The Clinical Study Of Prediction Swelling Tumor Cachexia By CT Quantitative Sarcopenia And Hematological Indexes

Objective:Cachexia is a syndrome caused by many factors that affect the quality of life and survival time of cancer patients.However,there is no clear method to diagnose cachexia as early as possible at home and abroad.Objective to study the changes of muscle content and hematological indexes in patients with tumor cachexia,and to explore the relationship between them and the occurrence of tumor cachexia,so as to provide reference for early clinical diagnosis and treatment of tumor cachexia,early diagnosis and early intervention,delay the development of advanced tumor patients and prolong the life cycle of tumor patients.Methods:The data of patients diagnosed as malignant tumor by pathological biopsy in interventional oncology department of Inner Mongolia International Mongolian Medical Hospital from January 2019 to December 2020 were retrospectively analyzed.According to the inclusion criteria and exclusion criteria,a total of 81 cases were selected.According to the international diagnostic criteria of cachexia,the experimental group was divided into cachexia group and non cachexia group,including 30 cases of cachexia group and 51 cases of non cachexia group.Then the blood routine and blood biochemical test results of the patients were obtained through the electronic medical record system.The skeletal muscle area(SMA)of the third lumbar spine midpoint cross section image was quantitatively measured by CT,and the skeletal muscle index(SMI)was calculated by dividing it by the square of the patient’s height.The relationship between cachexia and myopenia and the expression of related hematological indexes were compared and analyzed.Logistic regression analysis was used to determine the related factors between cachexia and myopenia.The predictive value of hematological indexes for cachexia was determined by ROC curve.All data were analyzed by spss22.0 software.Results:1.In this study,81 patients were selected as experimental cases for routine hematology index and CT quantitative analysis.There were 30 cases in cachexia group and 51 cases in non cachexia group.Compared with the two groups,cachexia group had lower BMI(47%VS.6%,P<0.05);patients with digestive system tumors were more likely to develop cachexia(67%VS.55%,P<0.05);patients with advanced tumors were more likely to develop cachexia than patients with early tumors(74%VS.60%,P<0.05).2.In the analysis of hematological indexes of the two groups of patients,there are mainly liver function,renal function,blood routine analysis.Compared with non cachexia group,the levels of cholinesterase(3586±1906 VS.5478±2678,P<0.05),total protein(59 ±11VS.64±13,P<0.05),albumin(32.5(28.0,36.6)VS.39.2(34.8,41.8),P<0.05),creatinine(51.5(41.3,61.2)VS.70.2(55.7,78.4),P<0.05),erythrocyte(3.27±0.68VS.4.00 ± 0.99,P<0.05)in cachexia group were significantly lower than those in non cachexia group,The decrease of hemoglobin(male:113 ± 8VS.136 ± 10,P<0.05;female:105±7VS.124±12,P<0.05)and muscle mass(32.397±6.1606VS.42.112± 6.8651,P<0.05)were the related factors of cachexia.Univariate logistic regression analysis showed that cholinesterase,total protein,albumin,creatinine,red blood cells,decreased hemoglobin and myopenia were the risk factors for cachexia in tumor patients.Multivariate logistic regression analysis showed that hypoproteinemia and decreased muscle mass were independent risk factors for cachexia.3.Objective to study the clinical cut-off value of hematological indexes for the prediction of cachexia in cancer patients.According to logistic regression analysis,albumin and red blood cells were the independent risk factors of cachexia(P<0.05).According to the results of ROC curve,the sensitivity,specificity and approximate index of albumin and red blood cells in predicting tumor cachexia were obtained,and the clinical cut-off value of albumin and red blood cells in hematological indexes in diagnosing cachexia was obtained.In the prediction of cachexia,albumin had better prediction effect than red blood cells(AUC=0.773)VS.AUC=0.621).Conclusions:1.The results showed that the levels of cholinesterase,total protein,albumin,creatinine and red blood cells in patients with cachexia were lower than those in patients without cachexia;2.The muscle content of cachexia patients was significantly lower than that of non cachexia patients;3.The combination of albumin and muscle content in blood routine with SMI can be used to diagnose and predict the occurrence of malignant tumor.