Diagnostic Value of Serum Creatinine and Cystatin-C-Based Indices and Ishii Score in Cancer-Related Sarcopenia

作者全名："Ding, Liming; Wang, Xingyu; Mao, Tiantao; Li, Jibin"

作者地址："[Ding, Liming; Li, Jibin] Chongqing Med Univ, Sch Publ Hlth, Chongqing 400016, Peoples R China; [Ding, Liming; Wang, Xingyu; Mao, Tiantao] Peoples Hosp Wuxi, Chongqing 405800, Peoples R China"

通信作者："Li, JB (通讯作者)，Chongqing Med Univ, Sch Publ Hlth, Chongqing 400016, Peoples R China."

来源：DIAGNOSTICS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001031167900001

JCR分区：Q1

影响因子：3

年份：2023

卷号：13

期号：13

开始页：　

结束页：　

文献类型：Article

关键词：cancer; sarcopenia; creatinine; cystatin C; Ishii score chart

摘要："Background: Sarcopenia is a key factor affecting the prognosis of cancer patients; however, identifying patients at risk remains challenging. The serum creatinine/cystatin C ratio (CCR) and the sarcopenia index (SI) are new biomarkers for sarcopenia screening. The Ishii test score is an equation based on age, grip strength, and calf circumference for sarcopenia screening. However, their performances in advanced cancer patients have not been thoroughly studied. We aimed to evaluate and compare the accuracy of three screening tools in diagnosing cancer-related sarcopenia. Methods: A total of 215 cancer patients with a median age of 60.5 y were enrolled in this cross-sectional study. The Asian Working Group for Sarcopenia 2019 (AWGS2019) criteria were used as a standard. The diagnostic accuracies of the CCR, SI, and Ishii screening test were analyzed in terms of sensitivity, specificity, negative and positive predictive values, the Youden index, and the receiver operating characteristic (ROC) curve. Results: According to the AWGS2019 criteria, the prevalence of sarcopenia and severe sarcopenia was 47.9% and 18.6%, respectively. The CCR, SI (positively), and Ishii scores (negatively) were correlated with muscle mass. Accordingly, sarcopenia was negatively correlated with CCR and SI, while it was significantly positively correlated with the Ishii score. In males, the AUCs of the CCR, SI, and Ishii scores were 0.743 (95%CI 0.65-0.836), 0.758 (95%CI 0.665-0.852), and 0.833 (95%CI 0.751-0.909), respectively. In females, the AUCs of the CCR, SI, and Ishii scores were 0.714 (95%CI 0.61-0.818), 0.737 (95%CI 0.635-0.839), and 0.849 (95%CI 0.775-0.932), respectively. The AUC of the Ishii score was significantly higher than that of the other screening tools (p < 0.001). The cut-off value of the optimal Ishii score was 102.3 (sensitivity: 93.2%, specificity: 59.1%) for males and 98.3 (sensitivity: 93.3%, specificity: 64.7%) for females. Conclusions: The CCR and SI based on serum CysC and creatinine had a remarkably similar overall diagnostic accuracy for sarcopenia in advanced cancer. Among the above three sarcopenia screening tools, the Ishii score chart seemed to have better predictive values of sarcopenia in cancer patients."

基金机构：Chongqing medical scientific research project (joint project of the Chongqing Health Commission and Science and Technology Bureau) [2022QNXM046]

基金资助正文："This research was funded by the Chongqing medical scientific research project (joint project of the Chongqing Health Commission and Science and Technology Bureau), grant number 2022QNXM046. The APC was funded by J.-B.L."