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

赵欣; 童继玉; 王华; 万诗萌; 蔡红兵

doi:10.14188/j.1671-8852.2024.0974

您当前的位置：

首页 >

文章列表页 >

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

肿瘤学研究 | 更新时间：2026-11-05

- 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
- Value of cachexia index in predicting prognosis of patients with epithelial ovarian cancer treated by surgery
- 武汉大学学报（医学版） 2025年46卷第11期页码：1441-1448
- 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：
  
  赵欣，女，2000—，医学硕士生，主要从事妇科肿瘤方面的研究，E⁃mail: 2022283030111@whu.edu.cn
  蔡红兵，女，1961—，医学博士，教授，主任医师，主要从事妇科肿瘤研究，E⁃mail: chb2105@163.com
- 基金信息：
  
  湖北省卫生健康委青年人才资助项目(WJ2023M067)
- DOI：10.14188/j.1671-8852.2024.0974
  中图分类号： R737.31
- 收稿：2024-12-16，
  
  纸质出版：2025-11-25
- 稿件说明：
移动端阅览
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

BRAY F , LAVERSANNE M , SUNG H , et al . Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries [J ] . CA Cancer J Clin , 2024 , 74 ( 3 ): 229 ⁃ 263 .

SCHOUTROP E , MOYANO⁃GALCERAN L , LHEUREUX S , et al . Molecular, cellular and systemic aspects of epithelial ovarian cancer and its tumor microenvironment [J ] . Semin Cancer Biol , 2022 , 86 ( Pt 3 ): 207 ⁃ 223 .

KONSTANTINOPOULOS P A , MATULONIS U A . Clinical and translational advances in ovarian cancer therapy [J ] . Nat Cancer , 2023 , 4 ( 9 ): 1239 ⁃ 1257 .

ARGILÉS J M , LÓPEZ⁃SORIANO F J , STEMMLER B , et al . Cancer⁃associated cachexia ⁃ understanding the tumour macroenvironment and microenvironment to improve management [J ] . Nat Rev Clin Oncol , 2023 , 20 ( 4 ): 250 ⁃ 264 .

SETIAWAN T , SARI I N , WIJAYA Y T , et al . Cancer cachexia: Molecular mechanisms and treatment strategies [J ] . J Hematol Oncol , 2023 , 16 ( 1 ): 54 .

PEIXOTO DA SILVA S , SANTOS J M O , COSTA E SILVA M P , et al . Cancer cachexia and its pathophysiology: Links with sarcopenia, anorexia and asthenia [J ] . J Cachexia Sarcopenia Muscle , 2020 , 11 ( 3 ): 619 ⁃ 635 .

FEARON K , STRASSER F , ANKER S D , et al . Definition and classification of cancer cachexia: An international consensus [J ] . Lancet Oncol , 2011 , 12 ( 5 ): 489 ⁃ 495 .

JAFRI S H R , PREVIGLIANO C , KHANDELWAL K , et al . Cachexia index in advanced non⁃small⁃cell lung cancer patients [J ] . Clin Med Insights Oncol , 2015 , 9 : 87 ⁃ 93 .

GOH M J , KANG W , JEONG W K , et al . Prognostic significance of cachexia index in patients with advanced hepatocellular carcinoma treated with systemic chemotherapy [J ] . Sci Rep , 2022 , 12 ( 1 ): 7647 .

BROWN L R , THOMSON G G , GARDNER E , et al . Cachexia index for prognostication in surgical patients with locally advanced oesophageal or gastric cancer: Multicentre cohort study [J ] . Br J Surg , 2024 , 111 ( 4 ): znae098 .

SAKURAI K , KUBO N , HASEGAWA T , et al . The cancer cachexia index can be used to prognostically predict patients with gastric cancer undergoing gastrectomy [J ] . Ann Nutr Metab , 2023 , 79 ( 6 ): 511 ⁃ 521 .

GO SI , PARK M J , PARK S , et al . Cachexia index as a potential biomarker for cancer cachexia and a prognostic indicator in diffuse large B⁃cell lymphoma [J ] . J Cachexia Sarcopenia Muscle , 2021 , 12 ( 6 ): 2211 ⁃ 2219 .

