Correlation Between Abdominal Fat Content And Clinical Pathological Features Of Bladder Tumor

Part one:The relationship between abdominal fat content and histological grade and invasion depth of bladder tumorPurpose:In recent years,it has been found that adipose tissue,as a special secretory organ,can secrete a variety of cytokines to form a cancer promoting microenvironment and participate in the occurrence and development of tumors.The purpose of this paper is to study the correlation between the content of abdominal fat and the histopathological characteristics of bladder tumor,and to find the predictive index which is helpful for the grading and staging of bladder tumor before operation.Methods:The clinical-pathological data of bladder cancer patients who underwent surgery in The First Affiliated Hospital of Suchow University from June 2015 to October 2018 were collected,including gender,age,diabetes history,blood lipid level,bladder tumor history,postoperative pathology report and the CT image data,then select a single sliced CT image to measure the area of visceral(VFA),subcutaneous(SFA)and total adipose tissue(TFA).Through t-test and chi square test to compare the differences between different groups,single factor and multi factor Logistic regression analysis model was used to screen the factors affecting the histological grade and depth of invasion of bladder tumor.Results:A total of 167 were enrolled.66 patients were high-grade urothelial carcinoma whereas101 patients were non high-grade urothelial carcinoma.151 were non muscle invasive bladder cancer(NMIBC),16 were muscle invasive bladder cancer(MIBC).There were 130 male patients and 37 female patients,the average age was 64.3 years old.The mean visceral fat area was 101.6 cm2,the mean subcutaneous fat area was 131.1 cm2,the mean total abdominal fat area was 232.7 cm2 and the mean proportion of visceral fat area was 43.7%.Multivariate analysis showed that age(P=0.037)and abdominal fat ratio(P=0.003)were independent predictors of bladder high-grade urothelial carcinoma,and abdominal fat area(P=0.016)was independent predictor of MIBC.Conclsion:The age and the abdominal fat ratio were related to high-grade urothelial carcinoma,while the abdominal fat area was related to MIBC.The abdominal obesity bladder tumor was more likely to be high-grade and muscle invasive bladder cancer.Part two:Effect of abdominal fat content on recurrence free survival time of patients with non muscle-invasive bladder tumor after electrotomy.Purpose:Obesity not only plays a role in the occurrence of tumor,but also is more likely to recur and metastasize in obese patients.We hope to investigate the effect of abdominal fat content on recurrence free survival time of non muscle-invasive bladder tumor after electrotomy.Methods:The clinical data of bladder cancer patients who underwent TURBT in the hospital from June 2015 to October 2018 were collected,including gender,age,diabetes history,blood lipid level,size and number of tumor,postoperative pathology report,the CT image and the time of recurrence after resection.Using chi square test to compare the difference of recurrence rate between different groups,then K-M method used to estimate the recurrence free survival time and draw the recurrence free survival curve.Finally,the independent risk factors influencing the recurrence free survival time of patients with non muscle-invasive bladder cancer were obtained by Cox regression analysis.Results:A total of 109 patients were enrolled in the group.The follow-up period was up to October 2019.28 patients recurred after resection.The median survival time of the patients was 53.2 months.Univariate analysis showed that the factors influencing the recurrence of NMIBC included tumor size,the number of tumor,T stage,histological grade and VFA%(P<0.05).Multivariate Cox regression analysis indicated that tumor number(HR=2.781),tumor size(HR=2.378)and VFA%(HR=2.394)were independent risk factors for recurrence of NMIBC after TURBT.Conclusion:Abdominal fat content is an independent risk factor for postoperative recurrence in patients with non muscle-invasive bladder cancer.Patients with a higher proportion of abdominal fat area are more likely to recur after TURBT.