内脏脂肪组织在鉴别透明细胞肾细胞癌与少脂肪肾血管平滑肌脂肪瘤中的潜力

The Potential of Visceral Adipose Tissue in Distinguishing Clear Cell Renal Cell Carcinoma from Renal Angiomyolipoma with Minimal Fat.

作者信息

Liu Jianhu, Bao Jie, Zhang Weijie, Li Qiaoxing, Hou Jianquan, Wei Xuedong, Huang Yuhua

机构信息

Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, People's Republic of China.

Department of Urology, Affiliated Kunshan Hospital of Jiangsu University, Suzhou, 215300, People's Republic of China.

出版信息

Cancer Manag Res. 2021 Nov 30;13:8907-8914. doi: 10.2147/CMAR.S336920. eCollection 2021.

DOI:10.2147/CMAR.S336920

PMID:34876853

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8643137/

Abstract

PURPOSE

To overcome the challenge of preoperative differentiation between clear cell renal cell carcinoma (ccRCC) and renal angiomyolipoma with minimal fat (RMFAML), we evaluated the potential of visceral adipose tissue (VAT) in distinguishing RMFAML from ccRCC.

PATIENTS AND METHODS

Patients (191) were divided into ccRCC and RMFAML groups according to postoperative pathology. Umbilical horizontal computed tomography (CT) images were used for visceral fat area (VFA), subcutaneous fat area (SFA) and total fat area (TFA) measurements. Logistic regression was used to identify risk factors for ccRCC. Areas under the receiver operating characteristic (ROC) curve (AUCs) were compared to identify the most valuable indicator for identifying ccRCC and RMFAML.

RESULTS

In total, 166 patients had ccRCC, and 25 had RMFAML. ccRCC and RMFAML patients showed significant differences in age (P<0.001), sex (P<0.001), hypertension (P=0.027), BMI (P<0.001), SFA (P=0.046), VFA (P<0.001) and TFA (P<0.001). According to multiple logistic regression analysis, male sex [4.311 (1.469~~12.653), p=0.008]; older age [1.047 (1.008~~1.088), p=0.017]; and higher BMI [1.305 (1.088~~1.566), p=0.004], SFA [1.013 (1.003~~1.023), p=0.008], VFA [1.026 (1.012~~1.041), p<0.001] and TFA [1.011 (1.005~~1.017), p=0.001] were associated with ccRCC. The AUCs of sex (male), age, BMI, TFA, VFA, and SFA were 0.726, 0.687, 0.783, 0.769, 0.840, and 0.645, respectively. The VFA cut-off value was 69.99 cm. The sensitivity and specificity of higher VFA (≥69.99 cm) for ccRCC diagnosis were 79.52% and 80.00%, respectively.

CONCLUSION

In differentiating ccRCC from RMFAML, male sex, older age, and higher BMI, TFA, SFA, and VFA are risk factors for ccRCC. VFA is the most effective indicator for identifying ccRCC.

摘要

目的

为了克服术前鉴别透明细胞肾细胞癌（ccRCC）与少脂肪肾血管平滑肌脂肪瘤（RMFAML）的挑战，我们评估了内脏脂肪组织（VAT）在区分RMFAML与ccRCC方面的潜力。

患者与方法

根据术后病理将191例患者分为ccRCC组和RMFAML组。采用脐水平计算机断层扫描（CT）图像测量内脏脂肪面积（VFA）、皮下脂肪面积（SFA）和总脂肪面积（TFA）。采用逻辑回归分析确定ccRCC的危险因素。比较受试者工作特征（ROC）曲线下面积（AUC），以确定鉴别ccRCC和RMFAML最有价值的指标。

结果

共有166例患者患有ccRCC，25例患有RMFAML。ccRCC组和RMFAML组患者在年龄（P<0.001）、性别（P<0.001）、高血压（P=0.027）、BMI（P<0.001）、SFA（P=0.046）、VFA（P<0.001）和TFA（P<0.001）方面存在显著差异。根据多因素逻辑回归分析，男性[4.311（1.469~~12.653），p=0.008]；年龄较大[1.047（1.008~~1.088），p=0.017]；较高的BMI[1.305（1.088~~1.566），p=0.004]、SFA[1.013（1.003~~1.023），p=0.008]、VFA[1.026（1.012~~1.041），p<0.001]和TFA[1.011（1.005~~1.017），p=0.001]与ccRCC相关。性别（男性）、年龄、BMI、TFA、VFA和SFA的AUC分别为0.726、0.687、0.783、0.769、0.840和0.645。VFA临界值为69.99 cm。较高的VFA（≥69.99 cm）诊断ccRCC的敏感度和特异度分别为79.52%和80.00%。