作者：靳兴汉1，胡春雷2，吴建龙2，侯佳宁2，吕国庆2，肖平1

单位：1.安徽医科大学北京大学深圳医院 临床学院，广东 深圳 518000； 2.北京大学深圳医院 胃肠外科，广东 深圳 518000

Authors:  JIN Xinghan1, HU Chunlei2, WU Jianlong2, HOU Jianing2, LV Guoqing2, XIAO Ping1

Unit:  1.Clinical Medical Institute of Peking University Shenzhen Hospital of Anhui Medical University, Shenzhen 518000, Guangdong, China;  2.Department of Gastrointestinal Surgery, Peking University Shenzhen Hospital, Shenzhen 518000, Guangdong, China

摘要：

目的  探讨肥胖与内脏脂肪肥胖对结直肠癌患者预后的影响。方法 回顾性分析北京大学深圳医院2012年1月至2016年12月期间179例结直肠癌患者身体质量指数(body mass index BMI)、内脏脂肪面积(visceral fat area VFA)、VFA/皮下脂肪面积(subcutaneous fat area SFA)比值(V/S比值)、肿瘤分期、肿瘤分化程度,化疗完成度等临床资料和随访数据,来评价肥胖及内脏脂肪肥胖是否影响结直肠癌预后。结果 高V/S比值组(V/S>50%)患者较低V/S比值组(V/S≤50%)的无病生存期(disease-free survival DFS)明显缩短(P=0.024),并与肿瘤分期、肿瘤分化程度、化疗完成度无关,但两组总生存期(overall survival OS)无差异(P=0.280)。超重和肥胖组患者与正常体重组患者相比DFS与OS均无差异。结论 内脏脂肪肥胖增加结直肠癌术后复发风险,缩短DFS。内脏脂肪肥胖对结直肠癌预后的影响值得进一步研究探讨。

关键词：  内脏脂肪肥胖；结直肠癌；无瘤生存期；总体生存期

Abstract：

Objective  To explore and discuss the influence of obesity and visceral adiposity on prognosis of colorectal cancer. Method  To investigate the prognostic significance of adiposity and visceral adiposity in patients with colorectal cancer, a retrospective analysis was used to analyse the association between the clinical data and follow-up data of 179 patients, who underwent surgery between January 2012 and December 2016 in our hospital. And the body mass index (BMI) , visceral fat area (VFA) , VFA/subcutaneous fat area (SFA) ratio (V/S) , tumor stage, tumor differentiation, and chemotherapy were included in the clinical data. Result  Patients with high VFA/SFA ratio (V/S > 50%) had significantly lower cumulative disease-free survival (DFS) rate compared to patients with low VFA/SFA ratio (V/S ≤50%) (P=0.024) , while there were no differences in tumor stage, tumor differentiation degree and chemotherapy between the two groups. However, there was no significant difference in overall survival (OS) between the two groups (P=0.280). There was no significant difference in both DFS and OS between the normal-weight and overweight group. Conclusion  Visceral adiposity is a risk factor for recurrence of colorectal cancer, and a significant predictor of DFS. The prognostic significance of visceral adiposity should further be determined.

Key Words:  Visceral adiposity; Colorectal cancer; Disease-free survival; Overall survival