晚期癌症治疗后恶性腹水与全身炎症和肌肉损失的相关性。

IF 8.9 1区 医学 Journal of Cachexia, Sarcopenia and Muscle Pub Date : 2023-07-28 DOI:10.1002/jcsm.13289
Chia-Sui Weng, Wan-Chun Huang, Chih-Long Chang, Ya-Ting Jan, Tze-Chien Chen, Jie Lee
{"title":"晚期癌症治疗后恶性腹水与全身炎症和肌肉损失的相关性。","authors":"Chia-Sui Weng,&nbsp;Wan-Chun Huang,&nbsp;Chih-Long Chang,&nbsp;Ya-Ting Jan,&nbsp;Tze-Chien Chen,&nbsp;Jie Lee","doi":"10.1002/jcsm.13289","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Malignant ascites is prevalent in advanced-stage ovarian cancer and may facilitate identification of the drivers of muscle loss. This study aimed to evaluate the association of ascites with changes in systemic inflammation and muscle after treatment of advanced-stage ovarian cancer.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We evaluated 307 patients with advanced-stage (III/IVA) ovarian cancer who underwent primary debulking surgery and adjuvant platinum-based chemotherapy between 2010 and 2019. The changes in skeletal muscle index (SMI) and radiodensity (SMD) were measured using pre-surgery and post-chemotherapy portal-venous phase contrast-enhanced computed tomography scans at L3. Systemic inflammation was measured using albumin levels, prognostic nutritional index (PNI), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR). Primary endpoint was the changes in SMI and SMD after treatment. Linear regression analysis was used to test associations between muscle change and other covariates. Mediation analysis was used to determine the mediator.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The median (range) age was 53 (23–83) years. The median duration (range) of follow-up was 5.2 (1.1–11.3) years. Overall, 187 (60.9%) patients had ascites. The changes in muscle and systemic inflammatory markers after treatment were significantly different between patients with and without ascites (SMI: −3.9% vs. 2.2%, <i>P</i> &lt; 0.001; SMD: −4.0% vs. −0.4%, <i>P</i> &lt; 0.001; albumin: −4.4% vs. 2.1%, <i>P</i> &lt; 0.001; PNI: −8.4% vs. −0.1%, <i>P</i> &lt; 0.001; NLR: 20.6% vs. −29.4%, <i>P</i> &lt; 0.001; and PLR: 1.7% vs. −19.4%, <i>P</i> &lt; 0.001). The changes in SMI and SMD were correlated with the changes in albumin, PNI, NLR, and PLR (all <i>P</i> &lt; 0.001). In multiple linear regression, ascites and NLR changes were negatively while albumin change was positively correlated with SMI change (ascites: β = −3.19, <i>P</i> &lt; 0.001; NLR change: β = −0.02, <i>P</i> = 0.003; albumin change: β = 0.37, <i>P</i> &lt; 0.001). Ascites and NLR changes were negatively while PNI change was positively correlated with SMD change (ascites: β = −1.28, <i>P</i> = 0.02; NLR change: β = −0.02, <i>P</i> &lt; 0.001; PNI change: β = 0.11, <i>P</i> = 0.04). In mediation analysis, ascites had a direct effect on SMI change (<i>P</i> &lt; 0.001) and an indirect effect mediated by NLR change (indirect effects = −1.61, 95% confidence interval [CI]: −2.22 to −1.08) and albumin change (indirect effects = −2.92, 95% CI: −4.01 to −1.94). Ascites had a direct effect on SMD change (<i>P</i> &lt; 0.001) and an indirect effect mediated by NLR change (indirect effects = −1.76, 95% CI: −2.34 to −1.22) and PNI change (indirect effects = −2.00, 95% CI: −2.79 to −1.36).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Malignant ascites was associated with enhanced systemic inflammation and muscle loss after primary debulking surgery and adjuvant chemotherapy in advanced-stage ovarian cancer. The association between ascites and muscle loss may be mediated by systemic inflammation.</p>\n </section>\n </div>","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":null,"pages":null},"PeriodicalIF":8.9000,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcsm.13289","citationCount":"0","resultStr":"{\"title\":\"Association of malignant ascites with systemic inflammation and muscle loss after treatment in advanced-stage ovarian cancer\",\"authors\":\"Chia-Sui Weng,&nbsp;Wan-Chun Huang,&nbsp;Chih-Long Chang,&nbsp;Ya-Ting Jan,&nbsp;Tze-Chien Chen,&nbsp;Jie Lee\",\"doi\":\"10.1002/jcsm.13289\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Malignant ascites is prevalent in advanced-stage ovarian cancer and may facilitate identification of the drivers of muscle loss. This study aimed to evaluate the association of ascites with changes in systemic inflammation and muscle after treatment of advanced-stage ovarian cancer.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>We evaluated 307 patients with advanced-stage (III/IVA) ovarian cancer who underwent primary debulking surgery and adjuvant platinum-based chemotherapy between 2010 and 2019. The changes in skeletal muscle index (SMI) and radiodensity (SMD) were measured using pre-surgery and post-chemotherapy portal-venous phase contrast-enhanced computed tomography scans at L3. Systemic inflammation was measured using albumin levels, prognostic nutritional index (PNI), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR). Primary endpoint was the changes in SMI and SMD after treatment. Linear regression analysis was used to test associations between muscle change and other covariates. Mediation analysis was used to determine the mediator.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>The median (range) age was 53 (23–83) years. The median duration (range) of follow-up was 5.2 (1.1–11.3) years. Overall, 187 (60.9%) patients had ascites. The changes in muscle and systemic inflammatory markers after treatment were significantly different between patients with and without ascites (SMI: −3.9% vs. 2.2%, <i>P</i> &lt; 0.001; SMD: −4.0% vs. −0.4%, <i>P</i> &lt; 0.001; albumin: −4.4% vs. 2.1%, <i>P</i> &lt; 0.001; PNI: −8.4% vs. −0.1%, <i>P</i> &lt; 0.001; NLR: 20.6% vs. −29.4%, <i>P</i> &lt; 0.001; and PLR: 1.7% vs. −19.4%, <i>P</i> &lt; 0.001). The changes in SMI and SMD were correlated with the changes in albumin, PNI, NLR, and PLR (all <i>P</i> &lt; 0.001). In multiple linear regression, ascites and NLR changes were negatively while albumin change was positively correlated with SMI change (ascites: β = −3.19, <i>P</i> &lt; 0.001; NLR change: β = −0.02, <i>P</i> = 0.003; albumin change: β = 0.37, <i>P</i> &lt; 0.001). Ascites and NLR changes were negatively while PNI change was positively correlated with SMD change (ascites: β = −1.28, <i>P</i> = 0.02; NLR change: β = −0.02, <i>P</i> &lt; 0.001; PNI change: β = 0.11, <i>P</i> = 0.04). In mediation analysis, ascites had a direct effect on SMI change (<i>P</i> &lt; 0.001) and an indirect effect mediated by NLR change (indirect effects = −1.61, 95% confidence interval [CI]: −2.22 to −1.08) and albumin change (indirect effects = −2.92, 95% CI: −4.01 to −1.94). Ascites had a direct effect on SMD change (<i>P</i> &lt; 0.001) and an indirect effect mediated by NLR change (indirect effects = −1.76, 95% CI: −2.34 to −1.22) and PNI change (indirect effects = −2.00, 95% CI: −2.79 to −1.36).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Malignant ascites was associated with enhanced systemic inflammation and muscle loss after primary debulking surgery and adjuvant chemotherapy in advanced-stage ovarian cancer. The association between ascites and muscle loss may be mediated by systemic inflammation.</p>\\n </section>\\n </div>\",\"PeriodicalId\":186,\"journal\":{\"name\":\"Journal of Cachexia, Sarcopenia and Muscle\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":8.9000,\"publicationDate\":\"2023-07-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcsm.13289\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Cachexia, Sarcopenia and Muscle\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/jcsm.13289\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cachexia, Sarcopenia and Muscle","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/jcsm.13289","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

