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Background <p>Alcohol consumption is a common risk factor for esophageal squamous cell carcinoma (ESCC) and hepatic fibrosis. Mac-2 binding protein glycosylated isomer (M2BPGi), a sensitive marker of fibrosis, may predict postoperative skeletal muscle loss by reflecting the metabolic link between liver function and muscle maintenance.</p> Methods <p>Eighty-nine patients with ESCC undergoing esophagectomy (June 2021–July 2024) with alcohol use and pretherapeutic M2BPGi levels were included; the cutoff was 0.66. Muscle mass was assessed by bioelectrical impedance analysis.</p> Results <p>The study population was stratified by M2BPGi levels into low (n = 59) and high (n = 30) groups. No significant differences were observed in sex, clinical stage, preoperative skeletal muscle mass, surgical approach, or intraoperative fluid balance. The high M2BPGi group showed lower preoperative albumin levels (4.2 vs. 4.0&#xa0;g/dL, <i>p</i> = 0.01) and higher CRP (0.1 vs. 0.4&#xa0;mg/dL, <i>p</i> &lt; 0.01) and ICG R15 values (9.2% vs. 12.8%, <i>p</i> = 0.04). Although there was no difference in the incidence of complications, the decrease in skeletal muscle mass at 3&#xa0;months was significantly greater in the high M2BPGi group (− 7.6% vs. − 12.0%, <i>p</i> = 0.02). In the propensity score–matched cohort (low n = 40; high n = 20), the high M2BPGi group showed significantly greater muscle loss at 3&#xa0;months (− 7.5% vs. − 12.6%, <i>p</i> = 0.04) and a trend toward longer hospital stays (22 vs. 25.5&#xa0;days, <i>p</i> = 0.06).</p> Conclusion <p>High pretherapeutic M2BPGi levels are independently associated with postoperative skeletal muscle loss at 3&#xa0;months.</p>

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Association between pretherapeutic M2BPGi levels and postoperative skeletal muscle depletion in patients with esophageal squamous cell carcinoma

  • 期刊论文

  • 发表日期：

    2026年5月13日

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  • Sanshiro Kawata,
  • Eisuke Booka,
  • Junko Honke,
  • Yuki Sakai,
  • Ryoma Haneda,
  • Wataru Soneda,
  • Tomohiro Murakami,
  • Tomohiro Matsumoto,
  • Makoto Takeda,
  • Yoshifumi Morita,
  • Hirotoshi Kikuchi,
  • Yoshihiro Hiramatsu,
  • Kazuhito Kawata,
  • Hiroya Takeuchi

摘要

Background

Alcohol consumption is a common risk factor for esophageal squamous cell carcinoma (ESCC) and hepatic fibrosis. Mac-2 binding protein glycosylated isomer (M2BPGi), a sensitive marker of fibrosis, may predict postoperative skeletal muscle loss by reflecting the metabolic link between liver function and muscle maintenance.

Methods

Eighty-nine patients with ESCC undergoing esophagectomy (June 2021–July 2024) with alcohol use and pretherapeutic M2BPGi levels were included; the cutoff was 0.66. Muscle mass was assessed by bioelectrical impedance analysis.

Results

The study population was stratified by M2BPGi levels into low (n = 59) and high (n = 30) groups. No significant differences were observed in sex, clinical stage, preoperative skeletal muscle mass, surgical approach, or intraoperative fluid balance. The high M2BPGi group showed lower preoperative albumin levels (4.2 vs. 4.0 g/dL, p = 0.01) and higher CRP (0.1 vs. 0.4 mg/dL, p < 0.01) and ICG R15 values (9.2% vs. 12.8%, p = 0.04). Although there was no difference in the incidence of complications, the decrease in skeletal muscle mass at 3 months was significantly greater in the high M2BPGi group (− 7.6% vs. − 12.0%, p = 0.02). In the propensity score–matched cohort (low n = 40; high n = 20), the high M2BPGi group showed significantly greater muscle loss at 3 months (− 7.5% vs. − 12.6%, p = 0.04) and a trend toward longer hospital stays (22 vs. 25.5 days, p = 0.06).

Conclusion

High pretherapeutic M2BPGi levels are independently associated with postoperative skeletal muscle loss at 3 months.