内脏脂肪面积与肾癌病理分型及分级的相关性  

Correlation between visceral fat area with the pathological type and grade in renal cell carcinoma

作　　者：翁同辉 任轲[1] 陈晗 杨雷 苟欣[1] 王明[1] WENG Tonghui;REN Ke;CHEN Han;YANG Lei;GOU Xin;WANG Ming(Department of Urology,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院泌尿外科,重庆400016

出　　处：《现代泌尿外科杂志》2021年第4期322-327,共6页Journal of Modern Urology

摘　　要：目的研究内脏脂肪面积(VFA)、皮下脂肪面积(SFA)以及肾周脂肪面积(PFA)与肾细胞癌(RCC)病理分型和Fuhrman分级之间的相关性。方法回顾性分析2015年1月至2018年12月重庆医科大学附属第一医院收治的212例行肾切除或者肾部分切除术患者的病例资料。术前CT测量VFA、SFA及PFA值,肾周脂肪百分比以肾周脂肪面积占总脂肪组织面积的比例计算,即PFA%=PFA/(VFA+SFA)×100%。分析各脂肪面积参数和临床常见指标(如年龄、性别、体质指数、肿瘤大小和T分期)与RCC病理分型和肿瘤分级的相关性。结果透明细胞肾细胞癌(ccRCC)组患者VFA(P=0.002)和年龄(P=0.001)均高于非透明细胞肾细胞癌(non-ccRCC)组;高级别肿瘤组患者PFA%(P=0.032)、肿瘤最大径(P<0.001)和T分期(P<0.001)均高于低级别肿瘤组。多因素Logistic回归分析显示,VFA(OR=1.007,95%CI:1.001~1.013,P=0.029)和年龄(OR=1.041,95%CI:1.015~1.067,P=0.002)与ccRCC病理亚型相关,PFA%(OR=2.590,95%CI:1.111~6.060,P=0.028)、肿瘤最大径(OR=1.037,95%CI:1.020~1.055,P<0.001)和T分期(OR=5.025,95%CI:2.127~14.280,P<0.001)与高级别肿瘤均相关。结论VFA与ccRCC病理亚型关系密切,且高PFA%与较高的Fuhrman分级相关。Objective To explore the correlation between visceral fat area(VFA),subcutaneous fat area(SFA)and perirenal fat area(PFA)with the pathological type and Fuhrman grade of renal cell carcinoma(RCC).Methods The clinical date of 212 patients who underwent nephrectomy or partial nephrectomy at our hospital during Jan.2015 and Dec.2018 were retrospectively analyzed.Before operation,VFA,SFA and PFA were measured with CT.The percentage of perirenal fat was calculated with the following formula,PFA%=[PFA/(VFA+SFA)×100%].The correlation between fat area parameters and clinical indicators(age,gender,body mass index,tumor size and T stage)with RCC pathological type and tumor grade was analyzed with Chi-square test,t-test and Logistic regression.Results The clear cell renal cell carcinoma(ccRCC)group had higher VFA(P=0.002)and older age(P=0.001)than the non-ccRCC group.The high-grade tumor group had higher percentage of PFA(P=0.032),larger tumor diameter(P<0.001)and higher T stage(P<0.001)than the low-grade tumor group.Multivariate Logistic regression analysis showed that VFA(OR=1.007,95%CI:1.001-1.013,P=0.029)and age(OR=1.041,95%CI:1.015-1.067,P=0.002)were associated with ccRCC;the percentage of PFA(OR=2.590,95%CI:1.111-6.060,P=0.028),tumor size(OR=1.037,95%CI:1.020-1.055,P<0.001),and T stage(OR=5.025,95%CI:2.127-14.280,P<0.001)were associated with high-grade tumors.Conclusion VFA was an important predictor of ccRCC and high percentage of PFA was associated with higher Fuhrman grade.

关 键 词：肾细胞癌 内脏脂肪 病理 

分 类 号：R737.11[医药卫生—肿瘤]