Association between CT-based adipose variables, preoperative blood biochemical indicators and pathological T stage of clear cell renal cell carcinoma

Zehua Sun; Yumei Zhang; Yuanhao Xia; Xinru Ba; Qingyin Zheng; Jing Liu; Xiaojing Kuang; Haizhu Xie; Peiyou Gong; Yinghong Shi; Ning Mao; Yongtao Wang; Ming Liu; Chao Ran; Chenchen Wang; Xiaoni Wang; Min Li; Wei Zhang; Zishuo Fang; Wanchen Liu; Hao Guo; Heng Ma; Yang Song

doi:10.1016/j.heliyon.2024.e24456

Association between CT-based adipose variables, preoperative blood biochemical indicators and pathological T stage of clear cell renal cell carcinoma

Heliyon. 2024 Jan 13;10(2):e24456. doi: 10.1016/j.heliyon.2024.e24456. eCollection 2024 Jan 30.

Authors

Zehua Sun¹, Yumei Zhang¹, Yuanhao Xia^{1

2}, Xinru Ba³, Qingyin Zheng⁴, Jing Liu⁵, Xiaojing Kuang⁶, Haizhu Xie¹, Peiyou Gong¹, Yinghong Shi¹, Ning Mao¹, Yongtao Wang¹, Ming Liu¹, Chao Ran¹, Chenchen Wang¹, Xiaoni Wang¹, Min Li⁷, Wei Zhang⁸, Zishuo Fang⁹, Wanchen Liu¹, Hao Guo¹, Heng Ma¹, Yang Song¹⁰

Affiliations

¹ Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University School of Medicine, Yantai, 264000, Shandong, China.
² Department of Radiology, Binzhou Medical University, Yantai, 264000, Shandong, China.
³ Department of Radiology, Yantaishan Hospital, Yantai, 264000, Shandong, China.
⁴ Department of Otolaryngology-Head & Neck Surgery, Case Western Reserve University, Cleveland, OH, 44106, United States.
⁵ Department of Pediatrics, Yantai Yuhuangding Hospital, Qingdao University School of Medicine, Yantai, 264000, Shandong, China.
⁶ School of Basic Medicine, Qingdao University, Qingdao, 266021, Shandong, China.
⁷ Department of Radiology, Yantai Traditional Chinese Medicine Hospital, Yantai, 264000, Shandong, China.
⁸ Department of Radiology, Yantai Penglai People's Hospital, Yantai, 265600, Shandong, China.
⁹ School of Electronic Science and Engineering, University of Electronic Science and Technology of China, Chengdu, 610000, China.
¹⁰ Department of Nutrition and Food Hygiene, School of Public Health, College of Medicine, Qingdao University, Qingdao, 266021, Shandong, China.

Abstract

Background: Clear cell renal cell carcinoma (ccRCC) is corelated with tumor-associated material (TAM), coagulation system and adipocyte tissue, but the relationships between them have been inconsistent. Our study aimed to explore the cut-off intervals of variables that are non-linearly related to ccRCC pathological T stage for providing clues to understand these discrepancies, and to effectively preoperative risk stratification.

Methods: This retrospective analysis included 218 ccRCC patients with a clear pathological T stage between January 1st, 2014, and November 30th, 2021. The patients were categorized into two cohorts based on their pathological T stage: low T stage (T1 and T2) and high T stage (T3 and T4). Abdominal and perirenal fat variables were measured based on preoperative CT images. Blood biochemical indexes from the last time before surgery were also collected. The generalized sum model was used to identify cut-off intervals for nonlinear variables.

Results: In specific intervals, fibrinogen levels (FIB) (2.63-4.06 g/L) and platelet (PLT) counts (>200.34 × 10⁹/L) were significantly positively correlated with T stage, while PLT counts (<200.34 × 10⁹/L) were significantly negatively correlated with T stage. Additionally, tumor-associated material exhibited varying degrees of positive correlation with T stage at different cut-off intervals (cut-off value: 90.556 U/mL).

Conclusion: Preoperative PLT, FIB and TAM are nonlinearly related to pathological T stage. This study is the first to provide specific cut-off intervals for preoperative variables that are nonlinearly related to ccRCC T stage. These intervals can aid in the risk stratification of ccRCC patients before surgery, allowing for developing a more personalized treatment planning.

Keywords: Adipose tissue; Blood chemical indicator; Clear cell renal cell carcinoma (ccRCC); Computed tomography (CT); Pathological T stage.