物，有助于预测结直肠癌患者的术后生存率，并帮助临床医生就患者的治疗做出明智的决定：要点：结直肠癌的预后可能与身体成分有关。高肌间脂肪面积和CEA是无病生存率低的独立预后因素。这种基于身体成分和肿瘤标志物的评分系统可以预测结直肠癌患者的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Radiology 医学-核医学

CiteScore

11.60

自引率

8.50%

发文量

874

审稿时长

2-4 weeks

期刊介绍： European Radiology (ER) continuously updates scientific knowledge in radiology by publication of strong original articles and state-of-the-art reviews written by leading radiologists. A well balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes ER an indispensable source for current information in this field. This is the Journal of the European Society of Radiology, and the official journal of a number of societies. From 2004-2008 supplements to European Radiology were published under its companion, European Radiology Supplements, ISSN 1613-3749.