Association between Intramuscular Fat Infiltration and Postoperative Sarcopenia in Esophageal Cancer
10.11969/j.issn.1673-548X.2025.07.026
- VernacularTitle:肌内脂肪浸润与食管癌术后肌肉减少症的相关性分析
- Author:
Shiming ZHENG
1
;
Meng ZHANG
1
;
Cheng WANG
1
Author Information
1. 730030 兰州大学第二医院、兰州大学第二临床医学院
- Publication Type:Journal Article
- Keywords:
Esophageal cancer;
Sarcopenia;
Myosteatosis
- From:
Journal of Medical Research
2025;54(7):145-151
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the factors influencing the occurrence of sarcopenia following esophageal cancer surgery and to as-sess the association between skeletal muscle fat infiltration and postoperative sarcopenia.Methods The retrospective study analyzed clin-ical data from patients who underwent radical esophagectomy in the Department of Thoracic Surgery at the Second Hospital of Lanzhou Uni-versity between January 2020 and December 2022.Based on whether the postoperative loss of skeletal muscle area exceeded 10%,pa-tients were categorized into a sarcopenia group(n=50)and a non-sarcopenia group(n=69).General clinical information,periopera-tive data,and imaging findings were collected.Statistical analyses were performed using R version 3.1.4,and cutoff values were deter-mined by receiver operating characteristic(ROC)curve analysis.Results There were statistically significant differences between the sar-copenia and non-sarcopenia groups in terms of postoperative chemotherapy,lymphocyte count,skeletal muscle area,skeletal muscle in-dex,prognostic nutritional index,and intramuscular fat content(P<0.05).At the level of the third lumbar vertebra,intramuscular fat content was significantly correlated with the rate of postoperative skeletal muscle loss(r=0.21,P<0.05),but showed no correlation with the preoperative skeletal muscle area(r=-0.07,P=0.45).Multivariate Logistic regression analysis revealed that preoperative in-tramuscular fat content,skeletal muscle index,and postoperative chemotherapy were independent predictors of postoperative sarcopenia.ROC curve analysis indicated that a cutoff value of-0.647 for preoperative intramuscular fat content at the third lumbar vertebra provided the optimal predictive efficacy for postoperative sarcopenia in esophageal cancer patients[area under the curve(AUC)=0.630,sensitivi-ty=80.00%,specificity=47.80%].Conclusions The degree of skeletal muscle fat infiltration at the L3 level is significantly associat-ed with the development of postoperative sarcopenia in patients with esophageal cancer.Early nutritional support and rehabilitation training in patients with high fat infiltration may help prevent the occurrence of postoperative sarcopenia.