Department of Obstetrics and Gynecology, School of Medicine, Kyung Hee University, Seoul, Korea.
Gynecol Oncol. 2010 Jul;118(1):24-8. doi: 10.1016/j.ygyno.2010.03.001. Epub 2010 Apr 18.
We aimed to evaluate the role of body mass index (BMI) as a risk and prognostic factor of endometrioid uterine cancer in Korean women.
The records of 937 patients with endometrioid uterine cancer treated between 2000 and 2006 in Korea were reviewed. To determine the disease risk by BMI, four age-matched controls were recruited from healthy women (1-year age group).
The obese (BMI > or =25 kg/m(2)) and overweight (23 kg/m(2)< or = BMI <25 kg/m(2)) women had an increased risk for endometrioid uterine cancer (OR=3.161, 95% CI=2.655-3.763 and OR=1.536, 95% CI=1.260-1.873, respectively) compared to the non-obese (BMI <23 kg/m(2)) women. That is, an increment of 1 kg/m(2) caused an 18% increase in the endometrioid uterine cancer risk (OR=1.181, 95% CI=1.155-1.207). However, there was no difference in overall survival according to the BMI-based subgroups (log-rank=0.366, p=0.8328). The crude Cox model showed that obesity was not associated with the patients' overall survival when the obese and non-obese women were compared (crude HR=0.82, 95% CI=0.40-1.66). Furthermore, there was a significant trend toward a better prognosis at increased increments of BMI (p for trend<0.001), but this was not found in the multivariate analysis.
A high BMI was a significant risk factor for endometrioid uterine cancer in an Asian population. However, it was not associated with overall survival, in spite of the earlier tumor stage of the obese women.
我们旨在评估体重指数(BMI)作为韩国女性子宫内膜样子宫癌的风险和预后因素的作用。
回顾了 2000 年至 2006 年间在韩国接受治疗的 937 例子宫内膜样子宫癌患者的记录。为了确定 BMI 对疾病的风险,从健康女性中招募了 4 名年龄匹配的对照者(每 1 岁年龄组 1 名)。
与非肥胖者(BMI<23kg/m²)相比,肥胖(BMI≥25kg/m²)和超重(23kg/m²≤BMI<25kg/m²)女性患子宫内膜样子宫癌的风险增加(OR=3.161,95%CI=2.655-3.763 和 OR=1.536,95%CI=1.260-1.873)。也就是说,BMI 每增加 1kg/m²,子宫内膜样子宫癌的风险增加 18%(OR=1.181,95%CI=1.155-1.207)。然而,基于 BMI 的亚组之间的总体生存率没有差异(对数秩检验=0.366,p=0.8328)。在肥胖和非肥胖女性之间进行比较时,粗 Cox 模型显示肥胖与患者的总体生存率无关(粗 HR=0.82,95%CI=0.40-1.66)。此外,BMI 增加的趋势与更好的预后呈显著相关(趋势检验的 p<0.001),但在多变量分析中未发现这种关系。
高 BMI 是亚洲人群子宫内膜样子宫癌的一个重要危险因素。然而,尽管肥胖女性的肿瘤分期较早,但 BMI 与总体生存率无关。