腹部脂肪组织脂肪酸组分的MRI定量检测及其在直肠癌中的应用价值初探
Quantitative MRI of fatty acid composition of abdominal adipose tissue and its application value in rectal cancer:a preliminary study
张筱 1袁正 2林光武1
作者信息
- 1. 复旦大学附属华东医院医学影像科,上海 200040
- 2. 上海交通大学医学院附属第九人民医院放射科,上海 200011
- 折叠
摘要
目的:利用化学位移编码磁共振成像(chemical-shift-encoded magnetic resonance imaging,CSE-MRI)技术定量检测脂肪组织脂肪酸组分,分析直肠癌患者不同部位脂肪酸组分变化情况,探讨该技术应用于评价脂肪酸影响直肠癌发生、发展的价值.方法:对2021年10月—2022年12月于复旦大学附属华东医院经术后病理学检查证实的直肠腺癌患者术前行直肠常规MRI扫描和多回波梯度回波CSE-MRI检查以测定直肠系膜、肠系膜和臀部皮下3个部位的脂肪组织脂肪酸组分[包括饱和脂肪酸分数(fraction of saturated fatty acid,fSFA)、单不饱和脂肪酸分数(fraction of monounsaturated fatty acid,fMUFA)和多不饱和脂肪酸分数(fraction of polyunsaturated fatty acid,fPUFA)].同期入组与年龄性别相匹配的对照组非直肠癌患者20例.分析直肠癌组与对照组间以及直肠癌患者中各部位脂肪组织脂肪酸组分变化,评价脂肪酸在肿瘤发生发展过程中的作用;分别分析直肠癌淋巴血管侵犯(lymphovascular invasion,LVI)、周围神经侵犯(peripheral nerve invasion,PNI)阳性组和阴性组各部位脂肪组织脂肪酸组分变化,评价脂肪酸对肿瘤侵袭性的影响.脂肪酸分数参数测量的观察者间一致性通过组内相关系数(intraclass correlation coefficient,ICC)评估.两组间差异分析用独立样本t检验或Mann-Whitney U检验;多组间差异分析用单因素方差分析(One-Way ANOVA)或Kruskal-Wallis H(K)检验.结果:共纳入56例直肠腺癌患者,包括男性36例,女性20例,平均(65.1±10.1)岁;LVI阳性11例(19.6%),PNI阳性10例(17.9%).对照组20例,其中男性12例,女性8例,平均(66.3±8.8)岁.观察者间各部位各脂肪酸分数的测量相关性良好,ICC均＞0.60.直肠癌组中直肠系膜脂肪组织fSFA高于对照组(37.2±4.2 vs 35.0±2.7,P=0.035);直肠癌患者中直肠系膜、肠系膜与臀部皮下脂肪组织中的fMUFA(分别为37.5±2.4、37.3±8.1和40.6±8.7,P=0.003)和fPUFA(分别为24.9±4.1、26.3±4.9和21.5±4.7,P<0.001)的差异均有统计学意义;LVI(+)直肠癌直肠系膜脂肪中fMUFA高于LVI(-)组(38.8±1.5 vs 37.1±2.5,P=0.035);PNI(+)/(-)直肠癌组间各部位脂肪组织各脂肪酸分数差异均无统计学意义(P>0.05).结论:① 直肠癌患者直肠系膜脂肪SFA分数与正常对照组存在差异;② 直肠癌患者直肠系膜和肠系膜脂肪的fMUFA和fPUFA与皮下脂肪组织之间存在差异;③ 直肠癌患者直肠系膜脂肪fMUFA与LVI存在关联.
Abstract
Objective:To quantitatively detect fatty acid composition of various adipose tissue depots using chemical shift-encoded magnetic resonance imaging(CSE-MRI)in patients with rectal cancer,and to explore the application value in evaluating fatty acid effects on rectal carcinogenesis and progression.Methods:Patients with surgically pathologically confirmed rectal adenocarcinoma underwent preoperative routine MRI and multi-echo gradient-echo CSE-MRI in Huadong Hospital,Fudan University from October 2021 to December 2022.The saturated fatty acid(fSFA),monounsaturated fatty acid(fMUFA)and polyunsaturated fatty acid(fPUFA)fractions of adipose tissue from rectal mesentery,ileal mesentery,and gluteal subcutaneous area were detected.Twenty age-and sex-matched controls with non-rectal cancer were enrolled at the same time.Changes in fatty acid fractions of adipose tissue at various sites were analyzed between the rectal cancer group and the control group as well as among rectal cancer patients to evaluate the role of fatty acids in tumorigenesis;changes in fatty acid fractions of adipose tissue at various sites were analyzed between the lymph vascular invasion(LVI)and peripheral nerve invasion(PNI)positive and the negative rectal cancer groups to evaluate the effect of fatty acids on tumor aggressiveness.Interobserver agreement of fatty acid fraction parameter measurements was assessed by intra-group correlation coefficient(ICC).Differences between two groups were analyzed by independent samples t-test or Mann-Whitney U-test;differences between multiple groups were analyzed by one-way ANOVA(One-Way ANOVA)or Kruskal-Wallis H(K)test.Results:A total of 56 patients with rectal adenocarcinoma were included,including 36 males and 20 females,with a mean age of(65.1±10.1)years.There were 11(19.6%)rectal adenocarcinomas with LVI and 10(17.9%)patients with PNI;and 20 cases in the control group,including 12 males and 8 females,with a mean age of(66.3±8.8)years.Measurements of each fatty acid fraction at each site correlated well between observers,with ICC＞0.60.The SFA fraction of rectal mesenteric adipose tissue was higher in the rectal cancer group than in the control group(37.2±4.2 vs 35.0±2.7,P=0.035);The fMUFA(37.5±2.4,37.3±8.1 and 40.6±8.7,respectively,P=0.003)and fPUFA(24.9±4.1,26.3±4.9 and 21.5±4.7,respectively,P<0.001)of adipose tissue from rectal mesentery,ileal mesentery,and gluteal subcutaneous area in patients with rectal cancer were statistically significant.The fMUFA of rectal mesenteric adipose tissue was higher in the LVI(+)rectal cancer than in the LVI(-)group(38.8±1.5 vs 37.1±2.5,P=0.035);none of the differences in the fractions of each fatty acid in adipose tissue of each site were statistically significant between the PNI(+)/(-)rectal cancer groups(P>0.05).Conclusion:① Differences were found between the SFA fractions of rectal mesenteric fat in rectal cancer patients and normal controls;② Differences were found between the fMUFA and fPUFA of rectal mesenteric and mesenteric fat of rectal cancer and subcutaneous adipose tissues;③ Associations were found between the fMUFA of rectal mesenteric fat of rectal cancer and LVI.
关键词
直肠癌/化学位移编码磁共振成像/脂肪酸组分/饱和脂肪酸/不饱和脂肪酸Key words
Rectal cancer/Chemical shift-encoded magnetic resonance imaging/Fatty acid composition/Saturated fatty acid/Unsaturated fatty acid引用本文复制引用
基金项目
上海市科学技术委员会科技计划(20Y11911900)
华东医院院级重点学科建设项目(ZDXK2009)
出版年
2024
NETL
NSTL
万方数据