University of Oulu

Aro R, Meriläinen S, Sirniö P, Väyrynen JP, Pohjanen V-M, Herzig K-H, Rautio TT, Mäkäräinen E, Häivälä R, Klintrup K, Mäkinen MJ, Saarnio J, Tuomisto A. Sarcopenia and Myosteatosis Are Associated with Neutrophil to Lymphocyte Ratio but Not Glasgow Prognostic Score in Colorectal Cancer Patients. Journal of Clinical Medicine. 2022; 11(9):2656.

Sarcopenia and myosteatosis are associated with neutrophil to lymphocyte ratio but not Glasgow prognostic score in colorectal cancer patients

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Author: Aro, Raila1,2; Meriläinen, Sanna1,2; Sirniö, Päivi3,4;
Organizations: 1Department of Surgery, Oulu University Hospital, 90014 Oulu, Finland
2Division of Operative Care, Medical Research Center, Oulu University Hospital, University of Oulu, 90014 Oulu, Finland
3Cancer and Translational Medicine Research Unit, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland
4Oulu University Hospital, Medical Research Center Oulu, P.O. Box 21, 90029 Oulu, Finland
5Research Unit of Biomedicine, Department of Physiology, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland
6Department of Pediatric Gastroenterology and Metabolism, Poznan University of Medical Sciences, 61-701 Poznan, Poland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.4 MB)
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Language: English
Published: Multidisciplinary Digital Publishing Institute, 2022
Publish Date: 2022-09-15


Cancer patients commonly present sarcopenia, myosteatosis, and systemic inflammation, which are risk factors of poor survival. In this study, sarcopenia and myosteatosis were defined from preoperative body computed tomography scans of 222 colorectal cancer (CRC) patients and analyzed in relation to tumor and patient characteristics, markers of systemic inflammation (modified Glasgow prognostic score (mGPS), neutrophil–lymphocyte ratio (NLR), serum levels of C-reactive protein (CRP), albumin, and 13 cytokines, and survival. Of the systemic inflammation markers, sarcopenia and/or myosteatosis associated with elevated NLR (p = 0.005) and low albumin levels (≤35 g/L) (p = 0.018), but not with mGPS or serum cytokine levels. In addition, myosteatosis was associated with a proximal tumor location (p = 0.039), serrated tumor subtype (p < 0.001), and severe comorbidities (p = 0.004). Multivariable analyses revealed that severe comorbidities and serrated histology were independent predictors of myosteatosis, and older age and elevated NLR were independent indicators of sarcopenia. Myosteatosis associated with shorter overall survival in univariable analysis (HR 1.959, 95% CI 1.24–3.10, p = 0.004) but not in multivariable analysis (p = 0.075). We conclude that sarcopenia and myosteatosis were associated with inflammatory marker NLR, but not with mGPS. Moreover, patients with serrated CRC may have an increased risk of myosteatosis. Myosteatosis or sarcopenia were not independent predictors of patient survival.

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Series: Journal of clinical medicine
ISSN: 2077-0383
ISSN-E: 2077-0383
ISSN-L: 2077-0383
Volume: 11
Issue: 9
Article number: 2656
DOI: 10.3390/jcm11092656
Type of Publication: A1 Journal article – refereed
Field of Science: 3122 Cancers
Funding: This research was funded by Thelma Mäkikyrö Foundation, the Emil Aaltonen Foundation, Oulu Medical Society Duodecim, the Suorsa Foundation, Terttu Foundation, Finnish Medical Foundation, and VTR funding for 2021.
Copyright information: © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (