确定准确的预后因素对于早期胃癌（EGC）患者的术后管理至关重要。骨骼肌质量（SMQ）由计算机断层扫描（CT）图像上的肌肉密度定义，已被提议作为一种新的预后因素。本研究比较了 EGC 术后 SMQ 变化与体重 (BW) 下降的既定因素的预后意义。这项单中心回顾性研究纳入了 297 名术后 EGC 患者（中位年龄 69 岁，68.4% 男性），有术前和术后1年的胃切除CT图像。 SMQ 定义为修正后的肌内脂肪组织含量（mIMAC = 骨骼肌密度 - CT 图像上的皮下脂肪密度），变化为 ΔmIMAC。使用对数秩检验、Kaplan-Meier 生存和 Cox 比例风险回归分析来评估预后与 ΔmIMAC 或 BW 变化 (ΔBW) 之间的关联。通过使用受试者工作特征曲线的曲线下面积 (AUC) 比较 ΔmIMAC 和 ΔBW 的预后预测。ΔmIMAC 与预后显着相关（对数秩检验；P = 0.037），但 ΔBW 则不然（P = 0.243） ）。 mIMAC 严重降低组的预后明显较差于保留组（多变量 Cox 比例风险回归分析；P = 0.030），但不受体重变化的影响（P = 0.697）。 AUC 表明 ΔmIMAC 的预后价值高于 ΔBW（ΔmIMAC：AUC = 0.697，ΔBW：AUC = 0.542）。胃切除术后一年的 SMQ 变化可能是比 BW 变化更好的 EGC 预后预测因子。© 2024。外科肿瘤学会。

Identifying accurate prognostic factors is crucial for postoperative management of early gastric cancer (EGC) patients. Skeletal muscle quality (SMQ), defined by muscle density on computed tomography (CT) images, has been proposed as a novel prognostic factor. This study compared the prognostic significance of SMQ changes with the well-established factor of body weight (BW) loss in the postoperative EGC setting.This single-center retrospective study included 297 postoperative EGC patients (median age 69 years, 68.4% male) who had preoperative and 1-year-postoperative gastrectomy CT images. SMQ was defined as the modified intramuscular adipose tissue content (mIMAC = skeletal muscle density-subcutaneous fat density on CT images) and the change as ΔmIMAC. Log-rank test, Kaplan-Meier survival, and Cox proportional hazards regression analyses were used to assess the associations between prognosis and either ΔmIMAC or BW change (ΔBW). Prognosis prediction by ΔmIMAC and ΔBW was compared by using the area under the curve (AUC) of the receiver operating characteristic curve.ΔmIMAC was significantly associated with prognosis (log-rank test; P = 0.037), but ΔBW was not (P = 0.243). Prognosis was significantly poorer in the severely decreased mIMAC group than in the preserved group (multivariate Cox proportional hazards regression analysis; P = 0.030) but was unaffected by BW changes (P = 0.697). The AUC indicated a higher prognostic value for ΔmIMAC than ΔBW (ΔmIMAC: AUC = 0.697, ΔBW: AUC = 0.542).One-year post-gastrectomy SMQ changes may be better prognostic EGC predictors than BW changes.© 2024. Society of Surgical Oncology.