妇科恶性肿瘤和良性病变的腹盆部脂肪组织分布研究

The distribution of abdominal and pelvic adipose tissue in malignant gynecologic tumor and benign gynecologic diseas

目的采用定量CT(QCT)对妇科恶性肿瘤患者和良性病变患者的腹盆部脂肪组织含量及分布特征进行前瞻性研究。方法对80例妇科恶性肿瘤患者和80例妇科良性病变患者采用64排螺旋CT及QCT体模进行腹盆部CT扫描,用QCT分析软件测量并计算总脂肪组织(TAT)、内脏脂肪组织(VAT)、皮下脂肪组织(SAT)的面积和体积(TFV、VFV、SFV)及VFV/SFV(V/S)值,分别比较恶性肿瘤和良性病变间、恶性肿瘤不同临床分期间、不同肿瘤类别间各项体积的差异,以及不同部位脂肪组织(AT)体积与总AT体积的相关性。结果 (1)恶性肿瘤组腹部和(或)盆部的TFV、VFV、SFV均高于良性病变组,除腹盆部VFV外,两组间AT体积比较,差异均有统计学意义(P<0.05);(2)恶性肿瘤早期组的腹盆部各项AT体积与中晚期组或良性病变组比较,差异均有统计学意义(P<0.05),早期组较高,后两组间比较,差异无统计学意义(P>0.05);两恶性肿瘤组的V/S值与良性病变组比较,差异均有统计学意义(P<0.05),良性病变组较高,早期组与中晚期组间差异无统计学意义(P>0.05);(3)内膜癌组与宫颈癌组的腹盆部各项AT体积间差异无统计学意义(P>0.05),内膜癌组略高;(4)所有病例的腹部或盆部的VFV、SFV与腹盆部TFV均呈正相关,以腹部SFV相关性最高。结论妇科恶性肿瘤患者比良性病变患者更肥胖,尤其早期恶性肿瘤患者,其SAT的增多较VAT更明显,且与TAT相关性更高,是肥胖的主要组成部分。

Objective To study the abdominal and pelvic adipose tissue volume and distribution in patients with malignant gynecologic tumor and benign gynecologic disease prospectively.Methods Eighty patients with malignant gynecologic tumor and eighty patients with benign gynecologic disease were underwent abdominal and pelvic CT scan by 64-slice spiral CT and QCT calibration phantom.The area and the volume of TAT,VAT,SAT of abdomen and（or）pelvis（TFV,VFV,SFV and VFV/SFV）were measured and calculated.The differences between the malignant gynecologic tumor group and the benign gynecologic disease group and between the different stages or types of malignant gynecologic tumor groups were compared,then the distribution of AT was analyzed.Results（1）Except the VFV of abdomen and pelvis,there were differences in TFV,VFV and SFV between the malignant gynecologic tumor group and the benign gynecologic disease group（P〈0.05）,the former was higher.（2）There were differences in abdominal and pelvic TFV,VFV,SFV between the early-stage and the advanced-stage malignant gynecologic tumor group and between the early-stage and the benign gynecologic disease group（P〈0.05）,the early-stage group was the highest;there was no difference between the advanced-stage and the benign gynecologic disease group（P〈0.05）.There were differences in VFV/SFV between the early-stage and the benign gynecologic disease group and between the advanced-stage and the benign gynecologic disease group（P〈0.05）,the benign gynecologic disease group was the highest;there was no difference between the early-stage and the advanced-stage group（P〈0.05）.（3）There was no difference in abdominal and pelvic TFV,VFV,SFV,VFV/SFV between the endometrial carcinoma and the cervical carcinoma group（P〈0.05）.（4）There were positive correlations between abdominal or pelvic VFV,SFV and abdominal and pelvic TFV,the abdominal SFV was the highest.Conclusion The patients with malignant gynecologic tumor,especially in the early-stage,were much fatter than the patients with benign gynecologic disease.In malignant gynecologic tumor patients,the SAT increased more significantly than the VAT,and had the highest correlation with TAT,and was the mainly composition of obesity.