Metastatik kolon kanserli hastalarda PET/BT' deki yağ dokusu dağılımı ve metabolik aktivitesinin prognostik faktörlerle ilişkisi
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Tarih
2020
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Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Obezite, yağ dokusunun işlevindeki değişikliklerle ilişkilidir. Bu değişikliklerin kanser gelişimini ve klinik süreci etkileyebileceği gösterilmiştir. Bu çalışmada, metastatik kolorektal kanserli (mKRK) hastalarda sağkalımı tahmin etmek için PET / BT'de yağ dokusu dağılımı ve metabolik aktivitesinin prognostik önemini değerlendirmeyi amaçladık. Materyal ve Metod: Çalışmaya 2010-2018 yılları arasında metastatik kolorektal kanser tanısı alan 83 hasta dahil edildi. Hastaların dosya ve laboratuvar sonuçları retrospektif olarak incelendi. Tedavi öncesi çekilen PET/BT görüntüleri yağ dokusu dağılımını ve metabolik aktivitesini belirlemek için yeniden değerlendirildi. Subkütan yağ dokusunun (SAT) ve visseral yağ dokusunun (VAT) hacmi ve metabolik aktivitesi PET / BT görüntüleri kullanılarak ölçüldü. SAT hacmi, SAT yoğunluğu (HU), SAT oranı (SAT hacmi / SAT yoğunluğu) hesaplandı. Tümör dokusunun maksimum standartlaştırılmış alım değeri (SUV) ölçüldü. Yağ dokusu ile sağkalım arasındaki ilişki incelendi. Bulgular: Medyan genel sağkalım 33.76 aydı (% 95 CI: 28.18-39.34). Primer tümörün yerleşim yeri (HR:2.5; p=0.008) ve SAT oranı (HR:0.5 p=0.053) ile genel sağkalım arasında anlamlı ilişki tespit edildi. SAT oranı değeri <-1.1 ve ≥ -1.1 olan hastalar için medyan OAS sırasıyla 38.5 (% 95 CI: 31.54-45.58) ve 24.5 (% 95 CI: 14.13-34.93) aydı (p=0.05). 69 hastada progresyon görüldü. Medyan progresyonsuz sağkalım süresi 11.03 aydı (%95 CI: 9,11-12,95). Komorbidite (HR:0.48; p=0.003) ve tümör SUV max (HR:0.95; p=0.014) ile progresyonsuz sağkalım arasında anlamlı ilişki tespit edildi. Tümör SUV max değeri <11.5 ve ≥11.5 olan hastalar için medyan PFS sırasıyla 9.2 (% 95 CI 7.25-11.27 ) ve 12.6 ( % 95 CI 10.02-15.27) aydı (p=0.014). VEGF hedefli tedavi alan 48 hasta vardı. Bu hastalarda VAT SUV mean (HR:0.09; p=0.008) ile progresyonsuz sağkalım arasında anlamlı ilişki tespit edildi. SAT oranı ile hem genel sağkalım (HR:0.58, p=0.05), hem de progresyonsuz sağkalım (HR:1.93, p=0.043) arasında anlamlı ilişki tespit edildi. Sonuç: SAT oranı, mKRK hastalarında sağkalım için bağımsız bir prognostik faktördü. Yüksek SAT hacmi, mKRK hastalarında daha uzun sağkalım ile ilişkilidir. Anahtar Kelimeler: Kolorektal kanser, 18 FDG PET/BT, yağ doku, prognoz
Obesity is associated with changes in the function of adipose tissue. It has been demonstrated that these changes might affect cancer development and clinical process. In this study, we aimed to evaluate prognostic significance of adipose tissue distribution and metabolic activity in PET/CT to predict survival in patients with metastatic colorectal cancer. Materials and Method: 83 patients diagnosed with metastatic colorectal cancer between 2010 and 2018 were included in the study. Patients file and laboratory results were analyzed retrospectively. PET/CT images taken before treatment were reevaluated to determine adipose tissue distribution and metabolic activity. The volume and metabolic activity of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were measured using PET / CT images. SAT volume, SAT density (HU), SAT ratio (SAT volume / SAT density) were calculated. The maximum standardized uptake value (SUV) of the tumor tissue was measured. The relationship between adipose tissue and survival was examined. Results: The median overall survival was 33.76 months (95% CI: 28.18-39.34). According to univariate analysis results, tumor location (HR:2.5; 95% CI 1.27-4.98, p=0.008) and SAT ratio (HR:0.5; 95% CI 0.34-1.00, p=0.053) were the significant parameters for the OAS. The median OAS for the patients with SAT ratio value <-1.1 and ≥ -1.1 were 38.5 (95% CI 31.54-45.58) and 24.5 (95% CI 14.13-34.93) months, respectively (p=0.05). During follow up, 69 patients experienced disease progression. The median progression-free survival was 11.03 months (95% CI: 9.11-12.95). Comorbidity (HR:0.48; p=0.003) and tumor SUV max (HR:0.95; p=0.014) were the significant parameters for the PFS. Median PFS for patients with tumor SUV max value <11.5 and ≥11.5 were 9.2 (95% CI 7.25-11.27) and 12.6 (95% CI 10.02-15.27) months, respectively (p=0.014). 