喉癌喉切除术后早期身体成分轨迹及探索性比值定义表型：一项前瞻性队列研究。
Early postoperative body-composition trajectories and exploratory ratio-defined phenotypes after laryngectomy for laryngeal cancer: a prospective cohort study.
文献信息
| PMID | 42859280 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Feilin Chen |
| 作者单位 | Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China. |
| 期刊 | Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer |
| SCI 分区 | Q1 |
| IF | 3.7 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 描述喉癌喉切除术后骨骼肌质量和脂肪质量的早期术后轨迹，并次要探索比值定义的相对身体成分表型。
方法： 在这项前瞻性队列中，230例患者在入院48小时内以及术后第1、2、4和8周接受了生物电阻抗分析（BIA）。BIA测量骨骼肌质量指数（SMI）和脂肪质量指数（FMI）。第2周比值R = 100 ×（ΔSMI₂w/ΔFMI₂w）描述相对 compartmental 变化；队列中位数（-22.1%）被用作脂肪质量优势型（FMDT）和骨骼肌质量优势型（SMDT）的探索性截断值。使用多变量logistic回归检查与FMDT相关的因素。
结果： FMI早期下降，并在第8周恢复至接近基线，而SMI在第1周变化很小，此后下降，并在第8周仍低于基线。FMDT和SMDT各包括115例患者（50.0%）。与高分化肿瘤相比，中分化和低分化肿瘤与FMDT相关（比值比[OR] 2.452，95%置信区间[CI] 1.229-4.893；OR 2.507，95% CI 1.094-5.746）。较高的术前体脂肪量与FMDT的较低几率相关（OR 0.939，95% CI 0.893-0.988）。
结论： FMI和SMI显示出不同的术后轨迹。比值定义的FMDT/SMDT描述了探索性相对 compartmental 变化模式，病理分化和术前体脂肪量与FMDT相关。在临床解释之前，这些发现需要在独立队列中确认。
英文摘要
PURPOSE: To characterize early postoperative trajectories of skeletal muscle mass and fat mass after laryngectomy for laryngeal cancer and secondarily explore ratio-defined relative body-composition phenotypes.
METHODS: In this prospective cohort, 230 patients underwent bioelectrical impedance analysis (BIA) within 48 h of admission and at postoperative weeks 1, 2, 4, and 8. BIA measured skeletal muscle mass index (SMI) and fat mass index (FMI). The week 2 ratio R = 100 × (ΔSMI₂w/ΔFMI₂w) described relative compartmental change; the cohort median (- 22.1%) was used as an exploratory cutoff for fat mass-dominant type (FMDT) and skeletal muscle mass-dominant type (SMDT). Factors associated with FMDT were examined using multivariable logistic regression.
RESULTS: FMI decreased early and returned toward baseline by week 8, whereas SMI changed little at week 1, declined thereafter, and remained below baseline at week 8. FMDT and SMDT each included 115 patients (50.0%). Compared with well-differentiated tumors, moderately and poorly differentiated tumors were associated with FMDT (odds ratio [OR] 2.452, 95% confidence interval [CI] 1.229-4.893; OR 2.507, 95% CI 1.094-5.746). Higher preoperative body fat mass was associated with lower odds of FMDT (OR 0.939, 95% CI 0.893-0.988).
CONCLUSION: FMI and SMI showed distinct postoperative trajectories. Ratio-defined FMDT/SMDT described exploratory relative compartmental-change patterns, and pathological differentiation and preoperative body fat mass were associated with FMDT. These findings require confirmation in independent cohorts before clinical interpretation.