肥胖对可手术乳腺癌患者淋巴结状态的影响。

Impact of the obesity on lymph node status in operable breast cancer patients.

作者信息

Keskin O, Aksoy S, Babacan T, Sarici F, Kertmen N, Solak M, Turkoz F P, Arik Z, Esin E, Petekkaya I, Altundag K

机构信息

Hacettepe University Cancer Institute, Ankara, Turkey.

出版信息

J BUON. 2013 Oct-Dec;18(4):824-30.

PMID:24344004

Abstract

PURPOSE

Although many studies have shown association of obesity and tumor size, the association with the lymph node status is not clear. We examined the relationship of the lymph node status and obesity and other possible factors in early breast cancer patients.

METHODS

In this retrospective cohort study, 1295 breast cancer patients who had axillary dissection were included. Patients were grouped according to their body mass index (BMI) values at the time of diagnosis. We analyzed the relationship between BMI and patient and tumor characteristics, especially lymph node status.

RESULTS

The median patient age was 48 years (range 20- 84). Of the patients 69.6% had modified radical mastectomy and the remaining 30.4% had breast-conserving surgery and axillary dissection. Median BMI of the patients was 27.2 kg/m(2) and 33.1% (N-429) of them had normal BMI, 36% (N-471) were overweight and 30.5% (N=395) were obese at the time of the diagnosis. Of the patients, 44.2% had N0 disease, and 55.8% had lymph node metastasis. N1 disease had 28.3% (N=367), 13.8% (N=179) had N2 and 13.7% (N=177) had N3 disease. When patients were classified as normal (≤24.9 kg/m(2)) and obese (>24.9 kg/m(2)) group, the total number of lymph nodes removed was higher in the obese group and this difference was statistically significant (18.12±10.48 and 20.36±11.37, respectively, p= 0.001). There was strong correlation between the number of the dissected lymph nodes and BMI (r=0.11; p<0.001). However, there was no statistically significant correlation between the number of metastatic lymph nodes and BMI. The mean number of the dissected and involved lymph nodes was higher in the HER2 positive group compared to the negative ones (21 vs 19, p=0.008; 6 vs 3, p<0.001; respectively)

CONCLUSION

The number of the dissected lymph nodes was slightly higher in obese patients but there was no correlation between metastatic lymph node number and BMI. The number of the dissected and involved lymph nodes was higher in the HER2 positive group.

摘要

目的

尽管许多研究已表明肥胖与肿瘤大小有关联，但与淋巴结状态的关联尚不清楚。我们研究了早期乳腺癌患者的淋巴结状态与肥胖及其他可能因素之间的关系。

方法

在这项回顾性队列研究中，纳入了1295例行腋窝清扫术的乳腺癌患者。根据诊断时的体重指数（BMI）值对患者进行分组。我们分析了BMI与患者及肿瘤特征之间的关系，尤其是淋巴结状态。

结果

患者的中位年龄为48岁（范围20 - 84岁）。其中69.6%的患者接受了改良根治性乳房切除术，其余30.4%的患者接受了保乳手术及腋窝清扫术。患者的中位BMI为27.2kg/m²，诊断时33.1%（N = 429）的患者BMI正常，36%（N = 471）超重，30.5%（N = 395）肥胖。患者中，44.2%为N0期疾病，55.8%有淋巴结转移。N1期疾病占28.3%（N = 367），13.8%（N = 179）为N2期，13.7%（N = 177）为N3期。当将患者分为正常（≤24.9kg/m²）和肥胖（>24.9kg/m²）组时，肥胖组切除的淋巴结总数更高，且这种差异具有统计学意义（分别为18.12±10.48和20.36±11.37，p = 0.001）。清扫的淋巴结数量与BMI之间存在强相关性（r = 0.11；p < 0.001）。然而，转移淋巴结数量与BMI之间无统计学显著相关性。与HER2阴性组相比，HER2阳性组清扫的和受累的淋巴结平均数量更高（分别为21对19，p = 0.008；6对3，p < 0.001）。