The Role Of L3 Skeletal Muscle Mass Index In Gastric Cancer Patients Nutritional Risk Evaluation And Prognosis Evaluation

ObjectiveTo Investigate whether the L3 skeletal muscle mass index can be used as predicting the prognosis of gastric cancer patients can influence factors and to evaluate the possibility of gastric cancer patients with nutritional risk.Methods41 patients with gastric cancer which aged 60 and above were choosen. The skeletal muscle (including the psoas major, shaft sma, waist muscle, the transverse abdominal muscle, the external oblique muscle,internal oblique)area was retrospectively measured on CT scans performed before surgery at the level of the third lumbar vertebra (L3) in the inferior direction with the patient in the supine position.For men, Sarcopenia was defined as the L3 skeletal muscle index (cm2/m2)<52.4cm2/m2.For women, Sarcopenia was defined as the L3 skeletal muscle index (cm2/m2)<38.5cm2/m2. through the NRS2002 nutrition score, assessment of nutritional risk in patients with preoperative, total score more than 3 points of nutritional risk, the need for nutrition intervention. The total score<3 patients without nutritional risk. By using non linear correlation analysis statistical methods, to evaluate its correlation with sarcopenia, and explore the L3 skeletal muscle mass index could be used to evaluate the nutritional risk of patients with gastric cancer. At the same time, The statistical method by using multiple linear regression analysis and logistic analysis, the possible impact on the two groups of patients with total hospitalization time, postoperative recovery time, complications (pneumonia, intestinal fistula, incision infection rate and mortality rate) influence factor analysis, L3 skeletal muscle mass index could be used to predicting the prognosis of patients with gastric cancer factor influence(age, gender, BMI, ALB, NRS2002 score, operation mode, operation time, bleeding volume, tumor size, tumor stage, L3 skeletal muscle mass index).Result41 patients with gastric cancer, diagnosed sarcopenia 17 cases (41.4%). Sarcopenia group and no sarcopenia were patients with an average length of stay was 29.71±10.49 days and 19.50±2.72 days difference between the two groups was statistically significant (P<0.01). Sarcopenia group and no sarcopenia postoperative hospital stay was 21.29±10.83 days, respectively, 11.79±1.64 days difference between the two groups was statistically significant (P<0.01). Sarcopenia sarcopenia group and no patients have complications 8 and 2, the difference between the two groups was statistically significant (P <0.05). Sarcopenia group and body mass index (BMI) of patients without sarcopenia were 21.14±2.97kg/m2 and 20.77±2.81 kg/m2, the two groups showed no significant difference (P> 0.05). Sarcopenia group and patients without sarcopenia L3 skeletal muscle mass index was as 46.24±5.09 cm2/m2 and 50.71±7.57 cm2/m2, the difference between the two groups was statistically significant (P<0.05). There were no deaths in the two groups. Non-linear correlation analysis showed that sarcopenia and nutrition risk of significant positive correlation (r=0.707, P<0.01). L3 skeletal muscle mass index can be used to assess nutritional risk of patients of gastric cancer (OR= 1.780, P<0.01).Multivariate multiple regression analysis and the regression analysis showed that the Logistics, L3 skeletal muscle mass index is predicted hospital stay of patients with gastric cancer, factor postoperative hospital stay, postoperative complications (P<0.05).ConclutionL3 skeletal muscle mass index can be used to predict the prognosis of patients with gastric cancer factor, can be used to assess nutritional risk of gastric cancer patients.