Donkers Hannah, Fasmer Kristine E, Mcgrane John, Pijnenborg Johanna M A, Bekkers Ruud, Haldorsen Ingfrid S, Galaal Khadra
Royal Cornwall Hospital NHS Trust, Truro, Cornwall, United Kingdom.
Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital Bergen, Bergen, Norway; Section for Radiology, Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Eur J Obstet Gynecol Reprod Biol. 2021 Jan;256:425-432. doi: 10.1016/j.ejogrb.2020.11.050. Epub 2020 Nov 21.
Obesity is an important risk factor for the development of endometrial cancer (EC). Recent data showed that body fat distribution might be more relevant than Body Mass Index (BMI). High visceral fat percentage was shown to be an independent predictor for survival in EC, but mainly included grade 1-2 EC.
To evaluate body fat distribution and its relation to outcome in high-grade endometrial cancer.
Retrospective study in women diagnosed with high-grade EC between February 2006 and August 2017 at the Royal Cornwall Hospital who had abdominal CT-scan as part of routine diagnostic work-up. Subcutaneous abdominal fat volumes and visceral abdominal fat volumes were quantified based on CT-scan measurements, and visceral fat percentage calculated.
A total of 176 patients with high-grade EC were included. The median age was 70 years and median BMI was 29.4 kg/m. The majority of patients had non-endometrioid endometrial cancer (NEEC; 62 %). High visceral fat percentage was associated with poor overall- and disease-specific survival (p = 0.006 and p = 0.026 respectively) in NEEC patients, but not in high-grade endometrioid EC (EEC). The most frequent obesity comorbidities hypertension and diabetes mellitus were significantly associated with high BMI and high visceral fat percentage.
In high-grade EC, high visceral fat percentage was an independent predictor of poor survival only in NEEC. The strong correlation between high visceral fat and obesity-related comorbidities might be reflective of an unhealthy macroenvironment.
肥胖是子宫内膜癌（EC）发生的重要危险因素。近期数据显示，体脂分布可能比体重指数（BMI）更具相关性。高内脏脂肪百分比被证明是EC患者生存的独立预测因素，但主要包括1-2级EC。
评估高级别子宫内膜癌患者的体脂分布及其与预后的关系。
对2006年2月至2017年8月在皇家康沃尔医院被诊断为高级别EC且接受腹部CT扫描作为常规诊断检查一部分的女性进行回顾性研究。根据CT扫描测量结果对腹部皮下脂肪体积和内脏脂肪体积进行量化，并计算内脏脂肪百分比。
共纳入176例高级别EC患者。中位年龄为70岁，中位BMI为29.4kg/m²。大多数患者患有非子宫内膜样子宫内膜癌（NEEC；62%）。高内脏脂肪百分比与NEEC患者的总体生存率和疾病特异性生存率较差相关（分别为p = 0.006和p = 0.026），但在高级别子宫内膜样EC（EEC）患者中并非如此。最常见的肥胖合并症高血压和糖尿病与高BMI和高内脏脂肪百分比显著相关。
在高级别EC中，高内脏脂肪百分比仅在NEEC中是生存不良的独立预测因素。高内脏脂肪与肥胖相关合并症之间的强相关性可能反映了不健康的宏观环境。
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