背景:恶性腹水在晚期癌症中普遍存在,可能有助于识别肌肉损失的驱动因素。本研究旨在评估晚期癌症治疗后腹水与全身炎症和肌肉变化的关系。方法:我们评估了307例癌症晚期(III/IVA)患者,他们在2010年至2019年间接受了初级减瘤手术和辅助铂基化疗。使用术前和化疗后L3的门静脉期对比增强计算机断层扫描测量骨骼肌指数(SMI)和放射密度(SMD)的变化。使用白蛋白水平、预后营养指数(PNI)、中性粒细胞淋巴细胞比率(NLR)和血小板淋巴细胞比率(PLR)测量全身炎症。主要终点是治疗后SMI和SMD的变化。线性回归分析用于检验肌肉变化和其他协变量之间的相关性。使用中介分析来确定调解员。结果:中位(范围)年龄为53岁(23-83岁)。随访的中位持续时间(范围)为5.2年(1.1-11.3)。总的来说,187名(60.9%)患者有腹水。有腹水和无腹水患者治疗后肌肉和全身炎症标志物的变化有显著差异(SMI:3.9%vs.2.2%,P结论:晚期卵巢癌症在初次减瘤手术和辅助化疗后,恶性腹水与全身炎症增强和肌肉损失有关。腹水与肌肉损失之间的联系可能是由全身炎症介导的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

