1 Department of Radiology, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea.
AJR Am J Roentgenol. 2015 Jan;204(1):W43-7. doi: 10.2214/AJR.14.12689.
The purpose of this study was to retrospectively evaluate the relationship between periprostatic fat thickness on MRI and Gleason score of prostate cancer using radical prostatectomy as the reference standard.
This study included 190 patients (mean age [± SD], 66.9 ± 7.0 years) who underwent MRI before radical prostatectomy. Two radiologists measured the subcutaneous and periprostatic fat thickness on midsagittal T2-weighted MR images as the shortest perpendicular distance from the pubic symphysis to the skin and prostate, respectively. Subcutaneous and periprostatic fat along with age, height, weight, body mass index, and prostate-specific antigen (PSA) were correlated with Gleason score by using Pearson (r) or Spearman (ρ) correlation coefficients and compared between low- (Gleason score = 6) and high- (≥ 7) grade prostate cancer by using univariate and multivariate logistic regression analyses.
The mean subcutaneous and periprostatic fat thicknesses were 24.0 ± 8.4 mm and 5.0 ± 2.0 mm, respectively. The Gleason score was significantly correlated with age (ρ = 0.181, p = 0.012), PSA (ρ = 0.345, p < 0.001), and periprostatic fat thickness (ρ = 0.228, p = 0.002). Multivariate analysis revealed that age, height, PSA level, and periprostatic fat thickness (odds ratio, 1.331; 95% CI, 1.063-1.666) were independently predictive of high-grade (p ≤ 0.013) disease.
Periprostatic fat thickness on MRI showed a mild to modest but significant correlation with Gleason score of prostate cancer with radical prostatectomy as the reference standard and was an independent predictive factor for high-grade prostate cancer.
本研究旨在回顾性评估 MRI 前列腺周脂肪厚度与前列腺癌 Gleason 评分的关系，以根治性前列腺切除术为参考标准。
本研究纳入了 190 例（平均年龄[±标准差]，66.9±7.0 岁）接受根治性前列腺切除术前行 MRI 检查的患者。两名放射科医生在正中矢状面 T2 加权 MR 图像上测量皮下和前列腺周脂肪厚度，分别为耻骨联合至皮肤和前列腺的最短垂直距离。采用 Pearson（r）或 Spearman（ρ）相关系数将皮下和前列腺周脂肪与年龄、身高、体重、体重指数和前列腺特异性抗原（PSA）与 Gleason 评分相关联，并通过单变量和多变量逻辑回归分析比较低分级（Gleason 评分=6）和高分级（≥7）前列腺癌之间的差异。
平均皮下和前列腺周脂肪厚度分别为 24.0±8.4mm 和 5.0±2.0mm。Gleason 评分与年龄（ρ=0.181，p=0.012）、PSA（ρ=0.345，p<0.001）和前列腺周脂肪厚度（ρ=0.228，p=0.002）显著相关。多变量分析显示，年龄、身高、PSA 水平和前列腺周脂肪厚度（优势比，1.331；95%置信区间，1.063-1.666）是预测高级别疾病（p≤0.013）的独立预测因素。
以根治性前列腺切除术为参考标准，MRI 前列腺周脂肪厚度与前列腺癌 Gleason 评分呈轻度至中度但显著相关，是预测高级别前列腺癌的独立预测因素。
