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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 prospectively study the content and distribution of abdominal adipose tissue in patients with gynecologic malignancies and benign lesions by quantitative computed tomography (QCT). Methods 80 cases of gynecological malignant tumor and 80 cases of gynecological benign lesions were treated with 64-slice spiral CT and QCT phantom for abdominal pelvic CT scan. The total adipose tissue (TAT), visceral adipose tissue (VAT) ), Subcutaneous adipose tissue (SAT) area and volume (TFV, VFV, SFV) and VFV / SFV (V / S) values were compared between malignant and benign lesions, malignant tumors in different clinical stages, between different tumor types The differences in volumes, as well as the correlation between the volume of AT and the total AT volume at different sites. Results (1) The TFV, VFV and SFV in the abdomen and / or pelvis of the malignant tumor group were higher than those in the benign lesion group. There was significant difference in AT volume between the two groups except for the VFV in the abdominal cavity (P < 0.05). (2) There was significant difference in AT volume between the early stage of malignant tumor and the advanced stage or benign lesion group (P <0.05), the early stage was higher and the latter two groups were compared , There was no significant difference between the two groups (P> 0.05). The V / S values of two malignant tumors were significantly different from those of benign lesions (P <0.05) There was no significant difference between the two groups (P> 0.05). (3) There was no significant difference in AT volume between the endometrial cancer group and the cervical cancer group (P> 0.05) ; (4) The VFV and SFV in the abdomen or pelvis of all cases were positively correlated with TFV in the abdomen, and the highest in the abdominal SFV. Conclusions Patients with gynecologic malignancy are more obese than those with benign lesions. Especially in patients with early malignant tumors, the increase of SAT is more obvious than VAT and more relevant to TAT, which is a major component of obesity.