腹部脂肪CT检测在新诊断多发性骨髓瘤中的预后价值分析  

Prognostic value of abdominal fat CT detection in newly diagnosed multiple myeloma

作　　者：高珊[1] 王宇彤 程晓光[2] 褚彬[1] 陆敏秋[1] 程克斌[2] 鲍立[1] GAO Shan;WANG Yu-tong;CHENG Xiao-guang(Department of Hematology,Beijing Jishuitan Hospital,Beijing100096,China;Department of Radiology,Beijing Jishuitan Hospital,Beijing100096,China)

机构地区：[1]北京积水潭医院血液科,北京100096 [2]北京积水潭医院影像科,北京100096

出　　处：《中国实验诊断学》2022年第7期1013-1018,共6页Chinese Journal of Laboratory Diagnosis

基　　金：北京市卫生与计划生育委员会(首发2014-2-1122)。

摘　　要：目的 探讨CT检测腹部脂肪含量在多发性骨髓瘤(multiple myeloma,MM)患者预后中的价值。方法 同时对36例新诊断MM(NDMM)患者和72例健康者腹部CT脂肪含量的检查。主要测量T12到S1的总脂肪面积(TFA)、内脏脂肪面积(VFA)和皮下脂肪面积(SFA)并进行相关分析,同时检测脂联素水平。结果 与健康人相比,NDMM患者的TFA、VFA和SFA均更高,而血浆脂联素显著降低。骨髓浆细胞百分比与SAT呈显著负相关,但与VFA/SFA呈正相关。在高危细胞遗传学异常1q21扩增和VFA之间观察到显著的负相关。SFA和VFA/SFA对治疗反应有显著影响。结论 与健康人相比,NDMM患者的腹部脂肪含量较高且脂联素水平较低。过多的皮下脂肪可能是高肿瘤负荷和不良治疗反应的预测因素。内脏脂肪含量可能与高危细胞遗传学异常有关。我们仍需要对更多的样本进行分析进一步以验证这种关联。Objective To explore the value of CT detection of abdominal fat content in the prognosis of patients with multiple myeloma(MM).Methods 36newly diagnosed MM(NDMM)patients underwent abdominal CT pre-chemotherapy,and 72matched healthy people were included.Total fat area(TFA),visceral fat area(VFA)and subcutaneous fat area(SFA)were measured from T12to S1and analyzed at six slices of vertebral interfaces.The level of adiponectin was also detected.Results NDMM patients had larger TFA,VFA and SFA while significantly lower plasma adiponectin than healthy people.The percentage of bone marrow plasma cells was significantly inversely correlated with SAT,but positively correlated with VFA/SFA.A significant inverse correlation was observed between the high-risk cytogenetic abnormality gain 1q21and VFA.SFA and VFA/SFA had a significant effect on treatment responses.Conclusion NDMM patients had higher abdominal fat content but lower adipokine levels than healthy people.Excessive subcutaneous fat might be a predictive factor for high tumor burden and poor treatment response.Visceral fat content may be correlated with high-risk cytogenetic abnormalities.However,further investigation in larger samples is necessary to verify this association.

关 键 词：内脏脂肪 皮下脂肪 治疗反应 新诊断多发性骨髓瘤 

分 类 号：R733.3[医药卫生—肿瘤]