目的:阐明少肌症在儿童神经母细胞性肿瘤(NTs)中的临床意义。
方法:我们进行了一项回顾性观察研究,并分析了身高的z得分,体重,身体质量指数,和骨骼肌指数(HT-z,BW-z,BMI-z,和SMI-z)以及36例NT患儿的临床特征。SMI-z是根据诊断时的138次计算机断层扫描计算得出的,治疗期间,在后续。使用国际神经母细胞瘤风险组分类来识别高危人群。我们分析了诊断时的数据,以进行预后分析,并在HT-z诊断后随时间的变化,BW-z,BMI-z,和SMI-z组。
结果:在诊断的四个参数中,只有SMI-z预测总生存率(风险比,0.58;95%置信区间,0.34-0.99)。SMI-z,HT-z,诊断后BW-z随时间显著下降(P<0.05),而BMI-z没有(P=0.11)。在没有疾病的高危NT病例中幸存下来,SMI-z,HT-z,BW-z随时间显著降低(P<0.05),BMI-z无差异(P=0.43)。
结论:在患有NT的儿童中,诊断时的SMI-z是一个重要的预后因素,在治疗和随访期间与HT-z和BW-z一起降低.监测肌肉质量很重要,因为肌肉减少症可能与生长障碍有关。
OBJECTIVE: To elucidate the clinical significance of sarcopenia in children with neuroblastic tumors (NTs).
METHODS: We conducted a retrospective observational study and analyzed the z-scores for height, body weight, body mass index, and skeletal muscle index (HT-z, BW-z, BMI-z, and SMI-z) along with the clinical characteristics of 36 children with NTs. SMI-z was calculated from 138 computed tomography scans at diagnosis, during treatment, and at follow-up. The International Neuroblastoma Risk Group classification was used to identify high-risk groups. We analyzed the data at diagnosis for prognostic analysis and changes over time after diagnosis in the HT-z, BW-z, BMI-z, and SMI-z groups.
RESULTS: Among the four parameters at diagnosis, only SMI-z predicted overall survival (hazard ratio, 0.58; 95% confidence interval, 0.34-0.99). SMI-z, HT-z, and BW-z significantly decreased over time after diagnosis (P < 0.05), while BMI-z did not (P = 0.11). In surviving high-risk NT cases without disease, SMI-z, HT-z, and BW-z significantly decreased over time (P < 0.05), while BMI-z did not (P = 0.43).
CONCLUSIONS: In children with NT, the SMI-z at diagnosis was a significant prognostic factor and decreased during treatment and follow-up along with HT-z and BW-z. Monitoring muscle mass is important because sarcopenia may be associated with growth impairment.