| 99 | 1 | 26 |
| 下载次数 | 被引频次 | 阅读次数 |
目的 研究子宫内膜癌患者内脏脂肪组织代谢活性(Visceral adipose tissue, VAT)与淋巴结转移的相关性。方法 以海南省肿瘤医院医学影像部2017年6月-2022年12月收治的116例子宫内膜癌患者为研究对象，术前行18F-FDG PET/CT检查，根据淋巴结转移情况分为淋巴结转移组和淋巴结非转移组，在PET/CT图像上(L4和L5椎体水平之间)分别测量两组患者的内脏组织VAT最大标准摄取值(Maximum standard uptake value, SUVmax)、皮下脂肪组织(Subcutaneous adipose tissue, SAT) SUVmax,脾脏SUVmax及骨髓(Bone marrow, BM)SUVmax。VAT代谢活性定义为V/S比值，即VAT SUVmax与SAT SUVmax的比值，分析VAT代谢活性与淋巴结转移的相关性。结果 与淋巴结非转移组比较，淋巴结转移组的V/S比值、脾脏SUVmax、骨髓SUVmax明显升高，且与V/S值有显著相关性。多因素Logistic回归分析结果显示V/S比值与淋巴结转移独立相关。结论 VAT代谢活性(V/S比)与子宫内膜癌患者的淋巴结转移独立相关，VAT可作为肥胖诱导的炎症与子宫内膜癌淋巴结转移相关的潜在标记物。
Abstract：Objective To study the correlation between visceral adipose tissue(VAT) metabolism and lymph node metastasis in patients with endometrial cancer. Methods 116 patients with endometrial cancer admitted to the hospital from June 2017 to December 2022 were selected as study subjects. Prior to surgery, the patients underwent 18F-FDG PET/CT examination and were divided into lymph node metastasis group and lymph node non-metastasis group based on their lymph node metastasis status. The maximum standard uptake value(SUVmax) of VAT, the SUVmax of subcutaneous adipose tissue(SAT), the SUVmax of spleen and the SUVmax of bone marrow(BM) of the 2 groups of the patients were measured on PET/CT images(between L4 and L5 vertebral levels). The metabolic activity of VAT was defined as V/S ratio, which was the ratio of the SUVmax of VAT to the SUVmax of SAT. The correlation between VAT metabolic activity and lymph node metastasis was analyzed. Results Compared with the non-metastatic lymph node group, the V/S ratio, the SUVmax of spleen, and the SUVmax of BM in the metastatic lymph node group was significantly increased, and there was a significant correlation with V/S values. The results of multivariate Logistic regression analysis showed that the V/S ratio was independently correlated with lymph node metastasis. Conclusion The metabolic activity of VAT(V/S ratio) was independently associated with lymph node metastasis in endometrial cancer patients, and VAT can serve as a potential marker for obesity induced inflammation and lymph node metastasis in endometrial cancer.
[1] HALES C M,CARROLL M D,FRYAR C D,et al.Prevalence of obesity among adults and youth:United States,2015-2016 [J].NCHS Data Brief ,2017,288(10):1-8.
[2] 林颖欣，张月华，张淦梅，等.免疫组化联合半定量法检测淋巴脉管间隙浸润在早期子宫内膜癌的预后价值[J].陆军军医大学学报，2022,44(13):1370-1377.
[3] 时娟娟，杨慧，杜超，等.子宫内膜增生中隐匿性子宫内膜癌的危险因素[J].现代妇产科进展杂志，2023,33 (1):1-3.
[4] AREM H,PARK Y ,PELSER C,et al.Prediagnosis body mass index,physical activity,and mortality in endometrial cancer patients[J].Natl Cancer Inst,2013,10(5):342-349.
[5] KHANDEKAR M J,COHEN P,SPIGELMAN B M.Molecular mechanisms of cancer development in obesity[J].Nat Rev Cancer,2011,11(12):886-895.
[6] PARK J,MORLEY T S,KIM M,et al.Obesity and cancer-mechanisms underlying tumour progression and recurrence[J].Nat Rev Endocrinol,2014,10(7):455-465.
