Mao Yi-Wen, Zeng Hong-Dou, Fang Ye, Wu Xin-Yao, Zhang Ming-Hao, Hu Cheng-Da, Zhao Ya-Xin
Department of Breast Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Department of Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Front Oncol. 2025 Mar 17;15:1506629. doi: 10.3389/fonc.2025.1506629. eCollection 2025.
Monitoring body composition through Computed Tomography (CT) scans, including muscle and adipose tissue, plays a key role in the prognosis of various cancers. However, abdominal CT is impractical for patients with breast cancer (BC), making chest CT an essential tool for postoperative surveillance. This study aims to evaluate the effect of subcutaneous fat tissue at the 11th thoracic vertebral plane on the postoperative prognosis of BC patients by analyzing chest CT images, providing evidence for postoperative nutritional and rehabilitation guidance.
We conducted a retrospective analysis of the medical records of 188 BC patients treated and discharged from the Second Affiliated Hospital of Wenzhou Medical University between January 1, 2013, and December 31, 2013. The subcutaneous fat area (SFA) at the 11th thoracic vertebra (T11) was measured using chest CT images, and the subcutaneous fat index (SFI, area/height) was calculated. Using multivariate Cox proportional hazards models and propensity score matching (PSM), the relationships between the SFI and overall survival (OS), as well as recurrence-free survival (RFS), were assessed. Additionally, Kaplan-Meier survival curves were applied to compare prognostic differences between the groups.
The median follow-up duration was 128 months (range: 27-188 months). Of the 188 patients included in the study, the optimal cutoff value for the SFI was determined to be 49.31 cm²/m². Multivariate analysis indicated that SFI was an independent prognostic factor for both OS (HR 2.50, 95% CI 1.07-5.83, = 0.034) and RFS (HR 2.04, 95% CI 1.10-3.78, = 0.024). After PSM, Kaplan-Meier survival curve analysis revealed significant differences in both RFS and OS between the two groups (P = 0.025 and P = 0.018, respectively). All the results showed that the prognosis of BC with more subcutaneous fat was poor.
The findings demonstrated that the SFI at T11 was negatively correlated with patient survival. This offers a new perspective on personalized management for BC patients, suggesting that future research should validate these results and investigate combining imaging assessments with lifestyle interventions, such as exercise, nutrition, and diet, to optimize patient outcomes.
通过计算机断层扫描（CT）监测身体成分，包括肌肉和脂肪组织，在各种癌症的预后中起着关键作用。然而，腹部CT对乳腺癌（BC）患者不适用，因此胸部CT成为术后监测的重要工具。本研究旨在通过分析胸部CT图像评估第11胸椎平面皮下脂肪组织对BC患者术后预后的影响，为术后营养和康复指导提供依据。
我们对2013年1月1日至2013年12月31日在温州医科大学附属第二医院接受治疗并出院的188例BC患者的病历进行了回顾性分析。使用胸部CT图像测量第11胸椎（T11）的皮下脂肪面积（SFA），并计算皮下脂肪指数（SFI，面积/身高）。使用多变量Cox比例风险模型和倾向得分匹配（PSM）评估SFI与总生存期（OS）以及无复发生存期（RFS）之间的关系。此外，应用Kaplan-Meier生存曲线比较各组之间的预后差异。
中位随访时间为128个月（范围：27 - 188个月）。在纳入研究的188例患者中，SFI的最佳截断值确定为49.31 cm²/m²。多变量分析表明，SFI是OS（HR 2.50，95% CI 1.07 - 5.83，P = 0.034）和RFS（HR 2.04，95% CI 1.10 - 3.78，P = 0.024）的独立预后因素。PSM后，Kaplan-Meier生存曲线分析显示两组之间的RFS和OS均存在显著差异（分别为P = 0.025和P = 0.018）。所有结果表明，皮下脂肪较多的BC患者预后较差。
研究结果表明，T11的SFI与患者生存率呈负相关。这为BC患者的个性化管理提供了新的视角，表明未来的研究应验证这些结果，并研究将影像评估与生活方式干预（如运动、营养和饮食）相结合，以优化患者预后。
