体质指数对绝经后ER阳性乳腺癌新辅助内分泌治疗预后的影响  

Body Mass Index on Survival of Breast Cancer Patient with Neoadjuvant Endocrine Therapy

作　　者：金一[1] 姜大庆[1] 赵林[1] 王彪[2] 孟欣[2] 张海燕[3] JIN Yi;JIANG Da-qing;ZHAO Lin(Cancer Hospital of China Medical University,Lictoning Cancer Hospital ＆ lnsititute ,Shenyang 110042, China)

机构地区：[1]中国医科大学肿瘤医院、辽宁省肿瘤医院,辽宁沈阳110042 [2]中国医科大学基础医学院生物化学与分子生物教研室,辽宁沈阳110001 [3]中国医科大学附属第一医院,辽宁沈阳110001

出　　处：《肿瘤学杂志》2018年第5期459-464,共6页Journal of Chinese Oncology

基　　金：国家自然科学基金项目(81572831)

摘　　要：目的]探讨体质指数（BMI）对绝经后ER阳性乳腺癌患者的新辅助内分泌疗效及对预后的影响。[方法]对118例经新辅助内分泌治疗乳腺癌患者进行回顾性分析,评估BMI对无病生存率和总生存率的影响。肥胖定义为BMI≥28kg/m2。生存分析采用Kaplan-Meier法和Log-rank检验,单因素和多因素分析采用Cox风险比例模型。[结果]118例乳腺癌均为绝经后女性,其中BMI≥28kg/m246例（38.9%）,BMI〈28kg/m272例（61.1%）。BMI≥28kg/m2患者经新辅助内分泌治疗后有效率为56.5%（20/46）,BMI〈28kg/m2患者有效率为62.5%（45/72）,两组差异具有统计学意义（P=0.033）。中位随访时间39个月,BMI〈28kg/m2和BMI≥28kg/m2组乳腺癌患者的39个月无病生存率分别为91.7%和73.9%（P=0.008）;BMI〈28kg/m2和BMI≥28kg/m2乳腺癌患者的39个月总生存率分别为93.1%和80.4%,差异有统计学意义（P=0.013）。多因素分析显示,BMI≥28kg/m2是影响乳腺癌患者新辅助内分泌疗效和预后的不良因素。[结论]超重和肥胖是影响乳腺癌患者内分泌治疗效果和预后的不良因素。[Objective]To analyze the relevance between body mass index（BMI）and survival of breast cancer after neoadjuvant endocrine therapy.[Methods]Retrospective analysis of 118 breast cancer patient after neoadjuvant endocrine therapy were conducted.The effect of BMI on disease-free survival（DFS）and overall survival（OS）in these patients were evaluated.Obesity was defined as a BMI≥28kg/m2.Kaplan-Meier analysis and Log-rank test were employed to perform survival analysis.The impact of different characteristics on survival was assessed by using Cox proportional-hazards regression model.[Results]In total 46（38.9%）patients were obese,and72（61.1%）were non-obese.The effective rate was 56.5%in the group of BMI28kg/m2and 62.5%in the group of BMI≥28kg/m2after neoadjuvant endocrine therapy（P=0.033）.The median follow up time was 39 months.The estimated DFS was 91.7%for non-obese and 73.9%for obese patients（P=0.008）,and the estimated OS was 93.1%for non-obese and 80.4%for obese patients（P=0.013）.Multivariate analysis indicated that obesity was an independent prognostic factor for DFS and OS.[Conclusions]BMI of postmenopausal breast cancer response to neoadjuvant endocrine therapy is effective indicator for predicting and is associated the poorer outcome in patient with breast cancer.

关 键 词：乳腺癌 新辅助内分泌治疗 体质指数 预后 

分 类 号：R737.9[医药卫生—肿瘤]