内脏脂肪组织对胃癌患者术前T分期准确性的影响  

The Effect of Visceral Adipose Tissue on the Accuracy of Preoperative T Staging in Gastric Cancer Patients

作　　者：侯越峰 刘慧慧 任毅楠 王吉[1] 卢保华 HOU Yue-feng;LIU Hui-hui;REN Yi-nan;WANG Ji;LU Bao-hua(Department of General Surgery,,Air Force Hospital of the Central Theater Command of thePeople's Liberation Army of China,Datong 037006,Shanxi Province,China;Department of Ultrasound Diagnosis,Air Force Hospital of the Central Theater Command ofthe People's Liberation Army of China,Datong 037006,Shanxi Province,China)

机构地区：[1]中国人民解放军中部战区空军医院普通外科 [2]中国人民解放军中部战区空军医院超声特诊科,山西大同037006

出　　处：《中国CT和MRI杂志》2024年第9期134-136,共3页Chinese Journal of CT and MRI

基　　金：山西省基础研究计划(202203021221289)。

摘　　要：目的探讨内脏脂肪组织(visceral adipose tissue,VAT)对胃癌临床T分期(clinical T,cT)准确性的影响。方法回顾性分析2020年1月至2023年6月在我院行胃癌切除术治疗患者资料。以术后病理结果为参考,根据cT和病理T分期(pathological T,pT)一致程度,将患者分为cT诊断准确组和cT诊断错误组。比较两组患者的临床、病理特征及L2/L3水平VAT。使用多因素Logistic回归分析分析影响cT分期准确性的独立因素,并构建判断cT分期准确性的列线图。结果共纳入455例胃癌患者,355例(78.02%)术前cT分期准确,100例(21.98%)术前cT分期不准确。cT分期与pT分期间的ICC分析一致性为0.881(95%CI:0.691-0.774)。VAT预测术前cT分期准确的最佳临界值为97.8cm2。多因素Logistic回归分析显示,肿瘤位置(相对于贲门位置,胃体OR=2.921,P=0.003、胃窦OR=1.754,P=0.026)、肿瘤直径>3.8 cm(OR=1.253,P<0.001)和高VAT(>97.8 cm2)(OR=5.962,P<0.001)是影响术前cT准确性的独立危险因素。列线图预测胃癌术前cT分期模型的准确性较高,C-index为0.826(95%CI=0.786-0.876)。结论VAT、胃癌肿瘤位置、肿瘤大小是影响术前cT分期准确性的独立影响因素,本研究构建的预测cT分期准确性列线图具有较高准确性,具有一定应用前景。Objective To investigated the effect of visceral adipose tissue(VAT)on the accuracy of clinical T staging(cT)in gastric cancer.Methods A retrospective analysis was conducted on the data of patients who underwent gastric cancer resection in our hospital from January 2020 to June 2023.Based on the postoperative pathological results and the degree of consistency between cT and pathological T staging(pT),patients were divided into cT accurate diagnosis group and cT incorrect diagnosis group.The clinical,pathological features,and L2/L3 levels of VAT between two groups of patients were compared.The multivariate Logistic regression analysis was used to identify independent factors that affect the accuracy of cT staging,and construct a column chart to determine the accuracy of cT staging.Results A total of 455 gastric cancer patients included in this study,of which 355(78.02%)had accurate preoperative cT staging,while 100(21.98%)had inaccurate preoperative cT staging.The consistency of ICC analysis between cT staging and pT staging was 0.881(95%CI:0.691-0.774).The optimal critical value for predicting preoperative cT staging accuracy with VAT was 97.8 cm2.The result of multivariate Logistic regression analysis showed that tumor location(relative to cardiac position,gastric body OR=2.921,P=0.003,gastric antrum OR=1.754,P=0.026),tumor diameter>3.8 cm(OR=1.253,P<0.001),and high VAT(>97.8 cm2)(OR=5.962,P<0.001)were independent risk factors affecting the accuracy of preoperative cT.The accuracy of the Nomogram chart prediction model for preoperative cT staging of gastric cancer is high,with a C-index of 0.826(95%CI=0.786-0.876).Conclusion VAT,gastric cancer tumor location,and tumor size are independent influencing factors that affect the accuracy of preoperative cT staging.The predicted cT staging accuracy Nomogram chart constructed in this study has high accuracy and has certain application prospects.

关 键 词：胃癌 内脏脂肪含量 T分期 

分 类 号：R735.2[医药卫生—肿瘤]