罗代琴;冉立;常建英;李凤虎;洪卫;何明媛;王鹤然;李永霞;詹连珊;
LUO Daiqin;RAN Li;CHANG Jianying;LI Fenghu;HONG Wei;HE Mingyuan;WANG Heran;LI Yongxia;ZHAN Lianshan;Department of Breast Oncology,Cancer Hospital of Guizhou Province;Department of Oncology,the Affiliated Hospital of Guizhou Medical University;Department of Nuclear Medicine,the Affiliated Hospital of Guizhou Medical University;

• 1:贵州省肿瘤医院乳腺肿瘤科
• 2:贵州医科大学附属医院肿瘤科
• 3:贵州医科大学附属医院核医学科

摘要(Abstract)：

目的:探讨乳腺浸润性导管癌的临床病理特征与体质量指数(BMI)的相关性。方法:收集809例经病理检查确诊为乳腺浸润性导管癌女性患者的年龄、身高、体质量、月经婚育史、免疫组化、分子分型、临床分期、空腹静脉血糖及生存随访等资料,计算BMI;根据BMI数值将其分为BMI正常组、中间组及肥胖组,分析临床病理特征与BMI的相关性。结果:纳入患者的中位年龄46岁,中位随访时间69个月,单因素χ2检验分析结果显示乳腺癌患者分子分型及治疗前空腹静脉血糖与BMI有关(χ2=4. 935,P=0. 046;χ2=7. 228,P=0. 038),肥胖组乳腺癌患者中三阴型乳腺癌比例较高,且患者空腹静脉血糖高于正常组及中间组,差异具有统计学意义(P <0. 05);年龄、月经状态、肿瘤大小、临床分期、淋巴结状态与BMI无关(P> 0. 05)。结论:乳腺浸润性导管癌的临床病理特征与BMI具有一定的关系,表现为肥胖的女性乳腺浸润性导管癌患者具有更差的分子分型,且其空腹静脉血糖水平高于正常。
Objective: To explore the correlation between clinicopathological characteristics and body mass index( BMI) of patients with breast invasive ductal carcinoma. Methods: We retrospectively collected 809 female patients diagnosed with breast invasive ductal carcinoma by pathological examination and collected relevant information including age,height,body weight,menstrual history,marriage histroy,childbirth history,immunohistochemistry,molecular typing,clinical staging,fasting venous blood glucose and follow-up survival. Based on these patients' BMI values,they were divided into normal group, middle group and obese group. The correlation between clinicopathological characteristics and BMI was analyzed. Results: The median age was 46 years old,and the median follow-up survival time was 69 months. The univariate χ2 test analysis showed that the molecular typing and fasting venous blood glucose before therapy were correlated with BMI( χ2= 4. 935,P = 0. 046; χ2=7. 228,P = 0. 038). The proportion of patients with triple negative breast cancer( TNBC) in obese group was higher than that in middle group. The fasting venous blood glucose levels were the highest in obese group( P < 0. 05). Age,menstrual status,tumor size,clinical stage and lymph node status were not significantly correlated with BMI( P > 0. 05). Conclusion: Some clinicopathological features of patients with breast invasive ductal carcinoma are correlated with BMI. The obese group has a worse molecular classification and the highest fasting venous blood glucose levels.

关键词(KeyWords)： 乳腺肿瘤;肿瘤转移;体质量指数;危险因素;体质量
breast neoplasms;neoplasm metastasis;body mass index(BMI);risk factors;body weight

Abstract:

Keywords:

基金项目(Foundation): 贵州省科技计划项目[黔科合LH字(2016)7396]

作者(Author): 罗代琴;冉立;常建英;李凤虎;洪卫;何明媛;王鹤然;李永霞;詹连珊;
LUO Daiqin;RAN Li;CHANG Jianying;LI Fenghu;HONG Wei;HE Mingyuan;WANG Heran;LI Yongxia;ZHAN Lianshan;Department of Breast Oncology,Cancer Hospital of Guizhou Province;Department of Oncology,the Affiliated Hospital of Guizhou Medical University;Department of Nuclear Medicine,the Affiliated Hospital of Guizhou Medical University;

Email:

