Shen Chih-Yu, Pan Jhih-Kai, Lin Wen-Der, Cheng Hui-Chuan, Hu Che-Yuan, Wu Kuan-Yu, Kuo Yung-Ming, Shieh Gia-Shing, Lu Pei-Jung
Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Department of Urology, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan.
Ann Surg Oncol. 2025 May 28. doi: 10.1245/s10434-025-17512-5.
We sought to characterize periprostatic adipose tissue (PPAT) with magnetic resonance imaging (MRI) featuring water-to-oil ratio (R) to detect brown adipocyte (BAT).
Between November 2021 and September 2023, 21 localized patients with prostate cancer were studied, categorized as low (n = 4), intermediate (n = 4), and high risk (n = 13). We utilized MRI to analyze the water-only signal and fat-only signal. R was used to predict the risk stratification. Tissue samples, including periprostate fat, were collected during surgery, processed, and stained with hemotoxylin and eosin (H&E) for microscopic analysis. Periprostate adipose cell supernatants were used to treat cancer cells (PC3 and LNCaP) in vitro.
We found significantly higher periprostatic adipose tissue R in the high and intermediate risk groups compared with the low risk group (52.12 versus 30.48; p < 0.0001). The receiver operating characteristic curve for distinguishing advanced tumors using PPAT R in MRI imaging yielded an area under the curve of 0.64, which increased to 0.90 after incorporating initial PSA. Immunofluorescence, H&E staining, and immunohistochemistry revealed the presence of brown adipocytes, marked by uncoupling protein 1 expression, in periprostate tumor fat. Results indicate that BAT-related adipokines promote epithelial-mesenchymal transition and invasiveness in human prostate cancer cells.
In the study, the chemical shift image of MRI in 21 localized patients with prostate cancer revealed higher periprostatic adipose tissue water-to-oil ratio among patients with high-risk prostate cancer. Adipokines within the tumor-microenvironment attribute to the cancer aggressiveness, and targeting the fat fraction signal in MRI could improve the current risk stratification strategy.
我们试图通过以水油比（R）为特征的磁共振成像（MRI）来表征前列腺周围脂肪组织（PPAT），以检测棕色脂肪细胞（BAT）。
在2021年11月至2023年9月期间，对21例局限性前列腺癌患者进行了研究，分为低风险组（n = 4）、中风险组（n = 4）和高风险组（n = 13）。我们利用MRI分析仅水信号和仅脂肪信号。R用于预测风险分层。在手术期间收集包括前列腺周围脂肪在内的组织样本，进行处理，并用苏木精和伊红（H&E）染色以进行显微镜分析。前列腺周围脂肪细胞上清液用于体外处理癌细胞（PC3和LNCaP）。
我们发现，与低风险组相比，高风险组和中风险组的前列腺周围脂肪组织R显著更高（52.12对30.48；p < 0.0001）。在MRI成像中使用PPAT R区分晚期肿瘤的受试者工作特征曲线的曲线下面积为0.64，纳入初始前列腺特异性抗原（PSA）后增加到0.90。免疫荧光、H&E染色和免疫组织化学显示，前列腺周围肿瘤脂肪中存在以解偶联蛋白1表达为特征的棕色脂肪细胞。结果表明，与BAT相关的脂肪因子促进人前列腺癌细胞的上皮-间质转化和侵袭性。
在本研究中，21例局限性前列腺癌患者的MRI化学位移图像显示，高危前列腺癌患者的前列腺周围脂肪组织水油比更高。肿瘤微环境中的脂肪因子导致癌症侵袭性，针对MRI中的脂肪分数信号可以改善当前的风险分层策略。
