Vona-Davis Linda, Rose David P, Hazard Hannah, Howard-McNatt Marissa, Adkins Farrell, Partin Jessica, Hobbs Gerald
Department of Surgery and Breast Cancer Research Program, Mary Babb Randolph Cancer Center, West Virginia University Robert C. Byrd Health Sciences Center, P.O. Box 9238, Morgantown, WV 26506, USA.
Cancer Epidemiol Biomarkers Prev. 2008 Dec;17(12):3319-24. doi: 10.1158/1055-9965.EPI-08-0544.
Our objective was to determine the clinicopathologic features of triple-negative (estrogen receptor, progesterone receptor, and human epidermal growth factor-2 receptor negative) breast cancer and their relationship to obesity in women drawn from a population with one of the highest obesity rates in the United States.
This retrospective study involved 620 White patients with invasive breast cancer in West Virginia. Hospital tumor registry, charts, and pathology records provided age at diagnosis, tumor histologic type, size, nodal status, and receptor status. Body mass index was calculated and a value of > or = 30 was considered indicative of obesity.
Triple-negative tumors occurred in 117 (18.9%) of the 620 patients, most often in association with invasive ductal carcinomas. Patients with triple-negative tumors were younger than those with other receptor types, 44.5% and 26.7%, respectively, being diagnosed at age <50 years (P = 0.0004). The triple-negative tumors were larger (P = 0.0003), most notably in the younger women, but small tumors (<2.0 cm) were more often accompanied by lymph node metastases. Obesity was present in 49.6% of those with triple-negative tumors but in only 35.8% of those with non-triple-negative tumors (P = 0.0098). Lymph node metastases were more frequently associated with T(2) tumors in obese patients (P = 0.032) regardless of their receptor status.
Triple-negative breast cancers within a White, socioeconomically deprived, population occurred in younger women, with later stage at diagnosis, and in association with obesity, which itself has been associated with a poor prognosis in breast cancer.
我们的目标是确定三阴性（雌激素受体、孕激素受体和人表皮生长因子-2受体均为阴性）乳腺癌的临床病理特征，以及它们与肥胖的关系，研究对象来自美国肥胖率最高的人群之一。
这项回顾性研究纳入了西弗吉尼亚州620例浸润性乳腺癌白人患者。通过医院肿瘤登记处、病历和病理记录获取诊断时的年龄、肿瘤组织学类型、大小、淋巴结状态和受体状态。计算体重指数，体重指数≥30被视为肥胖。
620例患者中有117例（18.9%）为三阴性肿瘤，最常与浸润性导管癌相关。三阴性肿瘤患者比其他受体类型的患者年轻，分别有44.5%和26.7%在50岁之前被诊断（P = 0.0004）。三阴性肿瘤更大（P = 0.0003），在年轻女性中尤为明显，但小肿瘤（<2.0 cm）更常伴有淋巴结转移。三阴性肿瘤患者中有49.6%存在肥胖，而非三阴性肿瘤患者中这一比例仅为35.8%（P = 0.0098）。无论受体状态如何，肥胖患者的淋巴结转移更常与T(2)肿瘤相关（P = 0.032）。
在一个社会经济条件较差的白人人群中，三阴性乳腺癌多见于年轻女性，诊断时分期较晚，且与肥胖有关，而肥胖本身与乳腺癌预后不良相关。
