体重指数与乳腺癌预后的相关性分析  

Relationship between body mass index and long-term outcome for breast cancer

作　　者：王斐[1] 刘丽媛[1] 王永久[1] 于理想[1] 周飞[1] 申朔豪 李亮[1] 马忠兵[1] 余之刚[1] 

机构地区：[1]山东大学第二医院乳腺外科,山东济南250033

出　　处：《中国现代普通外科进展》2016年第9期673-678,共6页Chinese Journal of Current Advances in General Surgery

基　　金：山东大学第二医院青年基金资助项目(Y2013 010039)

摘　　要：目的:评价体重指数(BMI)与乳腺癌预后的关系。方法:回顾性分析672例乳腺癌患者的临床病例资料及随访信息,根据BMI分为超重肥胖组(BMI≥25.0 kg/m2)与正常组(BMI<25.0 kg/m^2)。Kaplan-Me ie r法比较两组生存差异,非条件Logis tic回归分析不同BMI分组乳腺癌OS的相关因素。结果:456例患者纳入分析,超重肥胖组(286例)与正常组(170例)一般临床病理特征差异无统计学意义(P<0.05)。中位随访60.9个月,两组无病生存时间(DFS)及总生存时间(OS)差异无统计学意义(P=0.927、0.336)。年龄、月经状态、ER及HER2等与不同BMI分类乳腺癌的OS无关。BMI分类不影响新辅助化疗病理性完全缓解(pCR)率,但与新辅助化疗ER阳性乳腺癌的DFS(P=0.013)及OS(P=0.022)有关。超重肥胖组生存较差(OR=0.16,95%CI:0.03~0.93,P=0.042)。内分泌治疗亚组中超重肥胖组病例生存风险降低(OR=0.077,95%CI:0.08~0.714,P=0.024)。结论:BMI≥25.0 kg/m^2是ER阳性乳腺癌新辅助化疗后DFS和OS的危险因素,可能与内分泌治疗获益不足有关。Objective： To evaluate the relationship between body mass index （BMI） and re- sponse and long-term outcome for breast cancer, database of patients treated with chemotherapy was reviewed, and 456 patients With inclusion criteria were identified, Patients were divided into two grodps by BMI： overweight or Obese group （BMI≥25 kg/m2 and non-obese group （BM compared between those two groups, and univariate 〈25 kg/m2. Kaplan-Meier survival analysis was logistic regression analysis was used to analyze the factors of predicting long-term outcome stratified by BMI. Results： There was no statistical difference between overweight/obese and non-obese groups in baseline clinic-pathological factors. After a median follow-up period of 60.9 months, statistical difference was observed in neither dis- ease free survival（DFS）（P=0.927） of overall survival（OS） （P=0.336） between the two groups. Clin- ic--pathological factors such as age, menopausal status, ER status and HER2 status etc were not related to OS stratified by BMI. Complete pathological response rate among neoadjuvant groups was 12.1% and 12.5% in overweight/obese and non-obese group respectively, no statistical difference was observed （P=I.000）. BMI category was correlated with both DFS （P=0.013）and OS（P=0.022） among ER-positive breast cancer patients who received neoadjuvant chemotherapy, patients with BMI ≥25 kg/m2 experienced poorer OS （OR=0.16,95% CI： 0.03 - 0.93, P=0.042） . And among the subgroups who received adjuvant endocrine therapy, BMI ≥25 kg/m2 decreased the risk of OS （OR=0.077, 95%CI：0.08 - 0.714, P=0.024）. Conclusion： BMI ≥25 kg/m2 was correlated with DFS and OS for ER-positive breast cancer patients who received neoadjuvant chemotherapy, insufficient benefit from endocrine therapy may explain this relationship.

关 键 词：乳腺肿瘤 体重指数 新辅助化疗 预后 

分 类 号：R737.9[医药卫生—肿瘤]