Ruolo dell’analisi bioimpedenziometrica nella prognosi delle neoplasie neuroendocrine: uno studio retrospettivo-prospettico di coorte

Abstract

Introduzione: I dati in letteratura relativi all’analisi bioimpedenziometrica (BIA) nei tumori neuroendocrini (NET) risultano limitati. Obiettivo dello studio: valutare eventuale correlazione dei parametri bioimpedenziometrici e glico-metabolici con l’aggressività del NET. Materiali e metodi: Lo studio retrospettivo-prospettico di coorte includeva 115 soggetti, di cui 85 con G1-G2 NET (35 GI-NET, 29 panNET e 14 NET polmonare) e 30 soggetti sani. Tutti i partecipanti venivano sottoposti all’analisi BIA della composizione corporea, e raccolta delle informazioni demografiche-antropometriche. Dei pazienti con NET venivano raccolti i dati clinico-istopatologici e terapeutici relativi al NET, e i dati del metabolismo glico-lipidico. Risultati: I gruppi NET e controlli sani risultavano omogenei per età, sesso e BMI. Il gruppo di controllo presentava un valore medio di angolo di fase (PhA) superiore rispetto ai NET totali (5.18 vs 4.52, p=1.54e-06), panNET (5.18 vs 4.34, p=2.85e-06), e GI-NET (5.18 vs 4.49, p=2.1e-05). Tra i pazienti oncologici, livelli di PhA medio inferiore si associavano alla presenza di metastasi (MTS) (NET: 4.35 vs 4.66, p=0.05, panNET: 3.85 vs 4.69, p=1.46e-04), stadio IV di malattia (NET: IV vs I: 4.14 vs 4.71, p=0.02; panNET: 3.85 vs 4.69, p=1.13e-03), e alla progressione di malattia (PD) (panNET:3.87 vs 4.59, p=1.70e-0.3). Valori medi di VAT risultavano inferiori in caso di PD (NET: 2.32 vs 3.21, p=0.01; panNET: 1.81 vs 3.16, p=0.03), presenza di MTS (NET 2.52 vs 3.16, p=0.08; panNET1.77 vs 3.35, p=0.01) e stadio IV (panNET IV vs I: 1.77 vs 3.72, p=0.02). La massa muscolare scheletrica (SM) era minore in presenza di PD (NET: 19.94 vs 22.84, p=0.04, panNET: 18.29 vs 24.57, p=0.02), MTS (NET: 20.26 vs 22.95, p=0.04; panNET:18.85 vs 24.92, p=0.02), e stadio avanzato nei panNET (IV vs I: 18.85 vs 25.68, p=0.03) e GI-NET (differenza tra tutti gli stadi: p=1.85e-03). Nei NET totali di sesso maschile e panNET il Ki-67 correlava con HbA1c, insulinemia e

Introduction: There is limited evidence in the literature concerning the role of the bioelectrical impedance analysis (BIA) in neuroendocrine neoplasms (NENs). Aim: explore potential correlations of BIA and glyco-metabolic data with NET aggressiveness. Materials and methods: This is a retrospective-prospective cohort study conducted on 115 individuals, divided into a group of 85 G1-G2 NET (35 GI-NET, 29 panNET and 14 pulmonary NET) and a group of 30 non-oncological subjects. Demographic, anthropometric and clinical records of all participants, as well as clinicopathological and therapeutic data regarding NETs were collected. Body composition of all individuals was assessed through BIA Results: All groups were homogeneous for age, sex and BMI. Mean PhA was significantly higher in the control group versus NET (5.18 vs 4.52, p=1.54e-06), versus panNET (5.18 vs 4.34, p=2.85e-06), and GI-NET (5.18 vs 4.49, p=2.1e-05). Within NET patients, inferior mean PhA correlated with metastasis development (MTS) (NET: 4.35 vs 4.66, p=0.05, panNET: 3.85 vs 4.69, p=1.46e-04), stage IV (NET: IV vs I: 4.14 vs 4.71, p=0.02; panNET: 3.85 vs 4.69, p=1.13e-03) and progression disease (PD) (panNET:3.87 vs 4.59, p=1.70e-0.3). Lower VAT mean values were associated with PD (NET: 2.32 vs 3.21, p=0.01; panNET: 1.81 vs 3.16, p=0.03), MTS (NET 2.52 vs 3.16, p=0.08; panNET1.77 vs 3.35, p=0.01) and stage IV (panNET IV vs I: 1.77 vs 3.72, p=0.02). Skeletal muscle mass (SM) was inferior in patients with PD (NET: 19.94 vs 22.84, p=0.04, panNET: 18.29 vs 24.57, p=0.02), MTS (NET: 20.26 vs 22.95, p=0.04; panNET:18.85 vs 24.92, p=0.02), advanced stages of panNET (IV vs I: 18.85 vs 25.68, p=0.03) and of GI-NET (differences between stages: p= p=1.85e-03). In NET male patients and patients with panNET Ki-67 value correlated with HbA1c, insulin levels and HOMA index. Conclusions: Variations of PhA, VAT and SM may have a prognostic role in NET, especially if panNET. Ki-67 was significantly associated with