Division of Cancer Epidemiology and Prevention, Institute of Social and Preventive Medicine, University of Zurich, Basel, Switzerland.
Department of Obstetrics and Gynecology, Breast center, Hospital Grabs, Basel, Switzerland ; Breast Center, University Hospital Basel, Breast center, Hospital Grabs, Basel, Switzerland.
Breast Care (Basel). 2013 Jun;8(3):192-8. doi: 10.1159/000350002.
This study analyzes the association of body mass index (BMI) and prognostically relevant breast cancer (BC) characteristics in a country that has been rather spared of the global obesity epidemic.
Based on 20-year data (1999-2009, n = 1,414) of the prospective relational BC database of the University Hospital Basel, Switzerland, the associations between BMI, tumor size and stage, histological subtype, grading, hormonal receptor status, HER2 status and 'triple-negative' status were evaluated. Multivariate analysis considered BMI and patient's age.
The association between increasing BMI and the above-mentioned variables were as follows (results described in each case: Beta-coefficient or odds ratio, 95% confidence interval, p value): tumor size, (1) entire cohort: 0.03 (0.01-0.05), p < 0.001, (2) tumor found by self-palpation: 0.05 (0.03-0.07), p < 0.001, (3) tumor found by radiological examination: 0.03 (0-0.07), p = 0.044; advanced TNM stage: 1.16 (1.02-1.31), p = 0.022; histological subtype: 1.04 (0.89-1.22), p = 0.602; unfavorable grading: 1.11 (1.00-1.25), p = 0.057; positive estrogen receptor status: 0.95 (0.83-1.09), p = 0.459; positive HER2 status: 0.92 (0.74-1.15), p = 0.467; presence of a 'triple-negative' carcinoma: 1.19 (0.93-1.52), p = 0.165. Consideration of only postmenopausal BC patients (n = 1,063) did attenuate the results, but did not change the direction of the associations with BMI.
BMI was positively associated with TNM stage, grading and tumor size for tumors that were found by self-detection, as well as for those lesions detected by radiological breast examinations.
本研究分析了在一个相对未受全球肥胖流行影响的国家，体重指数（BMI）与预后相关的乳腺癌（BC）特征之间的关联。
基于瑞士巴塞尔大学医院前瞻性相关性 BC 数据库 20 年的数据（1999-2009 年，n=1414），评估 BMI 与肿瘤大小和分期、组织学亚型、分级、激素受体状态、HER2 状态和“三阴性”状态之间的关系。多变量分析考虑了 BMI 和患者年龄。
BMI 与上述变量的关联如下（每种情况下描述的结果：β系数或优势比，95%置信区间，p 值）：肿瘤大小，（1）整个队列：0.03（0.01-0.05），p<0.001，（2）自我触诊发现的肿瘤：0.05（0.03-0.07），p<0.001，（3）放射检查发现的肿瘤：0.03（0-0.07），p=0.044；进展期 TNM 分期：1.16（1.02-1.31），p=0.022；组织学亚型：1.04（0.89-1.22），p=0.602；不良分级：1.11（1.00-1.25），p=0.057；雌激素受体阳性状态：0.95（0.83-1.09），p=0.459；HER2 阳性状态：0.92（0.74-1.15），p=0.467；存在“三阴性”癌：1.19（0.93-1.52），p=0.165。仅考虑绝经后 BC 患者（n=1063）会减弱结果，但不会改变 BMI 与这些关联的方向。
BMI 与通过自我检测发现的 TNM 分期、分级和肿瘤大小以及通过放射乳腺检查发现的肿瘤呈正相关。