DOI: 10.19367/j.cnki.2096-8388.2020.07.015

参考文献(References)：

• [1]KELLY T,YANG W,CHEN C S,et al. Global burden of obesity in 2005 and projections to 2030[J]. Int J Obes Lond,2008,32(9):1431-1437.
• [2]PAREKH N,CHANDRAN U,BANDERA E V. Obesity in cancer Syrvival[J]. Annu Rev Nutr,2012,32(11):311-342.
• [3] PEARSON-STUTTARD J,ZHOU B,KONTIS V,et al.Worldwide burden of cancer attributable to diabetes and high body-mass index:a comparative risk assessment[J].Lancet Diabetes Endocrinol,2018,6(2):6-15.
• [4]AINA E,MARIT B,VEOERD S T,et al. Metabolic profile,physical activity,and mortality in breast cancer patients[J]. Breast Cancer Research and Treatment,2010,121(3):651-660.
• [5]CAAN B J,KWAN M L,HARTZELL G,et al. Pre-diagnosis body mass index,post-diagnosis weight change,and prognosis among women with early stage breast cancer[J]. Cancer Causes&Control,2008,19(10):1319-1328.
• [6]KAWAI M,MINAMI Y,KYDTAMA S,et al. Aipsity,adult weight change and breast cancer risk in postmenopausal Japanese women:the Mlyagi cohon study[J]. Br J Cancer,2010,103(9):1443-1447.
• [7] KROENKE C H,CHE N,ROSNER B,et al. Weight,weight gain,and survival after breast cancer diagnosis[J]. J Clin Oncol,2005,23(7):1370-1378.
• [8]HYEONGCON M,WONSHIK H,DONG Y,et al. Underweight and breast cancer recurrence and death:a report from the korean breast cancer society[J]. Journal of Cllnical Oncology,2009,27(35):5899-5906.
• [9]DEGLISE C,BOUCHARDY C,BURRII M,et al. Impact of obesity on diagnosis and treatment of breast cancer[J]. Breast Cancer Res Treat,2010,120(1):185-193.
• [10]ROBERTO A,ELISABETTA M G,PAOLO B,et al. Association of adiposity,dysmetabolisms,and inflammation with aggressive breast cancer subtypes:a cross-sectional study[J]. Breast Cancer Res Treat,2016,157(1):179-189.
• [11]SHI J,ZHANG M,LI L,et al. Body mass index and its change in adulthood and breast cancer risk in China[J].Asian Pac J Cancer Pre,2010,11(5):1213-1218.
• [12]ZHANG M,CAI H,BAO P,et al. Body mass index,waistto-hip ratio and late outcomes:a report from the shanghai breast cancer survival study[J]. Sci Rep,2017,7(1):6996.
• [13]GOODWIN P J. Commentary on:“Effect of obesity on survival in women with breast cancer:systematic review and meta-analysis”[J]. Breast Cancer Res Treat,2010,123(3):637-640.
• [14]付亚鹏，刘文涛，娄立惠，等．体重指数与乳腺癌患者预后相关性的研究[J]．实用肿瘤学杂志，2010,107(3):271-273.
• [15]KWAN M L,JOGN E M,CAAN B J,et al. Obesity and mortality after breast cancer by race ethnicity:the california breast cancer survivorshipconsortium[J]. Am J Epidemiol,2014,179(1):95-111.
• [16]MAJED B,MOREAU T,SENOUCI K,et al. Is obesity an independent prognosis factor in woman breast cancer[J].Breast Cancer Research and Treatment,2008,111(2):329-342.
• [17]MACCO A,MADEDDU C,GRAMIGNANO G,et al.Crrrelation of body mass index and 18 pt in with tumor size and stage of disease in hormone-dependem Postmenopausal breast cancer:preliminaty result and therapeutic implications[J]. Mol Med(Berl),2010,88(7):677-686
• [18]JUNG D,LEE S. BMI and breast cancer in Korean women:a meta-analysis[J]Asian Nursing Res,2009,3:31-40.
• [19]ZHENG Q,BANASZAK L,FRACCI S,et al. Leptin receptor maintains cancer stem-like properties in triple negative breast cancer cells[J]. Endocrine-Related Cancer,2013,20(6):797-808.
• [20]OH S W,PARK C Y,LEE E S,et al. Adipokines,insulin resistance,metabolic syndrome,and breast cancer:a cohort study[J]. Breast Cancer Res,2011,13:34.
• [21]AZRAD M,DEMARKWAHNEFRIED W. The association between adiposity and breast cancer recurrence and survival:a review of the recent literature[J]. Curr Nutr Rep,2014,3:9-15.
• [22]DEMARKWAHNEFRIED W,CAMPBELL K L,HAYES S C. Weight management and its role in breast cancer rehabiliation[J]. Cancer,2012,118:2277-2287.

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