Department of Nuclear Medicine, Korea University Anam Hospital, Seoul 02841, Korea.
Department of Obstetrics and Gynecology, Korea University Anam Hospital, Seoul 02841, Korea.
Int J Environ Res Public Health. 2021 Dec 22;19(1):92. doi: 10.3390/ijerph19010092.
Obesity contributes to increased cancer incidence and aggressiveness in patients with endometrial cancer. Inflamed metabolic activity of visceral adipose tissue (VAT) is regarded as a key underlying mechanism of adverse consequences of obesity. The aim of this study was to investigate the association between inflammatory metabolic activity of VAT evaluated by F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) and metastatic status of lymph nodes (LN) in patients with endometrial cancer. In total, 161 women with newly diagnosed endometrial cancer, who received preoperative 18F-FDG PET/CT, were enrolled. VAT inflammatory metabolic activity was defined as V/S ratio and measured from the maximum standardized uptake value (SUVmax) of VAT normalized to the SUVmax of subcutaneous adipose tissue (SAT). The positive LN metastasis group exhibited a significantly higher V/S ratio than the negative LN metastasis group. Systemic inflammatory surrogate markers including high sensitivity C-reactive protein, spleen SUVmax, and bone marrow SUVmax were also higher in the LN metastasis group than in the negative LN metastasis group, showing significant correlations with V/S ratio. In multivariate logistic regression analysis, V/S ratio was independently associated with LN metastasis. V/S ratio is independently associated with the LN metastasis status in patients with endometrial cancer. This finding could be useful as a potential surrogate marker of obesity-induced VAT inflammation associated with tumor aggressiveness.
肥胖会导致子宫内膜癌患者癌症发病率和侵袭性增加。内脏脂肪组织（VAT）的炎症代谢活性被认为是肥胖不良后果的关键潜在机制。本研究旨在探讨通过 F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（F-FDG PET/CT）评估的 VAT 炎症代谢活性与子宫内膜癌患者淋巴结（LN）转移状态之间的关联。共纳入 161 例新诊断为子宫内膜癌并接受术前 18F-FDG PET/CT 检查的女性。VAT 炎症代谢活性定义为 V/S 比值，通过将 VAT 的最大标准化摄取值（SUVmax）与皮下脂肪组织（SAT）的 SUVmax 标准化来测量。阳性 LN 转移组的 V/S 比值明显高于阴性 LN 转移组。包括高敏 C 反应蛋白、脾脏 SUVmax 和骨髓 SUVmax 在内的全身炎症替代标志物在 LN 转移组也高于阴性 LN 转移组，与 V/S 比值呈显著相关。在多变量逻辑回归分析中，V/S 比值与 LN 转移独立相关。V/S 比值与子宫内膜癌患者的 LN 转移状态独立相关。这一发现可能作为肥胖诱导的与肿瘤侵袭性相关的 VAT 炎症的潜在替代标志物有用。
