Can A, Alacacioglu A, Kucukzeybek Y, Erten C, Cokmert S, Demir L, Dirican A, Vedat Bayoglu I, Akyol M, Aslan F, Oktay Tarhan M
Medical Oncology Outpatient Clinic, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir ,Turkey.
J BUON. 2013 Oct-Dec;18(4):845-50.
The aim of this study was to investigate the effect of metabolic syndrome and insulin resistance at the time of diagnosis on the known prognostic factors of breast cancer in postmenopausal breast cancer patients.
The study included 71 patients with a recent diagnosis of postmenopausal breast cancer, admitted at the Medical Oncology outpatient clinic of the Izmir Ataturk Training and Research Hospital between June 2010 and June 2011. We determined whether the patients had metabolic syndrome and insulin resistance at diagnosis, and recorded known prognostic factors, such as tumor size, axillary lymph node involvement, presence of distant metastasis, tumor grade, estrogen receptor (ER), progesterone receptor (PR), and CerbB-2 status.
Among 71 patients, 25 (35%) had metabolic syndrome at the time of diagnosis, and 33 (46%) had insulin resistance with Homeostasis Model of Assessment-Insulin Resistance (HOMA-IR)>2.7. No statistically significant difference was found in the prognostic values of breast cancer, i.e. tumor size, axillary lymph node involvement, distant metastasis, tumor grade, ER, PR, and CerbB-2 status between the patients with and without metabolic syndrome. There was no statistically significant difference in the prognostic factors of breast cancer at the time of diagnosis between 33 patients with insulin resistance and 38 patients without insulin resistance.
Several previous studies showed a negative relationship between metabolic syndrome and insulin resistance and prognostic factors of breast cancer in postmenopausal breast cancer patients. However, our study failed to show such a relationship. The relationship between metabolic syndrome and insulin resistance and postmenopausal breast cancer was not well demonstrated due to the small number of patients, unknown duration of the metabolic syndrome and insulin resistance, and shorter follow-up period. Further studies are required to demonstrate the effect of metabolic syndrome and insulin resistance on the prognosis of breast cancer, including larger number of patients and longer follow-up periods.
本研究旨在调查绝经后乳腺癌患者诊断时的代谢综合征和胰岛素抵抗对乳腺癌已知预后因素的影响。
该研究纳入了2010年6月至2011年6月期间在伊兹密尔阿塔图尔克培训与研究医院医学肿瘤门诊就诊的71例近期诊断为绝经后乳腺癌的患者。我们确定了患者在诊断时是否患有代谢综合征和胰岛素抵抗，并记录了已知的预后因素，如肿瘤大小、腋窝淋巴结受累情况、远处转移情况、肿瘤分级、雌激素受体（ER）、孕激素受体（PR）和CerbB-2状态。
71例患者中，25例（35%）在诊断时患有代谢综合征，33例（46%）的稳态模型评估胰岛素抵抗（HOMA-IR）>2.7，存在胰岛素抵抗。在有或没有代谢综合征的患者之间，乳腺癌的预后价值，即肿瘤大小、腋窝淋巴结受累情况、远处转移、肿瘤分级、ER、PR和CerbB-2状态，未发现有统计学显著差异。33例有胰岛素抵抗的患者和38例无胰岛素抵抗的患者在诊断时乳腺癌的预后因素方面也没有统计学显著差异。
先前的几项研究表明，绝经后乳腺癌患者的代谢综合征和胰岛素抵抗与乳腺癌的预后因素之间存在负相关。然而，我们的研究未能显示出这种关系。由于患者数量较少、代谢综合征和胰岛素抵抗的持续时间未知以及随访期较短，代谢综合征和胰岛素抵抗与绝经后乳腺癌之间的关系尚未得到充分证明。需要进一步的研究来证明代谢综合征和胰岛素抵抗对乳腺癌预后的影响，包括纳入更多患者和更长的随访期。
