代谢综合征对女性乳腺癌患者长期生存的影响  

Impact of metabolic syndrome on long-term survival of female patients with breast cancer

作　　者：章懿欣 邬颖杰[1] 陆国文[1] 

机构地区：[1]宁波大学医学院附属鄞州人民医院肿瘤外科,浙江宁波315040

出　　处：《实用肿瘤杂志》2015年第5期455-458,共4页Journal of Practical Oncology

摘　　要：目的探讨女性乳腺癌患者代谢综合征与预后的关系。方法根据中华医学会糖尿病学会2004年制定的标准,对238例女性乳腺癌患者诊断代谢综合征。采用Kaplan-Meier法计算生存时间,采用Log-rank检验比较生存时间组间差异,采用多因素COX回归分析代谢综合征对乳腺癌术后5年总生存率及无瘤生存率的影响。结果合并代谢综合征46例（19.3%）,其中年龄≥45岁和绝经后的患者比例较高（均P〈0.05）,合并与未合并代谢综合征的患者间肿瘤大小、TNM分期、淋巴结状态、组织学分级、核分级、雌激素与孕激素受体状态及手术方式比较,差异均未见统计学意义（均P〉0.05）。合并代谢综合征患者平均5年总生存时间和无瘤生存时间依次为24.6月（95%CI：23.1～26.1）和18.3月（95%CI：17.4～19.3）,无代谢综合征患者为36.5月（95%CI：34.0～39.1）和29.6月（95%CI：27.5～31.7）,两者比较差异均有统计学意义（均P〈0.01）。代谢综合征是女性乳腺癌患者5年总生存率（HR=3.175,95%CI：1.712～5.889,P〈0.001）和无瘤生存率（HR=4.024,95%CI：2.399～6.749,P〈0.001）降低的独立危险因素。结论代谢综合征可影响女性乳腺癌患者5年总生存率及无瘤生存率。Objective To investigate the impact of metabolic syndrome on the long-term survival of female patients with breast cancer. Methods Two-hundred-and-thirty-eight female patients with breast cancer were included in the study.Metabolic syndrome was diagnosed based on the standard drafted by Chinese Diabetes Society in 2004. Survival time was calculated using Kaplan-Meier method,intergroup difference of survival time was compared using log-rank test and the effect of metabolic syndrome on post-operative 5-year overall survival（ OS） rate and disease-free survival（ DFS） rate of breast cancer was analyzed using multivariate Cox ＇s proportional hazard analysis. Results Forty-six cases（ 19. 3%） had metabolic syndrome. Higher percentages of patients aged≥45 years and with postmenopausal status were found in patients with metabolic syndrome（ both P 〈0. 05）. Intergroup differences in tumor size,TNM stage,lymph node status,histologic grade,nuclear grade,estrogen receptor status,progesterone receptor status and surgical modality were not statistically significant（ all P 〉0. 05）. Using Kaplan-Meier method,the mean 5-year overall survival time and disease-free survival time of patients with metabolic syndrome were 24. 6 months（ 95% CI： 23. 1 ～ 26. 1） and 18. 3 months（ 95% CI： 17. 4 ～ 19. 3）respectively and those of patients without metabolic syndrome were 36. 5 months（ 95% CI： 34. 0 ～ 39. 1） and 29. 6 months（ 95% CI： 27. 5 ～ 31. 7） respectively（ both P 〈0. 01）. Metabolic syndrome was an independent risk factor for 5-year overall survival rate（ HR = 3. 175,95% CI： 1. 712 ～ 5. 889,P 〈0. 001） and disease-free survival rate（ HR = 4. 024,95% CI： 2. 399～ 6. 749,P 〈0. 001）. Conclusion Metabolic syndrome can markedly affect 5-year overall survival rate and disease-free survival rate in female patients with breast cancer.

关 键 词：乳腺肿瘤 代谢综合征X 存活率 预后 回顾性研究 

分 类 号：R737.9[医药卫生—肿瘤]