Correlation Between Peri-Prostatic Fat And High-Risk Prostate Cancer

Objective:In recent years,adipose tissue has been considered to play an important role in the development of tumors.This study measures the peri-prostatic fat-related indicators(peri-prostatic fat area,subcutaneous fat thickness)on magnetic resonance(MRI)images of high-risk prostate cancer patients.We calculate the proportion of fat around the prostate(peri-prostatic fat area/prostate area),to explore its clinical significance in the development of high-risk prostate cancer and CRPC.Methods:A retrospective analysis of 200 patients with high-risk prostate cancer confirmed by transrectal ultrasound(TRUS)-guided prostate biopsy and confirmed by puncture pathology and clinical data between January 2015 and March 2017 was performed.Among them,155 patients were finally included according to the enrollment conditions.The researchers collected clinical and pathological data from patients;by measuring the relative fat around the prostate on magnetic resonance imaging(MRI)images of prostate cancer patients before prostate puncture,mainly periprostatic fat area(PFA),prostate area(prostate area,PA),Subcutaneous fat thickness(SFT),and calculate the proportion of fat around the prostate(periprostatic fat area/prostate area,P/A).The indicators measured by the fat around the prostate and the clinical and pathological data of prostate cancer patients were statistically analyzed using SPSS 22.0 and GraphPad 7.0.Result:1.There was no significant correlation between tPSA and peripheral fat area(PFA),prostate fat percentage(P/A)and subcutaneous fat thickness(SFT)before high puncture prostate cancer(r=-0.045,P=0.581;r=0.077).,P=0.341;r=-0.126,P=0.119);There was no significant correlation between the area of prostate fat(PFA)and body mass index(BMI)and subcutaneous fat thickness(SFT)(r=0.097,P=0.231;r=-0.096,P=0.233).2.155 patients with high-risk prostate cancer were divided into three groups according to Gleason score:Gleason=7,Gleason=8,and Gleason=9-10.Statistical analysis was performed using one-way ANOVA.There were no significant differences in age and BMI between the three groups(P>0.05).However,there was a statistically significant difference in peripheral fat area(PFA)between the three groups(P=0.028).,Gleason=7(PFA:12.98±4.19);Gleason=8(PFA:13.38 ± 5.55);Gleason=9-10(PFA:15.47±,5.73);however,the three groups in other fat determination indicators(P/A,No statistical difference was observed on SFT)(P=0.117,P=0.235).3.According to whether the tumor had a breakthrough prostate(breakthrough:T3,T4,no breakthrough:T2),the two groups were divided into two groups.The statistical difference was analyzed by t test.There was no statistical difference in age,BMI and SFT between the two groups(P>0.05);however,the difference of PFA,P/A and initial tPSA between the two groups was statistically significant(P<0.0001,P=0.02,P=0.005).4.Peri-parent fat related indicators(pfa,p/a)were statistically different in the lymph node metastasis group and the no lymph node metastasis group(p<0.0001;n0:13.13±4.72;n1:18.19±5.77,p=0.047;n0):0.97 ±0.5;n1:1.16± 0.42).5.Peri-parent fat related indicators(pfa,p/a)were not significantly different between the bone metastasis group and the boneless metastasis group(p=0.236;p=0.774).6.Two types of crpc patients with peri-prostatic fat(pfa:18.39±2.5;21.91±2.7,p/a:1.23±0.41;1.57±0.78)distribution than hormone-sensitive prostate cancer patients(pfa:11.24±3.69,p/a:0.93± 0.59),the difference was statistically significant(p<0.0001,p=0.012).7.Log-rank test was used(PFA>14.82cm2,n=31;PFA<14.82 cm2,n=28),two groups(P/A>1.0582,n=29;P/The time of CRPC occurrence of A<1.0582,n=30)was statistically significant(P<0.0001,P=0.038).Logistic analysis showed that there was a statistical correlation between PFA and high-risk prostate cancer progression to CRPC(P=0.018,OR=5.861).PFA was a risk factor for the development of high-risk prostate cancer to CRPC.Conclusion:1.The higher the prostate peripheral fat index(PFA,P/A),the higher the patient's Glesaon score and the higher the clinical stage.2.The higher the fat content around the prostate in patients with high-risk prostate cancer,the easier the lymph node metastasis.3.The fat content around the prostate is related to the occurrence of CRPC.We found that the more fat around the prostate,the earlier CRPC occurs.