SANTOS I , MENDES L , MANSINHO H , et al . Nutritional status and functional status of the pancreatic cancer patients and the impact of adjacent symptoms [J ] . Clin Nutr , 2021 , 40 ( 11 ): 5486 ⁃ 5493 .

BARACOS V E , MARTIN L , KORC M , et al . Cancer⁃associated cachexia [J ] . Nat Rev Dis Primers , 2018 , 4 : 17105 .

SIFF T , PARAJULI P , RAZZAQUE M S , et al . Cancer⁃mediated muscle cachexia: Etiology and clinical management [J ] . Trends Endocrinol Metab , 2021 , 32 ( 6 ): 382 ⁃ 402 .

DONG J , XUE H , AN F , et al . Correlation between the Neutrophil⁃to⁃lymphocyte ratio and clinicopathological parameters in epithelial ovarian cancer patients and its effect on prognosis—A retrospective cohort study [J ] . Gland Surg , 2022 , 11 ( 8 ): 1367 ⁃ 1373 .

BAI G , ZHOU Y , RONG Q , et al . Development of nomogram models based on peripheral blood score and clinicopathological parameters to predict preoperative advanced stage and prognosis for epithelial ovarian cancer patients [J ] . J Inflamm Res , 2023 , 16 : 1227 ⁃ 1241 .

CASSATELLA M A , ÖSTBERG N K , TAMASSIA N , et al . Biological roles of neutrophil⁃derived granule proteins and cytokines [J ] . Trends Immunol , 2019 , 40 ( 7 ): 648 ⁃ 664 .

VALENTI G , VITAGLIANO A , MOROTTI M , et al . Risks factors for anastomotic leakage in advanced ovarian cancer: A systematic review and meta⁃analysis [J ] . Eur J Obstet Gynecol Reprod Biol , 2022 , 269 : 3 ⁃ 15 .

GOINS E C , WEBER J M , TRUONG T , et al . Malnutrition as a risk factor for post⁃operative morbidity in gynecologic cancer: Analysis using a national surgical outcomes database [J ] . Gynecol Oncol , 2022 , 165 ( 2 ): 309 ⁃ 316 .

XU X , TIAN M , DING C C , et al . Skeletal muscle Index⁃based cachexia index as a predictor of prognosis in patients with cancer: A meta⁃analysis and systematic review [J ] . Nutr Rev , 2025 , 83 ( 3 ): e852 ⁃e865.

ONDA T , SATOH T , SAITO T , et al . Comparison of treatment invasiveness between upfront debulking surgery versus interval debulking surgery following neoadjuvant chemotherapy for stage Ⅲ/Ⅳ ovarian, tubal, and peritoneal cancers in a phase Ⅲ randomised trial: Japan clinical oncology group study JCOG0602 [J ] . Eur J Cancer , 2016 , 64 : 22 ⁃ 31 .

FAGOTTI A , FERRANDINA G , VIZZIELLI G , et al . Phase Ⅲ randomised clinical trial comparing primary surgery versus neoadjuvant chemotherapy in advanced epithelial ovarian cancer with high tumour load (SCORPION trial): Final analysis of peri⁃operative outcome [J ] . Eur J Cancer , 2016 , 59 : 22 ⁃ 33 .

KEHOE S , HOOK J , NANKIVELL M , et al . Primary chemotherapy versus primary surgery for newly diagnosed advanced ovarian cancer (CHORUS): An open⁃label, randomised, controlled, non⁃inferiority trial [J ] . Lancet , 2015 , 386 ( 9990 ): 249 ⁃ 257 .

VAN MEURS H S , TAJIK P , HOF M H P , et al . Which patients benefit most from primary surgery or neoadjuvant chemotherapy in stage ⅢC or Ⅳ ovarian cancer? An exploratory analysis of the european organisation for research and treatment of cancer 55971 randomised Trial [J ] . Eur J Cancer , 2013 , 49 ( 15 ): 3191 ⁃ 3201 .

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

特发性肺纤维化生存预后预测模型的建立及验证

基于新型复合指标构建脓毒症患者预后列线图模型

基于MIMIC⁃Ⅳ数据库构建和验证预测脓毒症相关肝损伤患者住院死亡风险的列线图

心力衰竭患者30天再入院预测模型构建及验证

人参皂苷防脱精华治疗雄激素性秃发的临床有效性和安全性研究