现代仪器与医疗

治疗前腰3椎体水平骨骼肌指数对不同FIGO分期宫颈癌患者生存预后的预测价值

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李寒冬 ¹ , 毕锋 ¹ , 邵杨 ²^,^*

现代仪器与医疗 | 临床研究 2026,32(3): 68-74

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现代仪器与医疗 |临床研究 2026 , 32 (3) : 68 -74

治疗前腰3椎体水平骨骼肌指数对不同FIGO分期宫颈癌患者生存预后的预测价值

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李寒冬¹, 毕锋¹, 邵杨²^,^*

作者信息

^1.湖南省肿瘤医院放射诊断中心，长沙　410013

^2.中南大学湘雅三医院超声科，长沙　410013

通讯作者:

邵杨，女，硕士研究生，主治医师，研究方向：妇科肿瘤

作者简介:

李寒冬，男，硕士研究生，主治医师，研究方向：影像组学

Predictive value of skeletal muscle index at the third lumbar vertebra before treatment on survival prognosis in cervical cancer patients with different FIGO stages

Handong Li¹, Feng Bi¹, Yang Shao²^,^*

Affiliations

^1.Department of Radiology Diagnosis, Hunan Cancer Hospital, Changsha 410013, China

^2.Department of Ultrasound, the Third Xiangya Hospital of Central South University, Changsha 410013, China

出版时间: 2026-06-10 doi: 10.11876/mimt202603009

文章导航

摘要

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目的

探讨治疗前腰3椎体水平骨骼肌指数（skeletal muscle index at the third lumbar vertebra，L3-SMI）对宫颈癌患者生存的预测价值，并分析其预测效能在不同国际妇产科联盟（International Federation of Gynecology and Obstetrics，FIGO）分期中的差异。

方法

回顾性收集2014年1月至2019年12月于湖南省肿瘤医院确诊并接受治疗的宫颈癌患者的临床资料及影像学图像。在腰3椎体中间层面勾画骨骼肌并测量骨骼肌面积，计算L3-SMI。通过受试者工作特征（receiver operating characteristic，ROC）曲线确定L3-SMI预测宫颈癌患者总生存期（overall survival，OS）的最佳截断值，采用Kaplan-Meier法和Log-Rank检验比较不同L3-SMI组患者的生存差异，采用Cox比例风险回归模型分析L3-SMI的独立预后价值。

结果

研究共纳入207例患者。生存分析显示，在早期组（FIGO I、II A期）患者中，L3-SMI与OS无显著相关性（P>0.05）；在晚期组（FIGO II B、III及IV期）患者中，L3-SMI与OS显著相关（P<0.05）。ROC曲线确定L3-SMI预测晚期患者OS的最佳截断值为39.8 cm²/m²，曲线下面积（area under curve，AUC）为0.668。据此将101例晚期患者分为高L3-SMI组（≥39.8 cm²/m²，n=51）和低L3-SMI组（<39.8 cm²/m²，n=50）。Kaplan-Meier分析显示，高L3-SMI组患者的OS显著优于低L3-SMI组，差异具有统计学意义（Log-Rank χ²=8.20，P=0.004 2）。多因素Cox回归分析显示，在校正了年龄、FIGO分期、病理类型后，低L3-SMI仍是晚期患者OS的独立危险因素（HR=2.561，95% CI：1.040~6.336，P=0.039）。

结论

治疗前L3-SMI是晚期（FIGO II B期及以上）宫颈癌患者生存的独立预测因子，该指标对预测晚期宫颈癌患者的预后有一定的价值。

关键词

宫颈癌 / 骨骼肌减少症 / 腰3椎体水平骨骼肌指数 / 预后 / 生存分析

Abstract

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Objective

To investigate the prognostic value of pre-treatment skeletal muscle index at the third lumbar vertebra (L3-SMI) for survival in patients with cervical cancer, and to analyze its predictive performance across different International Federation of Gynecology and Obstetrics (FIGO) stages.

