Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Nov 30:13:8907-8914.
doi: 10.2147/CMAR.S336920. eCollection 2021.

The Potential of Visceral Adipose Tissue in Distinguishing Clear Cell Renal Cell Carcinoma from Renal Angiomyolipoma with Minimal Fat

Jianhu Liu #  1   2 , Jie Bao #  3 , Weijie Zhang  1 , Qiaoxing Li  2 , Jianquan Hou  1 , Xuedong Wei  1 , Yuhua Huang  1
Affiliations

The Potential of Visceral Adipose Tissue in Distinguishing Clear Cell Renal Cell Carcinoma from Renal Angiomyolipoma with Minimal Fat

Jianhu Liu et al. Cancer Manag Res. .

Abstract

Purpose: To overcome the challenge of preoperative differentiation between clear cell renal cell carcinoma (ccRCC) and renal angiomyolipoma with minimal fat (RMFAML), we evaluated the potential of visceral adipose tissue (VAT) in distinguishing RMFAML from ccRCC.

Patients and methods: Patients (191) were divided into ccRCC and RMFAML groups according to postoperative pathology. Umbilical horizontal computed tomography (CT) images were used for visceral fat area (VFA), subcutaneous fat area (SFA) and total fat area (TFA) measurements. Logistic regression was used to identify risk factors for ccRCC. Areas under the receiver operating characteristic (ROC) curve (AUCs) were compared to identify the most valuable indicator for identifying ccRCC and RMFAML.

Results: In total, 166 patients had ccRCC, and 25 had RMFAML. ccRCC and RMFAML patients showed significant differences in age (P<0.001), sex (P<0.001), hypertension (P=0.027), BMI (P<0.001), SFA (P=0.046), VFA (P<0.001) and TFA (P<0.001). According to multiple logistic regression analysis, male sex [4.311 (1.469~12.653), p=0.008]; older age [1.047 (1.008~1.088), p=0.017]; and higher BMI [1.305 (1.088~1.566), p=0.004], SFA [1.013 (1.003~1.023), p=0.008], VFA [1.026 (1.012~1.041), p<0.001] and TFA [1.011 (1.005~1.017), p=0.001] were associated with ccRCC. The AUCs of sex (male), age, BMI, TFA, VFA, and SFA were 0.726, 0.687, 0.783, 0.769, 0.840, and 0.645, respectively. The VFA cut-off value was 69.99 cm2. The sensitivity and specificity of higher VFA (≥69.99 cm2) for ccRCC diagnosis were 79.52% and 80.00%, respectively.

Conclusion: In differentiating ccRCC from RMFAML, male sex, older age, and higher BMI, TFA, SFA, and VFA are risk factors for ccRCC. VFA is the most effective indicator for identifying ccRCC.

Keywords: body mass index; clear cell renal cell carcinoma; obesity-related index; renal angiomyolipoma with minimal fat; visceral adipose tissue; visceral fat area.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
(A) CT image at the umbilical level. (B) The red part shows the total fat area (TFA). (C) The red part shows the subcutaneous fat area (SFA). (D) The red part shows the visceral fat area (VFA).
Figure 2
Figure 2
(A) Student’s t-test showed a significant correlation between VFA and sex (P<0.001). (B) Pearson’s test showed that VFA was significantly associated with age (r=0.222, P<0.001).
Figure 3
Figure 3
(A) Pearson’s test showed that BMI was linearly correlated with VFA (r=0.635, P<0.001), SFA (r=0.596, P<0.001), and TFA (r=0.730, P<0.001). (B) Pearson’s test showed that VFA was linearly correlated with SFA (r=0.826, P<0.001) and TFA (r=0.417, P<0.001). (C) Pearson’s test showed that TFA was linearly correlated with SFA (r=0.857, P<0.001).
Figure 4
Figure 4
ROC curves of ccRCC vs RMFAML. The blue line represents VFA, the green line represents BMI, the Orange line represents TFA, the red line represents sex, the black line represents SFA, and the crimson line represents age.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Fujii Y, Ajima J, Oka K, Tosaka A, Takehara Y. Benign renal tumors detected among healthy adults by abdominal ultrasonography. Eur Urol. 1995;27:124–127. doi:10.1159/000475142 - DOI - PubMed
    1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68:394–424. doi:10.3322/caac.21492 - DOI - PubMed
    1. Gandaglia G, Ravi P, Abdollah F, et al. Contemporary incidence and mortality rates of kidney cancer in the United States. Can Urol Assoc J. 2014;8:247–252. doi:10.5489/cuaj.1760 - DOI - PMC - PubMed
    1. Song S, Park BK, Park JJ. New radiologic classification of renal angiomyolipomas. Eur J Radiol. 2016;85(10):1835–1842. doi:10.1016/j.ejrad.2016.08.012 - DOI - PubMed
    1. Kim JK, Park SY, Shon JH, Cho KS. Angiomyolipoma with minimal fat: differentiation from renal cell carcinoma at biphasic helical CT. Radiology. 2004;230:677–684. doi:10.1148/radiol.2303030003 - DOI - PubMed