Department of Clinical Sciences, Lund University, Malmö, Sweden.
Department of Surgery, Blekinge Hospital, Karlskrona, Sweden.
J Plast Surg Hand Surg. 2022 Jun;56(3):172-179. doi: 10.1080/2000656X.2021.1953042. Epub 2021 Aug 2.
Lymphedema is caused by dysfunctional lymph vessels or as a complication of cancer treatment leading to edema and adipose tissue deposition. One hypothesis is that adipocyte hypertrophy contributes to the volume increase in lymphedema. The aim of the study was to compare adipocyte size in arm and leg lymphedema and controls. The adipocyte size difference was also compared between the arms and legs. Furthermore, any link between adipocyte size difference and gender, lymphedema onset, duration, previous radio- and chemotherapy was studied, as well as any relationship to total excess volume increase in the extremities, body mass index (BMI) and body weight. Adipose tissue biopsies from the lymphedematous and non-affected extremities were taken from 47 patients. The adipocytes sizes were measured using an Olympus PROVIS microscope, Olympus DP50 camera (Olympus, Tokyo, Japan) and ImageJ program (NIH, Bethesda, MD). Additional information was obtained from the Lymphedema Center database. The data were assembled in Excel and statistics was calculated in SPSS Statistics 23 (IBM, Armonk, NY). The adipocyte size (mean ± SEM) in the lymphedematous extremities was significantly larger, 8880 ± 291 μm, compared to the adipocyte size in the non-affected extremities, where it was 7143 ± 280 μm, i.e. 24% larger ( < .001). The adipocyte size increase was larger in arm than in leg lymphedema. No correlation was found between adipocyte size and gender or onset. However, a negative correlation was found between adipocyte size difference and duration. No correlation was found between adipocyte size and previous chemo- or radiotherapy. There was a positive correlation between adipocyte size and BMI. Hypertrophy of adipocytes was seen in the lymphedematous extremities versus control and contributes to the excess volume.
淋巴水肿是由功能失调的淋巴管引起的，或是癌症治疗的并发症，导致水肿和脂肪组织沉积。有一种假说认为，脂肪细胞肥大导致淋巴水肿体积增加。本研究旨在比较手臂和腿部淋巴水肿患者与对照组的脂肪细胞大小。还比较了手臂和腿部的脂肪细胞大小差异。此外，还研究了脂肪细胞大小差异与性别、淋巴水肿发病、持续时间、既往放化疗之间的任何关联，以及与四肢总过度体积增加、体重指数（BMI）和体重之间的任何关系。从 47 名患者的淋巴水肿和未受影响的肢体中采集脂肪组织活检。使用 Olympus PROVIS 显微镜、Olympus DP50 相机（Olympus，东京，日本）和 ImageJ 程序（NIH，贝塞斯达，MD）测量脂肪细胞大小。从淋巴水肿中心数据库获得了其他信息。将数据组装到 Excel 中，并在 SPSS Statistics 23（IBM，Armonk，NY）中计算统计数据。与未受影响的肢体相比，淋巴水肿肢体中的脂肪细胞大小（平均值±SEM）明显更大，为 8880±291μm，而未受影响的肢体中的脂肪细胞大小为 7143±280μm，即大 24%（ < .001）。手臂淋巴水肿中的脂肪细胞大小增加大于腿部淋巴水肿。未发现脂肪细胞大小与性别或发病之间存在相关性。然而，发现脂肪细胞大小差异与持续时间之间存在负相关。未发现脂肪细胞大小与既往化疗或放疗之间存在相关性。发现脂肪细胞大小与 BMI 之间存在正相关。与对照组相比，淋巴水肿肢体中存在脂肪细胞肥大，导致过度体积。