[7] MARIANI A,DOWDY S,PODATZ K,et al.New surgical staging of endometrial cancer:20 years later[J].Int Gynaecol Obstet,2019,20 (5):110-111.
[8] PELIKAN H,TRUM J,BAKERS F,et al.Diagnostic accuracy of preoperative tests for lymph node status in endometrial cancer:a systematic review[J].Cancer Imaging,2013,13(3):314-322.
[9] YE S,WEN H,JIANG Z,et al.The effect of visceral obesity on clinicopathological features in patients with endometrial cancer:A retrospective analysis of 200 Chinese patients[J].BMC Cancer 2016,16(3):209-212.
[10] PAHK K,JOUNG C,KIM S.Visceral fat metabolic activity evaluated by preoperative 18F-FDG PET/CT significantly affects axillary lymph node metastasis in postmenopausal luminal breast cancer[J].Sci Rep,2020,10(1):1348-1352.
[11] PAHK K,CHOI S,KIM S.Functional visceral fat activity evaluated by preoperative F-18 FDG PET/CT predicts regional lymph node metastasis in differentiated thyroid cancer[J].Clin Endocrinol,2018,88(6):963-968.
[12] EMAMI H,SINGH P ,MACNABB M,et al.Splenic metabolic activity predicts risk of future cardiovascular events:Demonstration of a cardiosplenic axis in humans[J].Cardiovasc Imaging,2015,8(2):121-130.
[13] KIM E J,KIM S,KANG D O,et al.Metabolic activity of the spleen and bone marrow in patients with acute myocardial infarction evaluated by 18f-fluorodeoxyglucose positron emission tomograpic imaging[J].Cardiovasc Imaging,2014,7(3):454-460.
[14] SOSLOW R,TORNOS C,PARK K M.Endometrial carcinoma diagnosis:Use of FIGO grading and genomic subcategories in clinical practice:recommendations of the international society of gynecological pathologists[J].Int Gynecol Pathol,2019,38 (1):64-74.
[15] DESPRES J.Body fat distribution and risk of cardiovascular disease:An update[J].Circulation,2012,126(10):1301-1313.
[16] QUAIL D,DANNENBERG A.The obese adipose tissue microenvironment in cancer development and progression[J].Nat Rev Endcorinol,2019,15(6):139-154.
[17] ROSSI E,KOWALSKI L,SCALICI J,et al.A comparison of sentinel lymph node biopsy to lymphadenectomy for endometrial cancer staging (FIRES trial):A multicentre,prospective,cohort study[J] .Lancet Oncol,2017,18(7):384-392.
[18] MARIANI A,DOWDY S,CLIBY W,et al.Prospective assessment of lymphatic dissemination in endometrial cancer:a paradigm shift in surgical staging[J].Gynecol Oncol,2018,119(10):11-18.
[19] FRIBERG E,MANTZOROS C S,WOLK A.Diabetes and risk of endometrial cancer:A population-based prospective cohort study[J].Cancer Epidemiol Biomarkers Prev,2017,26(7):276-280.
[20] PATEL A,FEIGELSON H,TALBOT J,et al.The role of body weight in the relationship between physical activity and endometrial cancer:Results from a large cohort of US women[J].Int Cancer,2018,133(16):1877-1882.
[21] JOHN E,KOO J,HORN-ROSS P.Lifetime physical activity and risk of endometrial cancer [J].Cancer Epidemiol Biomarkers Prev,2020,29(8):1276-1283.
[22] FRIEDENREICH C,COOK L,WANG Q,et al.Prospective cohort study of pre-and postdiagnosis physical activity and endometrial cancer survival[J].Clin Oncol,2020,38(4):4107-4117.
基本信息:
中图分类号:R737.33
引用信息:
[1]龚伟,于丽娟,孟凡盛,等.子宫内膜癌患者内脏脂肪代谢活性与淋巴结转移的相关性研究[J].新疆医科大学学报,2024,47(02):233-237.
基金信息:
海南省重点研发项目(ZDYF2021SHFZ244)
2024-02-15
2024-02-15