Value of cachexia index in predicting prognosis of patients with epithelial ovarian cancer treated by surgery

ZHAO Xin; TONG Jiyu; WANG Hua; WAN Shimeng; CAI Hongbing

doi:10.14188/j.1671-8852.2024.0974

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Value of cachexia index in predicting prognosis of patients with epithelial ovarian cancer treated by surgery

更新时间：2026-11-05

- Value of cachexia index in predicting prognosis of patients with epithelial ovarian cancer treated by surgery
- Medical Journal of Wuhan University Vol. 46, Issue 11, Pages: 1441-1448(2025)
- 作者机构：
  
  武汉大学中南医院妇科肿瘤科湖北武汉 430071
- 作者简介：
- 基金信息：
- DOI：10.14188/j.1671-8852.2024.0974
  CLC： R737.31
- Received：16 December 2024，
  
  Published：25 November 2025
- 稿件说明：
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赵欣,童继玉,王华等.恶病质指数对手术治疗的上皮性卵巢癌患者预后的评估价值[J].武汉大学学报（医学版）,2025,46(11):1441-1448.

ZHAO Xin,TONG Jiyu,WANG Hua,et al.Value of cachexia index in predicting prognosis of patients with epithelial ovarian cancer treated by surgery[J].Medical Journal of Wuhan University,2025,46(11):1441-1448.
赵欣,童继玉,王华等.恶病质指数对手术治疗的上皮性卵巢癌患者预后的评估价值[J].武汉大学学报（医学版）,2025,46(11):1441-1448. DOI： 10.14188/j.1671-8852.2024.0974.

ZHAO Xin,TONG Jiyu,WANG Hua,et al.Value of cachexia index in predicting prognosis of patients with epithelial ovarian cancer treated by surgery[J].Medical Journal of Wuhan University,2025,46(11):1441-1448. DOI： 10.14188/j.1671-8852.2024.0974.

摘要

目的

探讨恶病质指数（CXI）在预测上皮性卵巢癌患者预后的价值。

方法

回顾性收集2019年1月至2024年3月期间于武汉大学中南医院就诊的上皮性卵巢癌患者的临床病理资料。根据患者术前一个月内CT图像计算其骨骼肌指数（SMI），结合SMI、术前白蛋白、中性粒细胞绝对数与淋巴细胞绝对数的比值（NLR）计算CXI，采用R软件计算CXI预测术后生存情况的最佳截点值为36.93，据此将患者分为低CXI组（<36.93）与高CXI组（≥36.93）。采用Cox回归模型分析影响术后总生存期（OS)的独立预后因素，基于独立预后因素构建列线图预测模型。最后通过C指数、校准曲线与决策曲线评估上述模型的准确性、一致性与临床实用性。

结果

与高CXI组相比，低CXI组患者术前淋巴细胞绝对数、白蛋白水平、SMI更低，中性粒细胞绝对数、CA125值、血小板水平、ECOG评分、ASA≥3级、腹水量更高，差异均有统计学意义（

0.05）。生存分析结果显示低CXI组患者的OS明显短于高CXI组（

=0.004）。多因素Cox回归分析表明，CA125值、术中残余瘤和CXI是影响总生存期的独立预后因素（

0.05）。

结论

CXI是上皮性卵巢癌患者术后生存的独立预后因素，有助于早期识别卵巢癌相关恶病质，并及时予以干预，以改善患者预后。

Abstract

Objective

To explore the value of cachexia index(CXI) in predicting the prognosis of patients with epithelial ovarian cancer(EOC).

Methods

Patients with epithelial ovarian cancer who were admitted to Zhongnan Hospital of Wuhan University from January 2019 to March 2024 were selected

and their basic clinical data and survival data were collected. The skeletal muscle index(SMI) was calculated from clinically acquired CT scans at diagnosis preoperatively

and the CXI was then computed based on the SMI

albumin (ALB)

and neutrophil⁃lymphocyte ratio (NLR). According to the cut⁃off value determined by the R software

patients were then classified into the low⁃CXI (<36.93) group and the high⁃CXI (≥36.93) group. The Cox regression model was used to identify the independent prognostic factors affecting overall survival and a nomogram model was then constructed. The predictive accuracy

good fit

and clinical utility of the nomogram were evaluated by the C index

calibration curve

and decision curve respectively.

Results

Compared with the high⁃CXI group

patients in the low⁃CXI group exhibited lower absolute lymphocyte count

SMI and albumin level

while having higher absolute neutrophil count

CA125 value

platelet level

ECOG score

ASA≥level 3 and volume of ascites. Differences were statistically significant (

0.05). Multivariate Cox regression analysis revealed that CA125

residual lesions and CXI were independent factors influencing overall survival (

0.05). Survival analysis results showed that patients in the low CXI group had significantly shorter OS than those in the high CXI group(

=0.004).

Conclusion

The cachexia index is an independent prognostic factor for postoperative survival of patients with epithelial ovarian cancer

which can provide help for early identification of ovarian cancer⁃related cachexia and intervention.

关键词

Keywords

references

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Related Author

ZHAO Xin

TONG Jiyu

WANG Hua

WAN Shimeng

CAI Hongbing

YANG Shuang

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Related Institution

Dept. of Gynecological Oncology, Zhongnan Hospital of Wuhan University

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Intensive Care Unit, Luzhou Traditional Chinese Medicine Hospital

Intensive Care Unit, Renmin Hospital of Wuhan University

Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University

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