Zhang Bei-Bei, Xie Han-Bing, Liu Ping-Ping, Liu Le, Li Xue-Meng, Zhao Lin, Wang Guang-Yu, Wang Rui-Tao
Department of Endoscope, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, China.
Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, China.
Pleura Peritoneum. 2025 Apr 24;10(2):81-88. doi: 10.1515/pp-2024-0030. eCollection 2025 Jun.
Synchronous peritoneal metastasis (PM) represents an advanced stage of colorectal cancer (CRC), indicating extensive tumor spread. Visceral adipose tissue (VAT) has been linked to cancer development and progression. This study aims to explore the relationship between VAT and occult synchronous PM in CRC patients before surgery.
We enrolled 681 CRC patients, with 419 in the primary cohort (356 non-metastatic and 63 with PM) and 262 in the validation cohort (239 non-metastatic and 23 with PM). Clinical characteristics and laboratory measurements were collected prior to surgery. Adipose and muscle tissues were delineated on preoperative contrast-enhanced computed tomography (CT) images. The association between visceral adipose tissue and synchronous PM was assessed using univariate and multivariate logistic regression analyses.
In the primary cohort, 419 patients were diagnosed with CRC, with 63 presenting with PM. Patients with PM had higher visceral adipose tissue index (VATI) levels compared to those without PM. Additionally, there was a trend towards increased PM incidence with elevated VATI. Multivariate logistic regression analysis confirmed that higher VATI was independently associated with PM. These findings were consistent in the validation cohort.
VATI is an independent risk factor for occult synchronous PM in patients with CRC.
同时性腹膜转移（PM）代表结直肠癌（CRC）的晚期阶段，提示肿瘤广泛扩散。内脏脂肪组织（VAT）与癌症的发生和进展有关。本研究旨在探讨CRC患者术前VAT与隐匿性同时性PM之间的关系。
我们纳入了681例CRC患者，其中419例在主要队列中（356例无转移，63例有PM），262例在验证队列中（239例无转移，23例有PM）。在手术前收集临床特征和实验室测量数据。在术前对比增强计算机断层扫描（CT）图像上勾勒出脂肪和肌肉组织。使用单因素和多因素逻辑回归分析评估内脏脂肪组织与同时性PM之间的关联。
在主要队列中，419例患者被诊断为CRC，其中63例有PM。与无PM的患者相比，有PM的患者内脏脂肪组织指数（VATI）水平更高。此外，随着VATI升高，PM发生率有增加的趋势。多因素逻辑回归分析证实，较高的VATI与PM独立相关。这些发现在验证队列中是一致的。
VATI是CRC患者隐匿性同时性PM的独立危险因素。
