Periprostatic Adipose Tissue Quantification As A Diagnostic Predictor Of Clinically Significant Prosta Te Carcinoma:A Preliminary Study

BACKGROUND:Although epidemiological studies have shown that intake of high saturated fat increases the risk of advanced prostate cancer,the results of cohort studies still remain inconsistent.In relation to periprostatic adipose tissue and clinically significant prostate cancers(CSPCa),there are inconsistencies in the results,hence more research is still to be verified.OBJECTIVE:To investigate the correlation between the periprostatic fat thickness(PPFT),periprostatic fat area(PPFA)and Gleason score(GS)and to predict its value with clinically significant prostate cancer(GS≥7).PATIENTS AND METHODS:This prospective study was approved by the Ethics Committee of Second Affiliated Hospital of Kunming Medical University.T2-weighted mid-sagittal MRI was used to measure the subcutaneous fat thickness and periprostatic fat thickness.Periprostatic fat area was quantified in T2-weighted axial MRI at the level of the femoral head and greater trochanter of the femur.The correlation between subcutaneous fat thickness,periprostatic fat thickness,periprostatic fat area with Gleason score was analyzed using Spearman correlation coefficient(rs).In addition,to compare the variables with low grade score(GS=6)and high(GS≥7)grade prostate cancers.Independent sample T-test was performed.Furthermore,to predict the independent variables of Gleason score,multinomial regression analysis was performed.One-way ANOVA test was performed to compare the different Gleason score with the variables.RESULTS:Our study includes 198 patients with mean age(72.65±7.5).A total of 175 patients with CSPCa(GS>7)and 23 cases with GS=6 were collected.The average values of subcutaneous fat thickness(SCFT),periprostatic fat thickness(PPFT)and periprostatic fat area(PPFA)are 19.09±8.67 mm(2.5-47.2),10.44±3.16mm(2.5-22)and 12.9±5.0sq.cm(4.3-46.2)respectively.The Gleason score is weakly correlated to PPFT(rs=0.240,P=0.001)and PPFA(rs=0.287,P=0.001),and showed no correlation with SCFT(rs=-0.013,P=0.855).Multivariate logistic regression analysis shows that periprostatic fat thickness and periprostatic fat area were independent predictors of CSPCa(P=0.054 and P=0.031 respectively).With each 1mm increase of PPFT,the incidence of CSPCa increased by 17.9%(OR 1.179;95%Cl,1.393-0.997).Each 1sq.cm increase of periprostatic fat area,the incidence of CSPCa increased by 16.8%(OR,1.168;95%CI,1.34-1.014).CONCLUSION:The positive correlation of periprostatic fat thickness,periprostatic fat area and Gleason score shows that they can be regarded as the risk factors and predictors of CSPCa.With the increase of periprostatic fat thickness and periprostatic fat area,the incidence of CSPCa increased.