Metabolic Activity of Visceral Adipose Tissue Is Associated with Metastatic Status of Lymph Nodes in Endometrial Cancer: A 18 F-FDG PET/CT Study

Kisoo Pahk, Ki-Jin Ryu, Chanmin Joung, Hyun Woo Kwon, Sanghoon Lee, Hyuntae Park, Tak Kim, Jae Yun Song and Sungeun Kim
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Kisoo Pahk: Department of Nuclear Medicine, Korea University Anam Hospital, Seoul 02841, Korea
Ki-Jin Ryu: Department of Obstetrics and Gynecology, Korea University Anam Hospital, Seoul 02841, Korea
Chanmin Joung: Institute of Inflammation Control, Korea University, Seoul 02841, Korea
Hyun Woo Kwon: Department of Nuclear Medicine, Korea University Anam Hospital, Seoul 02841, Korea
Sanghoon Lee: Department of Obstetrics and Gynecology, Korea University Anam Hospital, Seoul 02841, Korea
Hyuntae Park: Department of Obstetrics and Gynecology, Korea University Anam Hospital, Seoul 02841, Korea
Tak Kim: Department of Obstetrics and Gynecology, Korea University Anam Hospital, Seoul 02841, Korea
Jae Yun Song: Department of Obstetrics and Gynecology, Korea University Anam Hospital, Seoul 02841, Korea
Sungeun Kim: Department of Nuclear Medicine, Korea University Anam Hospital, Seoul 02841, Korea

IJERPH, 2021, vol. 19, issue 1, 1-11

Abstract: Obesity contributes to increased cancer incidence and aggressiveness in patients with endometrial cancer. Inflamed metabolic activity of visceral adipose tissue (VAT) is regarded as a key underlying mechanism of adverse consequences of obesity. The aim of this study was to investigate the association between inflammatory metabolic activity of VAT evaluated by 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) and metastatic status of lymph nodes (LN) in patients with endometrial cancer. In total, 161 women with newly diagnosed endometrial cancer, who received preoperative 18F-FDG PET/CT, were enrolled. VAT inflammatory metabolic activity was defined as V/S ratio and measured from the maximum standardized uptake value (SUVmax) of VAT normalized to the SUVmax of subcutaneous adipose tissue (SAT). The positive LN metastasis group exhibited a significantly higher V/S ratio than the negative LN metastasis group. Systemic inflammatory surrogate markers including high sensitivity C-reactive protein, spleen SUVmax, and bone marrow SUVmax were also higher in the LN metastasis group than in the negative LN metastasis group, showing significant correlations with V/S ratio. In multivariate logistic regression analysis, V/S ratio was independently associated with LN metastasis. V/S ratio is independently associated with the LN metastasis status in patients with endometrial cancer. This finding could be useful as a potential surrogate marker of obesity-induced VAT inflammation associated with tumor aggressiveness.

Keywords: obesity; visceral fat; endometrial cancer; metastasis; inflammation; positron-emission tomography (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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