目的 报告中国恶性肿瘤患者肌肉减少症的流行病学调查结果。 方法 纳入中国肿瘤营养队列研究常见恶性肿瘤 营养状态与临床结局相关性研究(INSCOC)数据库 2013 年 7 月至 2023 年 12 月 86 家三级甲等医院 19 种恶性肿瘤患者 61 627 例。 采用亚洲肌肉减少症工作组(AWGS)2019 年肌肉减少症诊断标准诊断肿瘤患者肌肉减少症。 χ 2 检验或 Fisher 确切概率法分析比较不同特征肿瘤患者肌肉减少症患病情况。 结果 肿瘤患者中肌肉减少症的患病率为 18. 1%(11 175 / 61 627)。 肌肉减少症患病率因肿瘤类型、TNM 分期、年龄、性别、地理区域及治疗情况不同而存在差异:消化系统肿瘤患者肌肉减少症患病 率较高,其中胰腺癌患者患病率最高[32. 4%(311 / 961)];肌肉减少症患病率随 TNM 分期增高而增大(P<0. 05);70 岁以上患者肌肉减少症患病率最高[34. 7%(3510 / 10 129)];女性肿瘤患者肌肉减少症患病率高于男性患者[16. 1%(5544 / 34 381)比20. 7%(5631 / 27 246),P< 0. 05];东北地区的患者患病率最低[ 14. 7% ( 2398 / 16 300)],接受手术治疗的患者患病率最高[22. 1%(1635 / 7412)]。 此外,在某些肿瘤类型中,不同医疗保险类型、职业、教育水平、民族、居住地的患者肌肉减少症患病率存在显著性差异,文化水平低、农民患者发生肌肉减少症的风险更高。 结论 本研究首次以大规模数据报告了肿瘤患者肌肉 减少症的患病率,消化道系统、老年、农民、低教育水平及进展期肿瘤患者等是发生肌肉减少症的高风险人群。

Objective This study aims to investigate the prevalence of sarcopenia specifically in Chinese patients with malignant tumors. Method A total of 61 627 patients with 19 types of malignant tumors from 86 grade-A hospitals from July 2013 to December 2023 were included in the INSCOC database of the Chinese Tumor Nutrition Cohort Study. The diagnostic criteria for sarcopenia provided by the Asian Working Group on Sarcopenia AWGS in 2019 were used. Chi-square test or Fisher exact test was used to compare the prevalence of sarcopenia in patients with different population characteristics. Result The prevalence of sarcopenia in cancer patients was 18. 1%. The prevalence of sarcopenia varied with tumor type TNM stage age gender administrative area and treatment. The prevalence of sarcopenia was higher in patients with digestive system cancers and the highest prevalence was found in patients with pancreatic cancer 32. 4% 311 / 961 . The prevalence of sarcopenia increased with the increase of TNM stage P< 0. 05 . The prevalence of sarcopenia was the highest in patients over 70 years old 34. 7% 3510 / 10 129 . The prevalence of sarcopenia in female cancer patients was higher than that in male patients 16. 1% 5544 / 34 381 vs 20. 7% 5631 / 27 246 P<0. 05 . The lowest prevalence was found in the Northeast region 14. 7% 2398 / 16 300 . Patients who received surgical treatment had the highest prevalence 22. 1% 1635 / 7412 . In addition in some tumor types there were significant differences in the prevalence of sarcopenia among patients with different medical insurance types occupation education level ethnicity and place of residence. Patients with low education level and farmers had a higher risk of sarcopenia. Conclusion This study is the first to report the incidence of sarcopenia in tumor patients on a large scale with a prevalence of 18%. Patients with digestive system cancers elderly farmers low education level and advanced tumor are high risk groups for sarcopenia.