Department of Internal Medicine, Fairview Hospital, a Cleveland Clinic Hospital, Cleveland, OH, USA.
Breast Cancer Res Treat. 2010 Jun;121(2):479-83. doi: 10.1007/s10549-009-0591-y. Epub 2009 Oct 23.
Metabolic syndrome, a conglomerate of obesity, insulin resistance, dyslipidemia, and hypertension has been linked with an increased risk of breast cancer. We investigated the possible association of highly aggressive triple-negative breast cancer and the metabolic syndrome. Information on metabolic syndrome components and tumor characteristics were reviewed in a cohort of 176 patients (including 86 triple-negatives). Retrospective comparison was performed using Pearson Chi-square test or Student's t test for data analysis. A statistically significant association of triple-negative breast cancer with the metabolic syndrome was observed. In accordance with the NCEP (National Cholesterol Education Program) definition, 58.1% of triple-negative patients had metabolic syndrome compared to only 36.7% of non-triple-negative patients (P = 0.004). Consistently, by the AACE (American Association of Clinical Endocrinologists) criteria, 52.3% of triple-negative patients had metabolic syndrome as compared to 34.4% of non-triple-negative patients (P = 0.017). Blood glucose, triglyceride, and HDL levels but not hypertension or BMI (body mass index) showed significant independent association with triple-negative breast cancer. Additionally, triple-negative tumors displayed a significantly higher histological grade and relative paucity of ductal carcinoma in situ (DCIS) when compared to the non-triple-negative tumors (P < 0.001). Our study suggests that metabolic syndrome is significantly more prevalent in triple-negative breast cancer patients as opposed to non-triple-negative patients. Furthermore, triple-negative breast cancer showed a significantly higher histological grade and a relative absence of DCIS. Whether the presence of metabolic syndrome preferentially increases the risk of developing triple-negative-breast cancer remains to be elucidated with future prospective studies.
代谢综合征是一种肥胖、胰岛素抵抗、血脂异常和高血压的综合体，与乳腺癌风险增加有关。我们研究了高度侵袭性三阴性乳腺癌与代谢综合征之间的可能关联。在包括 86 例三阴性乳腺癌患者在内的 176 例患者队列中，回顾性地分析了代谢综合征成分和肿瘤特征的信息。采用 Pearson Chi-square 检验或 Student's t 检验进行数据分析。三阴性乳腺癌与代谢综合征之间存在统计学显著关联。按照 NCEP（国家胆固醇教育计划）的定义，58.1%的三阴性乳腺癌患者存在代谢综合征，而非三阴性乳腺癌患者中只有 36.7%（P = 0.004）。同样，根据 AACE（美国临床内分泌医师协会）的标准，52.3%的三阴性乳腺癌患者存在代谢综合征，而非三阴性乳腺癌患者中只有 34.4%（P = 0.017）。血糖、甘油三酯和高密度脂蛋白水平，但不是高血压或 BMI（体重指数），与三阴性乳腺癌有显著的独立关联。此外，与非三阴性乳腺癌相比，三阴性乳腺癌的组织学分级明显更高，导管原位癌（DCIS）相对较少（P < 0.001）。我们的研究表明，与非三阴性乳腺癌患者相比，代谢综合征在三阴性乳腺癌患者中更为普遍。此外，三阴性乳腺癌的组织学分级明显更高，且相对缺乏 DCIS。代谢综合征是否会优先增加发生三阴性乳腺癌的风险，仍需要未来的前瞻性研究来阐明。
