Department of Endocrinology and Metabolism, Baskent University Hospital, Baskent University Ankara, Ankara, Turkey.
Clin Transl Oncol. 2012 Dec;14(12):923-30. doi: 10.1007/s12094-012-0878-z. Epub 2012 Jul 25.
The purpose of this study was to evaluate the relationship between body mass index and lipid profiles with breast cancer prognosis together with the relationship of these parametres with known breast cancer prognostic indices including c-erbB2 expression.
Four hundred and thirty-three patients diagnosed with breast cancer at Ankara University, Faculty of Medicine, Department of Medical Oncology made up the study population. The primary endpoints were relapse and death. Body mass index at the time of diagnosis, lipid levels at the time of diagnosis, estrogen receptor status, progesterone receptor status, c-erbB2 expression, tumor grade, patient age, axillary lymph node involvement level, tumor stage, menopausal status and surgery details were taken into account.
The mean body mass indices were similar in the remission, relapse and mortality groups. Patients with body mass indices higher than 30 kg/m² had a lower incidence of c-erbB2 expression when compared to patients with body mass indices < 18.5 kg/m(2) (19 vs. 50 %, p = 0.009). Survival analysis revealed that patients with body mass indices < 18.5 kg/m(2) had significantly shorter disease free survivals when compared to patients with body mass indices between 25 and 29.9 kg/m(2). Mean serum lipid levels were similar in the remission, relapse and mortality groups. A trend toward relapse was shown in patients with total cholesterol > 240 mg/dl, but this was statistically insignificant. Survival analysis revealed that patients with triglyceride levels lower than 150 mg/dl had a statistically significant longer disease-free survival when compared to the other groups. Again a trend towards shorter overall survival was seen in patients with total cholesterol > 240 mg/dl, but this relationship was also statistically insignificant.
Most large previous studies reported adverse breast cancer outcome with obesity. However in our study, patients with lower body weight had a shorter disease-free survival. This could be explained by the low number of patients in this study, genetic profile of the patient population, possible weight changes after treatment and the inverse relationship between body mass index and c-erbB2 expression.
本研究旨在评估体重指数和血脂水平与乳腺癌预后之间的关系，以及这些参数与已知的乳腺癌预后指标（包括 c-erbB2 表达）的关系。
本研究纳入了在安卡拉大学医学院肿瘤内科诊断为乳腺癌的 433 例患者。主要终点是复发和死亡。考虑了诊断时的体重指数、诊断时的血脂水平、雌激素受体状态、孕激素受体状态、c-erbB2 表达、肿瘤分级、患者年龄、腋窝淋巴结受累程度、肿瘤分期、绝经状态和手术细节。
缓解、复发和死亡组的平均体重指数相似。体重指数高于 30 kg/m²的患者 c-erbB2 表达的发生率低于体重指数<18.5 kg/m²的患者（19%比 50%，p=0.009）。生存分析显示，体重指数<18.5 kg/m²的患者无病生存率明显短于体重指数在 25 至 29.9 kg/m²之间的患者。缓解、复发和死亡组的平均血清血脂水平相似。总胆固醇>240 mg/dl 的患者有复发趋势，但无统计学意义。生存分析显示，三酰甘油水平低于 150 mg/dl 的患者无病生存率明显长于其他组。总胆固醇>240 mg/dl 的患者总生存率也较短，但这种关系也无统计学意义。
大多数先前的大型研究报告肥胖与不良乳腺癌结局相关。然而，在我们的研究中，体重较低的患者无病生存率较短。这可能是由于本研究患者数量较少、患者人群的遗传特征、治疗后体重可能发生变化以及体重指数与 c-erbB2 表达之间的反比关系所致。