摘要图片

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Association of malignant ascites with systemic inflammation and muscle loss after treatment in advanced-stage ovarian cancer

Background

Malignant ascites is prevalent in advanced-stage ovarian cancer and may facilitate identification of the drivers of muscle loss. This study aimed to evaluate the association of ascites with changes in systemic inflammation and muscle after treatment of advanced-stage ovarian cancer.

Methods

We evaluated 307 patients with advanced-stage (III/IVA) ovarian cancer who underwent primary debulking surgery and adjuvant platinum-based chemotherapy between 2010 and 2019. The changes in skeletal muscle index (SMI) and radiodensity (SMD) were measured using pre-surgery and post-chemotherapy portal-venous phase contrast-enhanced computed tomography scans at L3. Systemic inflammation was measured using albumin levels, prognostic nutritional index (PNI), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR). Primary endpoint was the changes in SMI and SMD after treatment. Linear regression analysis was used to test associations between muscle change and other covariates. Mediation analysis was used to determine the mediator.

Results

The median (range) age was 53 (23–83) years. The median duration (range) of follow-up was 5.2 (1.1–11.3) years. Overall, 187 (60.9%) patients had ascites. The changes in muscle and systemic inflammatory markers after treatment were significantly different between patients with and without ascites (SMI: −3.9% vs. 2.2%, P < 0.001; SMD: −4.0% vs. −0.4%, P < 0.001; albumin: −4.4% vs. 2.1%, P < 0.001; PNI: −8.4% vs. −0.1%, P < 0.001; NLR: 20.6% vs. −29.4%, P < 0.001; and PLR: 1.7% vs. −19.4%, P < 0.001). The changes in SMI and SMD were correlated with the changes in albumin, PNI, NLR, and PLR (all P < 0.001). In multiple linear regression, ascites and NLR changes were negatively while albumin change was positively correlated with SMI change (ascites: β = −3.19, P < 0.001; NLR change: β = −0.02, P = 0.003; albumin change: β = 0.37, P < 0.001). Ascites and NLR changes were negatively while PNI change was positively correlated with SMD change (ascites: β = −1.28, P = 0.02; NLR change: β = −0.02, P < 0.001; PNI change: β = 0.11, P = 0.04). In mediation analysis, ascites had a direct effect on SMI change (P < 0.001) and an indirect effect mediated by NLR change (indirect effects = −1.61, 95% confidence interval [CI]: −2.22 to −1.08) and albumin change (indirect effects = −2.92, 95% CI: −4.01 to −1.94). Ascites had a direct effect on SMD change (P < 0.001) and an indirect effect mediated by NLR change (indirect effects = −1.76, 95% CI: −2.34 to −1.22) and PNI change (indirect effects = −2.00, 95% CI: −2.79 to −1.36).

Conclusions

Malignant ascites was associated with enhanced systemic inflammation and muscle loss after primary debulking surgery and adjuvant chemotherapy in advanced-stage ovarian cancer. The association between ascites and muscle loss may be mediated by systemic inflammation.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Journal of Cachexia, Sarcopenia and Muscle
Journal of Cachexia, Sarcopenia and Muscle Medicine-Orthopedics and Sports Medicine
自引率
12.40%
发文量
0
期刊介绍: The Journal of Cachexia, Sarcopenia, and Muscle is a prestigious, peer-reviewed international publication committed to disseminating research and clinical insights pertaining to cachexia, sarcopenia, body composition, and the physiological and pathophysiological alterations occurring throughout the lifespan and in various illnesses across the spectrum of life sciences. This journal serves as a valuable resource for physicians, biochemists, biologists, dieticians, pharmacologists, and students alike.
期刊最新文献
Tocilizumab for Advanced Non‐Small‐Cell Lung Cancer With Concomitant Cachexia: An Observational Study Prediction of Fragility Fractures and Mortality in a Cohort of Geriatric Patients Clinical Impact of Sarcopenia Screening on Long‐Term Mortality in Patients Undergoing Coronary Bypass Grafting An Artificial Intelligence Approach for Test‐Free Identification of Sarcopenia GABA Prevents Sarcopenia by Regulation of Muscle Protein Degradation and Inflammaging in 23‐ to 25‐Month‐Old Female Mice
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1