维生素 D 缺乏与腔面型乳腺癌患者的不良结局相关。
Vitamin D deficiency is correlated with poor outcomes in patients with luminal-type breast cancer.
机构信息
Department of Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
出版信息
Ann Surg Oncol. 2011 Jul;18(7):1830-6. doi: 10.1245/s10434-010-1465-6. Epub 2010 Dec 14.
PURPOSE
Vitamin D deficiency may be an indicator of poor prognosis in patients with breast cancer before surgery. We investigated the association between serum vitamin D concentration and breast cancer prognosis according to intrinsic cancer subtypes.
METHODS
From June to December 2006, serum 25-OHD was measured in 310 Korean women with breast cancer who were treated at the Asan Medical Center, Korea. Clinicopathologic data were examined to determine the prognostic effects of serum 25-OHD. Expression of estrogen receptor (ER), progesterone receptor (PR), and epidermal growth factor receptor 2 (Her2) were measured using tissue microarrays. Patients were classified with luminal A, luminal B, Her2-enriched, or basal-like subtypes of breast cancer.
RESULTS
Mean patient age was 48.7 years, and mean serum 25-OHD concentration was 31.4 ± 16.1 ng/ml. The 25-OHD levels were deficient (< 20 ng/ml) in 75 patients (24.2%), insufficient (20-29 ng/ml) in 95 (30.6%), and sufficient (30-150 ng/ml) in 140 (45.2%). Women with deficient 25-OHD levels were at increased risk of recurrence compared with those with sufficient vitamin D levels (P = 0.002). The 25-OHD concentration was inversely associated with prognosis of patients with cancer of the luminal A (P = 0.012) and luminal B subtypes (P =0.023), but not with the prognosis of patients with Her2/neu-enriched (P = 0.245) or triple-negative (P = 0.879) cancer subtypes. This association remained valid after adjustment for age, tumor size, nodal status, and estrogen receptor status (hazards ratio = 3.97; 95% confidence interval = 1.77-9.61).
CONCLUSIONS
Vitamin D deficiency may be associated with poor outcomes in patients with luminal-type breast cancer.
目的
维生素 D 缺乏可能是手术前乳腺癌患者预后不良的一个指标。我们根据内在的癌症亚型研究了血清维生素 D 浓度与乳腺癌预后之间的关系。
方法
2006 年 6 月至 12 月，在韩国首尔峨山医学中心接受治疗的 310 名韩国乳腺癌女性患者的血清 25-羟维生素 D 进行了测量。检查了临床病理数据，以确定血清 25-羟维生素 D 的预后作用。使用组织微阵列测量了雌激素受体 (ER)、孕激素受体 (PR) 和表皮生长因子受体 2 (Her2) 的表达。将患者分为 luminal A、luminal B、Her2 富集或基底样乳腺癌亚型。
结果
患者平均年龄为 48.7 岁，平均血清 25-羟维生素 D 浓度为 31.4±16.1ng/ml。75 名患者（24.2%）的 25-羟维生素 D 水平不足（<20ng/ml），95 名患者（30.6%）不足（20-29ng/ml），140 名患者（45.2%）充足（30-150ng/ml）。与维生素 D 水平充足的患者相比，25-羟维生素 D 水平不足的女性复发风险增加（P=0.002）。25-羟维生素 D 浓度与 luminal A（P=0.012）和 luminal B 亚型（P=0.023）患者的预后呈负相关，但与 Her2/neu 富集（P=0.245）或三阴性（P=0.879）癌症亚型患者的预后无关。在调整年龄、肿瘤大小、淋巴结状态和雌激素受体状态后，这种相关性仍然有效（风险比=3.97；95%置信区间=1.77-9.61）。
结论
维生素 D 缺乏可能与 luminal 型乳腺癌患者的不良结局相关。
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