Wu Zong-Qian, Cheng Jie, Xiao Xi-Xi, Zhang Hua-Rong, Wang Jian, Peng Juan, Liu Chen, Cai Ping, Li Xiao-Ming
Department of Radiology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
Department of Oncology and Southwest Cancer Center, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
Front Surg. 2023 Jan 6;9:985168. doi: 10.3389/fsurg.2022.985168. eCollection 2022.
This study aimed to investigate whether visceral adipose tissue index (VATI) is a significant risk factor for the early recurrence (ER) of HBV-related hepatocellular carcinoma (HCC) (≤5 cm) after hepatectomy.
The recruited cohort patients who were positive for hepatitis B virus, presented with surgically confirmed HCC (≤5 cm) from Army Medical University (internal training cohort: = 192) and Chongqing Medical University (external validation group: = 46). We measured VATI, subcutaneous adipose tissue index (SATI) computed tomography (CT). ER was defined as recurrence within 2 years after hepatectomy. The impact of parameters on outcome after hepatectomy for HCC was analyzed.
Univariate analysis showed that alpha-fetoprotein levels ( = 0.044), body mass index (BMI) ( < 0.001), SATI ( < 0.001), and VATI ( < 0.001) were significantly different between ER and non-ER groups in internal training cohort. Multivariate analysis identified VATI as an independent risk factor for ER (odds ratio = 1.07, 95% confidence interval: 1.047-1.094, < 0.001), with a AUC of 0.802, based on the cut-off value of VATI, which was divided into high risk (≥37.45 cm/m) and low risk (<37.45 cm/m) groups. The prognosis of low risk group was significantly higher than that of high risk group (< 0.001). The AUC value of VATI in external validation group was 0.854.
VATI was an independent risk factor for the ER, and higher VATI was closely related to poor outcomes after hepatectomy for HBV-related HCC (≤5 cm).
本研究旨在探讨内脏脂肪组织指数（VATI）是否是乙肝相关肝细胞癌（HCC）（≤5 cm）肝切除术后早期复发（ER）的重要危险因素。
招募来自陆军军医大学（内部训练队列：n = 192）和重庆医科大学（外部验证组：n = 46）的乙肝病毒阳性、经手术确诊为HCC（≤5 cm）的队列患者。我们通过计算机断层扫描（CT）测量VATI、皮下脂肪组织指数（SATI）。ER定义为肝切除术后2年内复发。分析了各参数对HCC肝切除术后结局的影响。
单因素分析显示，内部训练队列中，ER组和非ER组之间的甲胎蛋白水平（P = 0.044）、体重指数（BMI）（P < 0.001）、SATI（P < 0.001）和VATI（P < 0.001）存在显著差异。多因素分析确定VATI是ER的独立危险因素（比值比 = 1.07，95%置信区间：1.047 - 1.094，P < 0.001），基于VATI的截断值，其AUC为0.802，分为高风险（≥37.45 cm/m）和低风险（<37.45 cm/m）组。低风险组的预后显著高于高风险组（P < 0.001）。外部验证组中VATI的AUC值为0.854。
VATI是ER的独立危险因素，较高的VATI与乙肝相关HCC（≤5 cm）肝切除术后的不良结局密切相关。
