Visceral Obesity and Risk of High Grade Disease in Clinical T1a Renal Cell Carcinoma
Visceral Obesity and Risk of High Grade Disease in Clinical T1a Renal Cell Carcinoma
复制标题
临床 T1a 肾细胞癌的内脏肥胖和重度疾病风险
DOI：
10.1016/j.juro.2012.09.030
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发表时间：
2013-02-01
影响因子：
6.6
通讯作者：
Ye, Ding-Wei
中科院分区：
文献类型：
--
作者：
Zhu, Yao;Wang, Hong-Kai;Ye, Ding-Wei
目的：准确评估疾病特征是小肾肿块治疗决策的前提。在这项研究中，我们评估了cT1a肾细胞癌患者内脏肥胖和Fuhrman分级之间的关系。材料和方法：我们回顾性收集了186例手术治疗的cT1a肾细胞癌患者的资料。使用单层计算机断层扫描测量内脏和皮下脂肪组织的面积。内脏肥胖的计算方法是内脏脂肪组织占总脂肪组织的比例。其他分析的因素包括临床特征（年龄、性别、体重指数和肿瘤大小）以及由R.E.N.A.L.肾测量评分定义的肿瘤解剖特征。预测因子与高级别疾病（Fuhrman III级或IV级）之间的相关性采用logistic回归分析进行评估。结果：高分级47例（25.3%）。男性参与者的内脏脂肪组织百分比较高，但与体重指数、年龄或肿瘤大小无关。在单变量分析中，内脏脂肪组织百分比和肿瘤大小与较高的Fuhrman分级显著相关。多因素分析显示，内脏脂肪组织百分比（OR 1.06, p = 0.0018）和肿瘤大小（OR 1.91, p = 0.047）是高级别癌症的独立预测因子。在包含肿瘤临床特征和解剖特征的模型中加入内脏脂肪组织的百分比，显著提高了其鉴别能力（p = 0.0010）。结论：发现内脏肥胖增加与cT1a肾细胞癌患者较高的Fuhrman分级密切相关。需要进一步的研究来证实这些发现并发现潜在的生物学机制。
Purpose: Accurate assessment of disease characteristics is a prerequisite for treatment decision making regarding small renal masses. In this study we evaluate the association between visceral obesity and Fuhrman grade in patients with cT1a renal cell carcinoma.Materials and Methods: We retrospectively collected data on 186 patients with surgically treated cT1a renal cell carcinoma. Single slice computerized tomography was used to measure the area of visceral and subcutaneous adipose tissue. Visceral obesity was calculated as the proportion of visceral adipose tissue to overall adipose tissue. Other analyzed factors included clinical characteristics (age, gender, body mass index and tumor size) and anatomical features of the tumor defined by the R.E.N.A.L. nephrometry score. The association between predictors and high grade disease (Fuhrman grade III or IV) were assessed using logistic regression analyses.Results: A total of 47 (25.3%) tumors were classified as high grade. The percentage of visceral adipose tissue was higher in male participants but did not correlate with body mass index, age or tumor size. In univariate analyses the percentage of visceral adipose tissue and tumor size were significantly associated with higher Fuhrman grade. Multivariate analysis showed that the percentage of visceral adipose tissue (OR 1.06, p = 0.0018) and tumor size (OR 1.91, p = 0.047) were independent predictors of high grade cancer. Addition of the percentage of visceral adipose tissue to a model including clinical characteristics and anatomical features of the tumor remarkably improved its discriminatory ability (p = 0.0010).Conclusions: Increased visceral obesity was found to be strongly associated with higher Fuhrman grade in patients with cT1a renal cell carcinoma. Further studies are needed to confirm these findings and discover the underlying biological mechanism.