癌症恶病质的发生和进展与全身炎症和身体机能有关。然而，很少有相关研究报道结直肠癌（CRC）恶病质患者全身炎症和身体机能的生存结果预测。本研究调查了 CRC 恶病质患者全身炎症和体力状态的预后预测价值。这项多中心队列研究前瞻性收集了 905 名 CRC 患者（58.3% 为男性，59.3 ± 11.5 岁）。癌症恶病质根据 2011 年 Fearon 恶病质诊断共识进行诊断。使用曲线下面积、一致性指数和多变量生存分析来确定系统炎症指标的预后价值。表现状态通过东部肿瘤合作组表现评分（ECOG-PS）进行评估。采用单变量和多变量Cox回归分析对生存数据进行分析。曲线下面积、一致性指数和生存分析显示C反应蛋白（CRP）、淋巴细胞与CRP比值（LCR）和CRP与白蛋白比值（CAR）更在非恶病质和恶病质人群中，其与 CRC 患者的生存率稳定且一致。在 CRC 恶病质患者中，高炎症[低 LCR，风险比 (HR) 95% 置信区间 (95% CI) = 3.33 (2.08-5.32)；高 CAR，HR (95% CI) = 2.92 (1.88-4.55)；与非恶病质患者相比，高 CRP，HR (95% CI) = 3.12 (2.08-4.67)] 表明预后较差[低 LCR，HR (95% CI) = 2.28 (1.65-3.16)；高 CAR，HR (95% CI) = 2.36 (1.71-3.25)；高 CRP，HR (95% CI) = 2.58 (1.85-3.60)]。同样，在 CRC 恶病质患者中，高 PS [ECOG-PS 2，HR (95% CI) = 1.61 (1.04-2.50)；与无恶病质的 CRC 患者相比，ECOG-PS 3/4，HR (95% CI) = 2.91 (1.69-5.00]) 表明预后较差 [ECOG-PS 2, HR (95% CI) = 1.28 (0.90- 1.81）； ECOG-PS 3/4，HR (95% CI) = 2.41 (1.32-4.39])。与 ECOG-PS 评分为 0/1 且炎症程度较低的患者相比，ECOG-PS 评分为 2 或 3-4 且炎症程度高的 CRC 恶病质患者的中位生存时间较短。 、CAR和CRP对CRC患者具有稳定的预后价值。 ECOG-PS 可能是 CRC 的独立危险因素。对 CRC 恶病质患者的全身炎症和 ECOG-PS 进行联合评估可以提供简单的生存预测。© 2023 作者。 《恶病质、肌肉减少症和肌肉杂志》由 Wiley periodicals LLC 出版。

The development and progression of cancer cachexia are connected to systemic inflammation and physical performance. However, few relevant studies have reported the survival outcomes prediction of systemic inflammation and physical performance in patients with colorectal cancer (CRC) cachexia. This study investigated the prognostic prediction value of systemic inflammation and performance status in patients with CRC cachexia.This multicentre cohort study prospectively collected 905 patients with CRC (58.3% males, 59.3 ± 11.5 years old). Cancer cachexia was diagnosed according to the 2011 Fearon Cachexia Diagnostic Consensus. The prognostic value of systematic inflammatory indicators was determined using the area under the curve, concordance index, and multivariate survival analysis. Performance status was evaluated with Eastern Coopertive Oncology Group performance score (ECOG-PS). Survival data were analysed using univariate and multivariate Cox regression analyses.The area under the curve, concordance index and survival analysis showed that C-reactive protein (CRP), lymphocyte to CRP ratio (LCR) and CRP to albumin ratio (CAR) were more stable and consistent with the survival of patients with CRC, both in non-cachexia and cachexia populations. Among patients with CRC cachexia, high inflammation [low LCR, hazard ratio (HR) 95% confidence interval (95% CI) = 3.33 (2.08-5.32); high CAR, HR (95% CI) = 2.92 (1.88-4.55); high CRP, HR (95% CI) = 3.12 (2.08-4.67)] indicated a worse prognosis, compared with non-cachexia patients [low LCR, HR (95% CI) = 2.28 (1.65-3.16); high CAR, HR (95% CI) = 2.36 (1.71-3.25); high CRP, HR (95% CI) = 2.58 (1.85-3.60)]. Similarly, among patients with CRC cachexia, high PS [ECOG-PS 2, HR (95% CI) = 1.61 (1.04-2.50); ECOG-PS 3/4, HR (95% CI) = 2.91 (1.69-5.00]) indicated a worse prognosis, compared with patients with CRC without cachexia [ECOG-PS 2, HR (95% CI) = 1.28 (0.90-1.81); ECOG-PS 3/4, HR (95% CI) = 2.41 (1.32-4.39]). Patients with CRC cachexia with an ECOG-PS score of 2 or 3-4 and a high inflammation had a shorter median survival time, compared with patients with an ECOG-PS score of 0/1 and a low inflammation.The systemic inflammatory markers LCR, CAR and CRP have stable prognostic values in patients with CRC. The ECOG-PS may be an independent risk factor for CRC. Combined evaluation of systemic inflammation and ECOG-PS in patients with CRC cachexia could provide a simple survival prediction.© 2023 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by Wiley Periodicals LLC.