肥胖对女性乳腺癌患者腋窝淋巴结转移的影响  

Effect of obesity on axillary lymph node metastasis in patients with female breast cancer

作　　者：张晓静 杨磊[2] 樊翠珍[1] 严冬[1] 安广宇[1] ZHANG Xiaojing;YANG Lei;FAN Cuizhen;YAN Dong;AN Guangyu(Department of Oncology;Basic Medical Research Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China)

机构地区：[1]首都医科大学附属北京朝阳医院肿瘤科,北京1000200 [2]首都医科大学附属北京朝阳医院基础医学研究中心,北京1000200

出　　处：《癌症进展》2018年第4期522-525,528,共5页Oncology Progress

摘　　要：目的探讨肥胖对女性乳腺癌患者腋窝淋巴结转移的影响及其与临床特征的关系。方法回顾性分析225例女性乳腺癌患者的病历资料,收集患者术前的身高、体重、月经状态、既往病史等临床数据,同时采集术后组织病理分级、分期及免疫组化各指标的情况等信息。根据中国体重指数(BMI)参考标准将患者分为超重肥胖组(n=134)和非超重肥胖组(n=91),分析BMI与女性乳腺癌患者临床特征的关系及其对腋窝淋巴结转移的影响。结果 225例女性乳腺癌患者的平均BMI为24.94 kg/m^2。超重肥胖组患者的平均腋窝淋巴结转移数目多于非超重肥胖组(P=0.047)。两组患者的腋窝淋巴结平均切除数量及淋巴结转移分期比较,差异均无统计学意义(P>0.05)。非超重肥胖组与超重肥胖组已绝经患者所占比例分别为29.2%、70.8%,两组比较,差异有统计学意义(P<0.01);超重肥胖组患者的高血压、2型糖尿病发病率均较非超重肥胖组高(P<0.05);两组患者的冠心病发病率、有肿瘤家族史比例、病理分级、病理分期、肿块大小及脉管癌栓比例比较,差异均无统计学意义(P>0.05)。在免疫组化指标中,两组患者的ER、PR、HER2、p53及Ki-67阳性表达情况比较,差异均无统计学意义(P>0.05)。结论与非超重肥胖乳腺癌患者相比,超重肥胖患者的平均腋窝淋巴结转移数量偏多,因此超重肥胖可能影响乳腺癌的疾病进展。Objective To investigate the effect of obesity on the axillary lymph node metastatic in female breast cancer patients, and the relationship with clinical characteristics. Method The medical records of 225 female breast cancer patients were retrospectively reviewed. The clinical data of the patients, including the height and weight, the menstrual history and previous medical history, were collected before operation, while the information of postoperative tissues were gathered, such as histopathologic grading, staging and immunohistochemical indicators. The patients were divided into the overweight and obesity group（n=134） and the non-overweight and non-obesity group（n=91） according to body mass index（BMI） reference standard in China. The impact of BMI on clinical characteristics, especially the state of axillary lymph node metastasis, was analyzed. Result The median BMI of the patients was 24.94 kg/m-2. The average number of metastatic axillary lymph node in overweight and obesity group was higher than that in non-overweight and non-obesity group（P=0.047）. The difference of the average number of dissected axillary lymph node and lymph node metastatic staging in two groups was not statistically significant（P〉0.05）. The proportion of menopause patients of non-overweight and non-obesity group was 29.2%,lower than that of overweight and obesity group at 70.8%（P〈0.01）. The incidence of hypertension and type 2 diabetes were higher in overweight and obesity group than that in the non-overweight group（P〈0.05）. However, there were no significant differences in the incidence of coronary heart disease, the proportion of tumor family history, pathological grade, pathological stage, size of tumor and the proportion of vascular tumor thrombus of the both groups（P〉0.05）. There was no significant difference in the expression of ER, PR, HER2, p53 and Ki-67 between the two groups in immunohistochemistry（P〉0.05）. Conclusion Compared with non-overweight and non-obesity patients,the averag

关 键 词：体重指数 肥胖 乳腺癌 腋窝淋巴结 

分 类 号：R737.9[医药卫生—肿瘤]