Adipose tissue radiodensity and mortality among patients with nonmetastatic breast cancer.
Adipose tissue radiodensity and mortality among patients with nonmetastatic breast cancer.
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DOI：
10.1016/j.clnu.2022.09.016
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发表时间：
2022-12
影响因子：
6.3
通讯作者：
Feliciano, Elizabeth M. Cespedes
中科院分区：
文献类型：
--
作者：
Cheng, En;Caan, Bette J.;Chen, Wendy Y.;Irwin, Melinda L.;Prado, Carla M.;Feliciano, Elizabeth M. Cespedes
关键词：
计算机断层扫描 (CT) 扫描可以测量脂肪组织的数量和分布，这与乳腺癌的预后相关。作为一种新的预后标志物，脂肪组织的放射密度已在多种癌症类型中进行了检查，但从未在乳腺癌中进行过检查。较低的密度表明脂肪细胞较大，脂质含量较高，而较高的密度可以反映炎症、纤维化、血管分布甚至代谢变化；两者都可能影响乳腺癌的预后。我们纳入了 2005 年 1 月至 2013 年 12 月期间在北加州 Kaiser Permanente（一个综合医疗保健系统）诊断出的 2,868 名非转移性乳腺癌患者。根据诊断时的 CT 扫描，我们评估了第三腰椎皮下 (SAT) 和内脏脂肪组织 (VAT) 的放射密度，并将其放射密度分为三个级别：低（低于平均值 <1 个标准差 [SD]）、中（平均值 ± 1 SD）和高（高于平均值 > 1 SD）。使用多变量 Cox 比例风险回归并调整包括体重指数在内的临床病理特征，我们计算了脂肪组织放射密度与总体死亡率和乳腺癌特异性死亡率之间关系的风险比（HR [95% 置信区间]）。诊断乳腺癌的中位年龄为 56.0 岁，大多数 (63.3%) 为非西班牙裔白人，近一半 (45.6%) 为 II 期。与中等 SAT 放射密度相比，高 SAT 放射密度与总体死亡率风险增加显着相关（HR：1.45 [1.15–1.81]），与乳腺癌特异性死亡率不显着相关（HR：1.32 [0.95–1.84]）。低 SAT 放射密度和高或低 VAT 放射密度均与总体死亡率或乳腺癌特异性死亡率显着相关。诊断非转移性乳腺癌时 SAT 的高放射密度与总体死亡率风险增加相关，与肥胖和其他预后因素无关。考虑不同位置脂肪组织的放射密度和数量可以加深对肥胖在乳腺癌生存中的作用的理解。
Computed tomography (CT) scans can measure quantity and distribution of adipose tissue, which are associated with breast cancer prognosis. As a novel prognostic marker, radiodensity of adipose tissue has been examined in multiple cancer types, but never in breast cancer. Lower density indicates larger adipocytes with greater lipid content, whereas higher density can reflect inflammation, fibrosis, vascularity, or even metabolic changes; and both may impact breast cancer prognosis. We included 2,868 nonmetastatic patients with breast cancer diagnosed between January 2005 and December 2013 at Kaiser Permanente Northern California, an integrated healthcare system. From CT scans at diagnosis, we assessed the radiodensity of subcutaneous (SAT) and visceral adipose tissue (VAT) at the third lumbar vertebra and categorized their radiodensity into three levels: low (<1 standard deviation [SD] below the mean), middle (mean ± 1 SD), and high (>1 SD above the mean). Using multivariable Cox proportional hazards regression with adjustment for clinicopathological characteristics including body mass index, we calculated hazard ratios (HRs [95% confidence intervals]) for the associations of adipose tissue radiodensity with overall mortality and breast-cancer-specific mortality. Median age at diagnosis of breast cancer was 56.0 years, most (63.3%) were non-Hispanic White and nearly half (45.6%) were stage II. Compared to middle SAT radiodensity, high SAT radiodensity was significantly associated with increased risk of overall mortality (HR: 1.45 [1.15–1.81]), non-significantly with breast-cancer-specific mortality (HR: 1.32 [0.95–1.84]). Neither low SAT radiodensity nor high or low VAT radiodensity was significantly associated with overall or breast-cancer-specific mortality. High radiodensity of SAT at diagnosis of nonmetastatic breast cancer was associated with increased risk of overall mortality, independent of adiposity and other prognostic factors. Considering both radiodensity and quantity of adipose tissue at different locations could deepen understanding of the role of adiposity in breast cancer survival.
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DOI：
10.1093/ajcn/nqab285
发表时间：
2021-12-01
期刊：
The American journal of clinical nutrition
影响因子：
--
作者：
Feliciano EMC;Winkels RM;Meyerhardt JA;Prado CM;Afman LA;Caan BJ
通讯作者：
Caan BJ
影响因子：
5.5
作者：
Barrett, JF;Keat, N
通讯作者：
Keat, N
影响因子：
5.8
作者：
Cozzo AJ;Fuller AM;Makowski L
通讯作者：
Makowski L
影响因子：
2.8
作者：
Boutin, Robert D.;Katz, Jeremy R.;Lenchik, Leon
通讯作者：
Lenchik, Leon
影响因子：
8.3
作者：
Ebadi, Maryam;Dunichand-Hoedl, Abha R.;Rider, Elora;Kneteman, Norman M.;Shapiro, James;Bigam, David;Dajani, Khaled;Mazurak, Vera C.;Baracos, Vickie E.;Montano-Loza, Aldo J.
通讯作者：
Montano-Loza, Aldo J.