目的 本研究旨在探讨血肌酐(Cr)与胱氨酸抑素 C (CysC)比值对晚期非小细胞肺癌(NSCLC)患者肌肉减少症的 预测价值。 方法 本研究选取 2019 年 1 月至 2022 年 1 月期间于南通大学附属海门医院初诊并接受化疗的 134 例晚期 NSCLC 患者,通过计算机断层扫描测量第三腰椎旁肌肉质量指数(SMI)和双握力检测定义肌肉减少症。 使用 Pearson 相关系数评估 血清 Cr/ CysC 比值与不同营养参数的线性关系,受试者操作特征(ROC)曲线用于评估其对肌肉减少症的预测价值。 结果 共 有 46 例(34. 3%)NSCLC 患者被诊断为肌肉减少症,包括男性 35 例(33. 0%),女性 11 例(39. 3%)。 血清 Cr/ CysC 比值与血清 白蛋白 (r = 0. 186, P= 0. 032)、SMI 值(r = 0. 288, P= 0. 020)及握力(r = 0. 362, P<0. 001)呈明显正相关。 ROC 曲线展示血 清 Cr/ CysC 比值预测肌肉减少症的最佳截止点为 0. 872,AUC 值为 0. 744 (95%CI = 0. 660 ~ 0. 829),灵敏度与特异度分别为 84. 8%和 61. 4%。 血清 Cr/ CysC 比值(OR= 0. 005, 95%CI = 0. 001 ~ 0. 061, P<0. 001)是晚期 NSCLC 患者的保护因素。 结 论 血清 Cr/ CysC 比值与肌肉质量和肌肉力量具有显著相关性,或许是筛查晚期 NSCLC 患者肌肉减少症一项简单、有效的 工具。

Objective This study aimed to explore the clinical value of serum creatinine Cr / cystatin C CysC ratio as a predictor of sarcopenia for patients with advanced non-small cell lung cancer NSCLC . Method This study included 134 advanced NSCLC patients who were initially diagnosed and treated with chemotherapy in our hospital from January 2019 to January 2022. The skeletal muscle index SMI at the third lumbar level measured by computed tomography CT and handgrip strength were used to diagnose sarcopenia. The linear relationships between serum Cr/ CysC ratio and various nutritional parameters were determined by the Pearson's correlation coefficient and the receiver operating characteristics ROC curve was used to evaluate its predictive value for sarcopenia. Result 46 34. 3% of 134 advanced NSCLC patients were diagnosed with sarcopenia which was found in 35 males 33. 0% and 11 females 39. 3% . Serum Cr/ CysC ratio was positively correlated with with serum albumin value r = 0. 186 P = 0. 032 SMI r = 0. 288 P = 0. 020 and handgrip strength r = 0. 362 P < 0. 001 . The ROC curve showed that the best threshold of serum Cr/ CysC ratio was 0. 872 and its AUC value was 0. 744 95%CI = 0. 660-0. 829 with a sensitivity of 84. 8% and specificity of 61. 4% respectively. The serum Cr/ CysC ratio OR= 0. 005 95%CI = 0. 001-0. 061 P<0. 001 was identified as a protect risk factor of sarcopenia for advanced NSCLC patients. Conclusion The serum Cr/ CysC ratio was significantly correlated with skeletal muscle mass and muscle strength and it could be a simple and effective tool of sarcopenia screening for advanced NSCLC patients.