Otani Kensuke, Kitayama Joji, Kaisaki Shoichi, Ishigami Hironori, Hidemura Akio, Fujishiro Mitsuhiro, Omata Masao, Nagawa Hirokazu
Department of Surgical Oncology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Gastric Cancer. 2008;11(2):86-95. doi: 10.1007/s10120-008-0459-6. Epub 2008 Jul 2.
Visceral obesity is known to be a risk factor for diabetes and cardiovascular disease. Cancer of the gastric cardia has been shown to have a close association with obesity in Western countries. In order to examine the possible relationship between fat volume and the development of gastric cancer (GC), we quantified visceral and subcutaneous fat areas of computed tomography (CT) images of patients with early GC.
A total of 210 patients who underwent endoscopic resection or surgical gastrectomy and whose disease was pathologically diagnosed as early GC were investigated for total fat area (TFA), visceral fat area (VFA), and subcutaneous fat area (SFA) with Fat Scan software, using a CT slice at the umbilical level, and the relationships of these findings with clinical and pathological data were analyzed. The same analysis was performed in 147 patients with early colorectal cancer (CRC).
TFA, VFA, and SFA values in GC patients were not significantly different from the values in CRC patients. These values did not differ with the location of the GC. However, patients with undifferentiated-type GC had significantly smaller VFAs and SFAs than those with differentiated-type GC. Among the patients with undifferentiated GC, TFA and SFA values in the patients with submucosal cancer were significantly smaller than those in the patients with mucosal cancer.
GC has different associations with adipose tissue volume according to its histological type. As compared with differentiated GC, lower adipose tissue volume may be a preferential environment for the development and progression of undifferentiated GC.
内脏肥胖是已知的糖尿病和心血管疾病的危险因素。在西方国家，贲门癌已被证明与肥胖密切相关。为了研究脂肪体积与胃癌（GC）发生之间的可能关系，我们对早期GC患者的计算机断层扫描（CT）图像中的内脏和皮下脂肪面积进行了量化。
使用Fat Scan软件，利用脐水平的CT切片，对210例行内镜切除或手术胃切除术且病理诊断为早期GC的患者进行总脂肪面积（TFA）、内脏脂肪面积（VFA）和皮下脂肪面积（SFA）的调查，并分析这些结果与临床和病理数据的关系。对147例早期结直肠癌（CRC）患者进行了同样的分析。
GC患者的TFA、VFA和SFA值与CRC患者的值无显著差异。这些值与GC的位置无关。然而，未分化型GC患者的VFA和SFA明显小于分化型GC患者。在未分化GC患者中，黏膜下癌患者的TFA和SFA值明显小于黏膜癌患者。
GC根据其组织学类型与脂肪组织体积有不同的关联。与分化型GC相比，较低的脂肪组织体积可能是未分化型GC发生和进展的有利环境。