48 patients received VEGF targeted therapy. In these patients, a significant correlation was found between VAT SUV mean (HR: 0.09; p=0.008) progression-free survival. SAT ratio was the significant parameter for the OAS (p=0.05) and PFS (p=0.043). Conclusions: SAT ratio was an independent prognostic factor for survival in patients with mCRC. Higher SAT volume is correlated with longer survival in mCRC patients. Key words: Colorectal cancer, 18 FDG PET/CT, adipose tissue , prognosis
Obesity is associated with changes in the function of adipose tissue. It has been demonstrated that these changes might affect cancer development and clinical process. In this study, we aimed to evaluate prognostic significance of adipose tissue distribution and metabolic activity in PET/CT to predict survival in patients with metastatic colorectal cancer. Materials and Method: 83 patients diagnosed with metastatic colorectal cancer between 2010 and 2018 were included in the study. Patients file and laboratory results were analyzed retrospectively. PET/CT images taken before treatment were reevaluated to determine adipose tissue distribution and metabolic activity. The volume and metabolic activity of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were measured using PET / CT images. SAT volume, SAT density (HU), SAT ratio (SAT volume / SAT density) were calculated. The maximum standardized uptake value (SUV) of the tumor tissue was measured. The relationship between adipose tissue and survival was examined. Results: The median overall survival was 33.76 months (95% CI: 28.18-39.34). According to univariate analysis results, tumor location (HR:2.5; 95% CI 1.27-4.98, p=0.008) and SAT ratio (HR:0.5; 95% CI 0.34-1.00, p=0.053) were the significant parameters for the OAS. The median OAS for the patients with SAT ratio value <-1.1 and ≥ -1.1 were 38.5 (95% CI 31.54-45.58) and 24.5 (95% CI 14.13-34.93) months, respectively (p=0.05). During follow up, 69 patients experienced disease progression. The median progression-free survival was 11.03 months (95% CI: 9.11-12.95). Comorbidity (HR:0.48; p=0.003) and tumor SUV max (HR:0.95; p=0.014) were the significant parameters for the PFS. Median PFS for patients with tumor SUV max value <11.5 and ≥11.5 were 9.2 (95% CI 7.25-11.27) and 12.6 (95% CI 10.02-15.27) months, respectively (p=0.014). 48 patients received VEGF targeted therapy. In these patients, a significant correlation was found between VAT SUV mean (HR: 0.09; p=0.008) progression-free survival. SAT ratio was the significant parameter for the OAS (p=0.05) and PFS (p=0.043). Conclusions: SAT ratio was an independent prognostic factor for survival in patients with mCRC. Higher SAT volume is correlated with longer survival in mCRC patients. Key words: Colorectal cancer, 18 FDG PET/CT, adipose tissue , prognosis
Açıklama
Anahtar Kelimeler
Kolorektal kanser, 18 FDG PET/BT, Yağ doku, Prognoz, Colorectal cancer, 18 FDG PET/CT, Adipose tissue, Prognosis
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Scopus Q Değeri
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Künye
Karaçelik, T. (2020). Metastatik kolon kanserli hastalarda PET/BT' deki yağ dokusu dağılımı ve metabolik aktivitesinin prognostik faktörlerle ilişkisi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Bölümü, İç Hastalıkları Anabilim Dalı, Konya.
