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出生体重与乳腺癌患者生存:乌普萨拉出生队列研究。

Birth size and survival in breast cancer patients from the Uppsala Birth Cohort Study.

机构信息

Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.

出版信息

Cancer Causes Control. 2013 Sep;24(9):1643-51. doi: 10.1007/s10552-013-0238-5. Epub 2013 May 31.

Abstract

PURPOSE

Previous studies suggest that larger birth size is associated with a higher breast cancer incidence, but studies on birth measures and mortality in breast cancer cases are scarce. This study investigates survival of women after breast cancer diagnosis (n = 437) in the Uppsala Birth Cohort born in 1915-1929.

METHODS

Cox regression was used to analyze mortality from any cause after a breast cancer diagnosis. Birth measures including gestational age (GA), birth weight (BW), BW for GA, birth length, and ponderal index (PI) were converted to standard deviation (SD) scores, and all analyses were adjusted for age and calendar time at diagnosis. Analyses were performed with and without adjustment for other birth measures, reproductive history, and adult socioeconomic position.

RESULTS

In fully adjusted analyses, one SD increase in GA was associated with 17% [95% confidence interval (CI) 6-26%] lower mortality and one SD increase in BW was associated with 29% (7-56%) higher mortality. PI showed a weaker trend in the same direction: hazard ratio = 1.16 (95% CI 1.03-1.30).

CONCLUSIONS

Our results bring in new evidence that both high GA and low BW predict a better survival in breast cancer cases. Further studies need to investigate mediation of these associations.

摘要

目的

先前的研究表明,较大的出生体重与更高的乳腺癌发病率相关,但关于出生指标和乳腺癌患者死亡率的研究很少。本研究调查了 Uppsala 出生队列中 1915 年至 1929 年出生的乳腺癌患者(n=437)在诊断后的生存情况。

方法

使用 Cox 回归分析乳腺癌诊断后任何原因导致的死亡率。出生指标包括胎龄(GA)、出生体重(BW)、GA 对应的 BW、出生长度和体质量指数(PI),并转换为标准偏差(SD)评分,所有分析均根据诊断时的年龄和日历时间进行调整。分析分别在不调整和调整其他出生指标、生育史和成人社会经济地位的情况下进行。

结果

在完全调整的分析中,GA 每增加一个 SD,死亡率降低 17%(95%置信区间 6%-26%),BW 每增加一个 SD,死亡率增加 29%(7%-56%)。PI 也呈现出类似的较弱趋势:风险比=1.16(95%置信区间 1.03-1.30)。

结论

我们的研究结果提供了新的证据,表明 GA 高和 BW 低均预示着乳腺癌患者的生存更好。需要进一步研究来探讨这些关联的中介作用。

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