The objective of this study was to explore the possible association between low skeletal muscle mass (SMM)—assessed by computed tomography (CT) and ultrasound (US)—and hematologic toxicity in cancer patients. A prospective cohort study was conducted in cancer patients who received anthracycline-based chemotherapy between 2018 and 2020 and who had baseline abdominal CT including L3 level for measuring SMM. Regional muscle measurements were carried out using US. A total of 65 patients (14 males, 51 females) were included. ROC (receiver operating characteristic) analysis identified threshold values of 18.0 mm [AUC (area under the curve) = 0.765] for females and 20.0 mm (AUC = 0.813) for males, predicting severe neutropenia. Using these cut-offs, females with low rectus femoris (RF) thickness (<18.0 mm) had a significantly higher incidence of grade ≥3 neutropenia (50.0% vs. 10.8%,p= 0.005), and males with low RF values (<20.0 mm) had a higher incidence (80.0% vs. 22.2%,p= 0.063). A regression analysis, irrespective of age, gender, and body mass index, revealed that only low RF muscle thickness increased the risk of grade 3–4 neutropenia by 9.210 times (95% CI = 2.401–35.326,p= 0.001). Utilizing US to measure RF muscle thickness aids in identifying cancer patients at an elevated risk of developing neutropenia. Needless to say, US can serve as a convenient and easily accessible tool for assessing low SMM, providing repeat point-of-care evaluations in clinical practice.
本研究旨在探讨通过计算机断层扫描（CT）和超声（US）评估的低骨骼肌质量（SMM）与癌症患者血液学毒性之间的潜在关联。研究对2018年至2020年间接受蒽环类化疗的癌症患者进行了一项前瞻性队列研究，这些患者均接受了包含L3水平的基线腹部CT扫描以测量SMM，同时使用超声进行局部肌肉测量。共纳入65例患者（男性14例，女性51例）。受试者工作特征（ROC）分析确定了预测严重中性粒细胞减少的阈值：女性为18.0毫米（曲线下面积AUC=0.765），男性为20.0毫米（AUC=0.813）。应用这些阈值发现，股直肌（RF）厚度较低（<18.0毫米）的女性患者发生≥3级中性粒细胞减少症的比例显著更高（50.0% vs. 10.8%，p=0.005）；而RF值较低（<20.0毫米）的男性患者发生率也更高（80.0% vs. 22.2%，p=0.063）。回归分析显示，在排除年龄、性别和体重指数的影响后，仅低RF肌肉厚度就会使3-4级中性粒细胞减少症的风险增加9.210倍（95% CI=2.401–35.326，p=0.001）。使用超声测量RF肌肉厚度有助于识别中性粒细胞减少症风险较高的癌症患者。毋庸置疑，超声可作为评估低SMM的便捷工具，在临床实践中提供可重复的即时评估。
肿瘤(癌症)患者之家