Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) Is Associated with Cervical Stromal Involvement in Endometrial Cancer Patients: A Cross-Sectional Study in South China

Xite Lin; Chunxia Chen; Tingting Jiang; Jincheng Ma; Lixiang Huang; Leyi Huang; Huifang Lei; Yao Tong; Guanxiang Huang; Xiaodan Mao; Pengming Sun

doi:10.3390/curroncol30040287

Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) Is Associated with Cervical Stromal Involvement in Endometrial Cancer Patients: A Cross-Sectional Study in South China

Curr Oncol. 2023 Mar 29;30(4):3787-3799. doi: 10.3390/curroncol30040287.

Authors

Xite Lin^{1

2

3}, Chunxia Chen⁴, Tingting Jiang^{1

2

3}, Jincheng Ma^{1

2

3}, Lixiang Huang^{1

2

3}, Leyi Huang^{1

2

3}, Huifang Lei¹, Yao Tong¹, Guanxiang Huang^{1

2

3}, Xiaodan Mao^{1

2

3}, Pengming Sun^{1

2

3}

Affiliations

¹ Laboratory of Gynecologic Oncology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou 350001, China.
² Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou 350001, China.
³ Fujian Clinical Research Center for Gynecological Oncology, Fujian Maternity and Child Health Hospital, Fuzhou 350001, China.
⁴ Department of Imaging, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou 350001, China.

Abstract

Background: Metabolic dysfunction-associated fatty liver disease (MAFLD) is a significant health issue closely associated with multiple extrahepatic cancers. The association between MAFLD and clinical outcomes of endometrial cancer (EC) remains unknown.

Methods: We retrospectively included 725 EC patients between January 2012 and December 2020. The odds ratios (ORs) were calculated using logistic regression analyses. Kaplan-Meier survival curves were used for survival analysis.

Results: Among EC patients, the prevalence of MAFLD was 27.7% (201/725, 95% confidence interval (Cl) = 0.245-0.311). MAFLD was significantly associated with cervical stromal involvement (CSI) (OR = 1.974, 95% confidence interval (Cl) = 1.065-3.659, p = 0.031). There was a significant correlation between overall survival (OS) and CSI (HR = 0.31; 95%CI: 0.12-0.83; p = 0.020), while patients with MAFLD had a similar OS to those without MAFLD (p = 0.952). Moreover, MAFLD was significantly associated with CSI in the type I EC subgroup (OR = 2.092, 95% confidence interval (Cl) = 1.060-4.129, p = 0.033), but not in the type II EC subgroup (p = 0.838). Further logistic regression analysis suggested that the hepatic steatosis index (HSI) was significantly associated with CSI among type I EC patients without type 2 diabetes mellitus (T2DM) (OR = 1.079, 95% confidence interval (Cl) = 1.020-1.139, p = 0.012).

Conclusions: About one-quarter of our cohort had MAFLD. MAFLD was associated with the risk of CSI in EC patients, and this association existed in type I EC patients but not in type II EC patients. Furthermore, the HSI can help predict CSI in type I EC patients without T2DM.

Keywords: cervical stromal involvement; endometrial cancer; hepatic steatosis index; metabolic dysfunction-associated fatty liver disease.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

China / epidemiology
Cross-Sectional Studies
Diabetes Mellitus, Type 2* / complications
Endometrial Neoplasms* / complications
Female
Humans
Liver Diseases*
Retrospective Studies

Grants and funding

This research was funded by National Key Research and Development Program of China (2022YFC2704303), National Nature Science Foundation of China (Grant no. 82203739), Joint Funds for the Innovation of Science and Technology (2020Y9160) and Fujian Provincial Nature Science Foundation of China (2020J02059, 2021J01404 and 2021Y9157).