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大学・研究所にある論文を検索できる 「Association of Sarcopenia with a Poor Prognosis and Decreased Tumor-Infiltrating CD8-Positive T Cells in Pancreatic Ductal Adenocarcinoma: A Retrospective Analysis」の論文概要。リケラボ論文検索は、全国の大学リポジトリにある学位論文・教授論文を一括検索できる論文検索サービスです。

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Association of Sarcopenia with a Poor Prognosis and Decreased Tumor-Infiltrating CD8-Positive T Cells in Pancreatic Ductal Adenocarcinoma: A Retrospective Analysis

Masuda, Shigeto Yamakawa, Kohei Masuda, Atsuhiro Toyama, Hirochika Sofue, Keitaro Nanno, Yoshihide Komatsu, Shohei Omiya, Satoshi Sakai, Arata Kobayashi, Takashi Tanaka, Takeshi Tsujimae, Masahiro Ashina, Shigeto Gonda, Masanori Abe, Shohei Uemura, Hisahiro Kohashi, Shinya Inomata, Noriko Nagao, Kae Harada, Yoshiyuki Miki, Mika Irie, Yosuke Juri, Noriko Kanzawa, Maki Itoh, Tomoo Fukumoto, Takumi Kodama, Yuzo 神戸大学

2023.09

概要

Background: Sarcopenia, defined as a loss of skeletal muscle mass and quality, is found in 30–65% of patients with pancreatic ductal adenocarcinoma (PDAC) at diagnosis, and is a poor prognostic factor. However, it is yet to be evaluated why sarcopenia is associated with poor prognosis. Therefore, this study elucidated the tumor characteristics of PDAC with sarcopenia, including driver gene alterations and tumor microenvironment. Patients and Methods: We retrospectively analyzed 162 patients with PDAC who underwent pancreatic surgery between 2008 and 2017. We defined sarcopenia by measuring the skeletal muscle mass at the L3 level using preoperative computed tomography images and evaluated driver gene alteration (KRAS, TP53, CDKN2A/p16, and SMAD4) and tumor immune (CD4⁺, CD8⁺, and FOXP3⁺) and fibrosis status (stromal collagen). Results: In localized-stage PDAC (stage ≤ IIa), overall survival (OS) and recurrence-free survival were significantly shorter in the sarcopenia group than in the non-sarcopenia group (2-year OS 89.7% versus 59.1%, P = 0.03; 2-year RFS 74.9% versus 50.0%, P = 0.02). Multivariate analysis revealed that sarcopenia was an independent poor prognostic factor in localized-stage PDAC. Additionally, tumor-infiltrating CD8⁺ T cells in the sarcopenia group were significantly less than in the non-sarcopenia group (P = 0.02). However, no difference was observed in driver gene alteration and fib.rotic status. These findings were not observed in advanced-stage PDAC (stage ≥ IIb). Conclusions: Sarcopenia was associated with a worse prognosis and decreased tumor-infiltrating CD8⁺ T cells in localized-stage PDAC. Sarcopenia may worsen a patient’s prognosis by suppressing local tumor immunity.

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