Demirkan Binnaz, Alacacioglu Ahmet, Yilmaz Ugur
Dokuz Eylül University Institute of Oncology, Department of Clinical Oncology, Division of Medical Oncology, Izmir, Turkey.
Jpn J Clin Oncol. 2007 Apr;37(4):256-65. doi: 10.1093/jjco/hym023.
The correlation between body mass index (BMI) and patient and tumor characteristics related to prognosis has not been well explored and may help to elucidate the mechanisms involved in the carcinogenesis. Because of the equivocal, inconsistent and uncertain research results as well as racial and ethnic differences, we aimed to evaluate the prognostic significance of high BMI in Turkish women with operable breast carcinoma.
Two hundred and sixty-six patients who had operable invasive breast carcinoma diagnosed from 2000 through 2004 in a single institution were evaluated for their demographic features, BMI, histopathological/immunohistochemical examinations and treatments. Quetelet BMI [weight (kg)/height (m)2] categories were selected according to the World Health Organization definition. Disease free survival (DSF) as well as distant disease free survival (DDSF) analyses were performed to identify independent prognostic factors.
Post-menopausal patients were significantly in the higher quartile of BMI than pre-menopausal patients (P = 0.003). While post-menopausal obese patients had worse DSF and DDFS (P = 0.001), vascular invasion was the independent prognostic factor for both survival indices (P = 0.031).
Post-menopausal obese Turkish women are at increased risk of developing breast tumors with aggressive phenotype and obesity is a strong predictor of poor DSF and DDFS. Preventive strategies to reduce not only the prevalence of obesity and breast cancer but also the mortality must be recognized as the cost-effective public-health policy for Turkey.
体重指数(BMI)与患者及肿瘤预后相关特征之间的相关性尚未得到充分研究,可能有助于阐明致癌机制。由于研究结果含糊、不一致且不确定,以及种族差异,我们旨在评估高BMI对可手术治疗的土耳其乳腺癌女性患者预后的意义。
对2000年至2004年在单一机构诊断为可手术浸润性乳腺癌的266例患者的人口统计学特征、BMI、组织病理学/免疫组织化学检查及治疗情况进行评估。根据世界卫生组织的定义选择体重指数[体重(千克)/身高(米)²]类别。进行无病生存期(DFS)及远处无病生存期(DDFS)分析以确定独立预后因素。
绝经后患者的BMI显著高于绝经前患者(P = 0.003)。绝经后肥胖患者的DFS和DDFS较差(P = 0.001),而血管侵犯是这两个生存指标的独立预后因素(P = 0.031)。
绝经后肥胖的土耳其女性患具有侵袭性表型乳腺癌的风险增加,肥胖是DFS和DDFS较差的有力预测指标。降低肥胖和乳腺癌患病率以及死亡率的预防策略必须被视为土耳其具有成本效益的公共卫生政策。