Obesity is associated with a higher risk of clear-cell renal cell carcinoma than with other histologies.
Obesity is associated with a higher risk of clear-cell renal cell carcinoma than with other histologies.
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DOI：
10.1111/j.1464-410x.2009.08706.x
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发表时间：
2010-01
影响因子：
4.5
通讯作者：
Russo P
中科院分区：
文献类型：
--
作者：
Lowrance WT;Thompson RH;Yee DS;Kaag M;Donat SM;Russo P
为了研究体重指数（BMI）和肾细胞癌（RCC）组织学之间的关联，在当代队列中，肥胖在美国越来越普遍，可能是导致RCC发病率增加的原因，但对肥胖与RCC不同组织学亚型的关系知之甚少。从2000年1月至2007年12月，我们确定了1640例肾皮质肿瘤患者在我们的机构接受手术摘除，并记录了他们的BMI。多变量逻辑回归模型用于检验BMI与RCC组织学的相关性。中位（四分位距）BMI为28（25-32）kg/m2，38%的患者被归类为肥胖（BMI > 30 kg/m2）。在校正了肿瘤大小、年龄、性别、美国麻醉医师协会评分、估计肾小球滤过率、高血压、糖尿病和吸烟等因素后，BMI与透明细胞组织学显著相关;每单位BMI的优势比为1.04（95%可信区间，CI，1.02-1.06; P < 0.001）和1.48，当比较肥胖与非肥胖患者时（95% CI 1.19-1.84; P < 0.001）。在RCC患者亚组（排除良性肾皮质肿瘤）中，BMI仍然是透明细胞组织学的独立预测因子（比值比1.04，95%CI 1.02-1.06，P = 0.001）。这些结果表明，BMI是肾皮质肿瘤患者透明细胞组织学的独立预测因子。虽然这种现象的病因需要进一步研究，但这些发现可能对确定患者隐藏透明细胞RCC的风险以及随后的治疗建议具有影响。
To investigate the association between body mass index (BMI) and histology of renal cell carcinoma (RCC) in a contemporary cohort, as obesity is increasingly prevalent in the USA and might be contributing to the increasing incidence of RCC, but little is known about the relationship of obesity with the different histological subtypes of RCC. From January 2000 to December 2007 we identified 1640 patients with renal cortical tumours undergoing surgical extirpation at our institution, and who had their BMI recorded. Multivariable logistic regression models were used to test the association of BMI with RCC histology. The median (interquartile range) BMI was 28 (25–32) kg/m2 and 38% of patients were classified as obese (BMI > 30 kg/m2). After adjusting for tumour size, age, gender, American Society of Anesthesiologists score, estimated glomerular filtration rate, hypertension, diabetes mellitus and smoking, the BMI was significantly associated with clear-cell histology; the odds ratios were 1.04 for each unit of BMI (95% confidence interval, CI, 1.02–1.06; P < 0.001) and 1.48 when comparing obese vs non-obese patients (95% CI 1.19–1.84; P < 0.001). In the subgroup of patients with RCC (excluding benign renal cortical tumours), BMI was still an independent predictor of clear-cell histology (odds ratio 1.04, 95% CI 1.02–1.06, P = 0.001). These results suggest that BMI is an independent predictor of clear-cell histology in patients with a renal cortical tumour. While the aetiology of this phenomenon requires further study, these findings might have implications in determining a patient's risk of harbouring a clear-cell RCC and in subsequent treatment recommendations.