Methods

Clinical data and imaging studies of patients with cervical cancer diagnosed and treated at Hunan Cancer Hospital from January 2014 to December 2019 were retrospectively collected. Skeletal muscle was segmented at the mid-vertebral level of the third lumbar vertebra, and skeletal muscle area (SMA) was measured. L3-SMI was calculated as SMA divided by body surface area (BSA). The optimal cut-off value of L3-SMI for predicting overall survival (OS) in cervical cancer patients was determined using receiver operating characteristic (ROC) curve analysis. Survival differences between patients with different L3-SMI levels were compared using the Kaplan-Meier method and Log-Rank test. The independent prognostic value of L3-SMI was analyzed using the Cox proportional hazards regression model.

Results

A total of 207 patients were enrolled in this study. Survival analysis showed that L3-SMI was not significantly correlated with OS in the early-stage group (FIGO stages I and IIA, P>0.05), but was significantly correlated with OS in the advanced-stage group (FIGO stages IIB, III and IV, P<0.05). The optimal cut-off value of L3-SMI for predicting OS in advanced-stage patients was 39.8 cm²/m², with an area under curve (AUC) of 0.668. Accordingly, 101 advanced-stage patients were divided into the high L3-SMI group (≥39.8 cm²/m², n=51) and the low L3-SMI group (<39.8 cm²/m², n=50). Kaplan-Meier analysis demonstrated that patients in the high L3-SMI group had significantly better OS than those in the low L3-SMI group, with a statistically significant difference (Log-Rank χ²=8.20, P=0.004 2). Multivariate Cox regression analysis revealed that low L3-SMI remained an independent risk factor for OS in advanced-stage patients after adjusting for age, FIGO stage, and pathological type (HR=2.561, 95%CI: 1.040~6.336, P=0.039).

Conclusion

Pre-treatment L3-SMI is an independent prognostic factor for survival in patients with advanced-stage cervical cancer (FIGO stage IIB and above), and this biomarker has clinical value in predicting the prognosis of advanced cervical cancer patients.

Key words

Cervical cancer / Sarcopenia / Skeletal muscle index at the third lumbar vertebra / Prognosis / Survival analysis

引用本文

李寒冬, 毕锋, 邵杨. 治疗前腰3椎体水平骨骼肌指数对不同FIGO分期宫颈癌患者生存预后的预测价值. 现代仪器与医疗, 2026 , 32 (3) : 68 -74 . DOI: 10.11876/mimt202603009

Handong Li, Feng Bi, Yang Shao. Predictive value of skeletal muscle index at the third lumbar vertebra before treatment on survival prognosis in cervical cancer patients with different FIGO stages[J]. Modern Instruments & Medical Treatment, 2026 , 32 (3) : 68 -74 . DOI: 10.11876/mimt202603009

基金

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湖南省卫生健康委科研计划项目(D202309018789)

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2026年第32卷第3期

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文章信息

doi: 10.11876/mimt202603009

接收时间：2026-04-11
首发时间：2026-10-23
出版时间：2026-06-10

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收稿日期：2026-04-11

基金

湖南省卫生健康委科研计划项目(D202309018789)

作者信息

^1.湖南省肿瘤医院放射诊断中心，长沙　410013

^2.中南大学湘雅三医院超声科，长沙　410013

通讯作者:

邵杨，女，硕士研究生，主治医师，研究方向：妇科肿瘤

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2种不同金属材料的力学参数

科 Family	属数 Number of genus	种数 Number of species	占总种数比例 Percentage of total species (%)	属 Genus	种数 Number of species	占总种数比例 Percentage of total species (%)
鹅膏菌科Amanitaceae	2	11	5.26	鹅膏菌属 Amanita	10	4.78
小菇科 Mycenaceae	2	12	5.74	丝盖伞属 Inocybe	5	2.39
多孔菌科 Polyporaceae	8	14	6.70	蜡蘑属 Laccaria	5	2.39
红菇科 Russulaceae	3	23	11.00	小皮伞属 Marasmius	6	2.87
				小菇属 Mycena	11	5.26
				光柄菇属 Pluteus	5	2.39
				红菇属 Russula	17	8.13
				栓菌属 Trametes	5	2.39

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