Sini V, Lunardi G, Cirillo M, Turazza M, Bighin C, Giraudi S, Levaggi A, Piccioli P, Bisagni G, Gnoni R, Stridi G, Porpiglia M, Picardo E, Ponzone R, Marenco D, Mansutti M, Puglisi F, Del Mastro L
1] Medical Oncology Unit, Sacro Cuore Don Calabria Hospital, Via Sempreboni, 5, 37024 Negrar (Verona), Italy [2] Oncology Unit, Surgical and Medical Department of Clinical Sciences, Sant'Andrea Hospital, via di Grottarossa, 1035, 00189 Rome, Italy.
Medical Oncology Unit, Sacro Cuore Don Calabria Hospital, