肌少症与结直肠癌生存率关系的系统评价和Meta分析

摘要/Abstract

摘要： 目的：研究结直肠癌（CRC）患者肌少症与总生存期(overall survival，OS)和无病生存期 (disease-free survival，DFS) 之间的关系。方法：检索Pubmed、Web of Science、Elsevier ScienceDirect (SD)、OVID-lww-oup（医学全文）、万方、中国知网数据库、中国生物医学文献数据库，检索时间为建库时间至2022年10月，纳入使用Cox回归分析评估肌少症对CRC生存预后影响的研究。使用预后研究质量工具来评估偏倚风险和研究质量。结果：本研究纳入了来自9个国家的19项研究、9338名患者。单因素Cox分析结果(HR=1.94， 95%CI 1.64~2.28， P<0.000 01， I2=62%) 和多因素Cox分析 (HR 1.90， 95%CI 1.58~2.28，P<0.000 01，I2=65%)，结果显示肌少症与CRC患者OS减少相关。在多因素Cox比例风险分析 (HR=1.97， 95% CI 1.60~2.44， P<0.000 01， I2=37%) 和单因素Cox比例风险分析(HR=1.55，95% CI 1.30~1.84， P<0.000 01， I2=31%)中，肌少症也与CRC的DFS减少显著相关。结论：低肌肉指数（skeletal muscle index，SMI)与CRC患者的OS和DFS相关。肌少症是结直肠癌患者生存的独立危险因素，可通过治疗肌少症来改善结直肠癌患者的预后。

关键词: font-size:medium, ">肌少症；结直肠癌；总生存期；无病生存期；系统评价

Abstract: Objective： To study the relationship between sarcopenia and overall survival (OS) and disease-free survival (DFS) in patients with colorectal cancer (CRC). Methods： Pubmed， Web of Science， Elsevier ScienceDirect (SD)，OVID-lww-oup， Wanfang， CNKI， Chinese Biomedical Literature Database were searched， and the retrieval time range was from the time of database construction to October 2022. Studies which use Cox regression analysis to evaluate the impact of sarcopenia on survival and prognosis of CRC were included. This study used quality tools for prognostic studies to evaluate the risk of bias and study quality. Results： 19 studies from 9 countries were included， which included and 9338 patients. Univariate Cox analysis (HR=1.94， 95% CI 1.64-2.28， P<0.000 01， I2=62%) and multivariate Cox analysis (HR 1.90， 95% CI 1.58-2.28， P<0.000 01， I2=65%) results showed that sarcopenia was associated with reduced OS in CRC patients. Sarcopenia was also significantly associated with decreased OS in CRC in univariate and multivariate Cox proportional hazard analysis. Sarcopenia was also significantly associated with an decreased DFS in CRC both in multivariate Cox proportional hazard analysis (HR=1.97， 95% CI 1.60-2.44， P<0.000 01， I2=37%) and in univariate Cox proportional hazard analysis (HR=1.55， 95% CI 1.30-1.84， P<0.000 01， I2=31%). Conclusion： Low SMI is associated with OS and DFS in CRC patients. Sarcopenia is an independent risk factor for survival in CRC patients. Treating sarcopenia may improve CRC prognosis.

Key words: font-size:medium, ">Sarcopenia； Colorectal cancer； Overall survival； Disease-free survival； Systematic review

中图分类号:

胡悦a, 孙超, 金武勇b. 肌少症与结直肠癌生存率关系的系统评价和Meta分析[J]. 中国医药导刊, 2023, 25(8): 833-841.

HU Yuea, SUN Chao, JING Wuyongb. The Relationship Between Sarcopenia and Survival of Colorectal Cancer：A Systematic Review and Meta-analysis[J]. CHINESE JOURNAL OF MEDICINAL GUIDE, 2023, 25(8): 833-841.

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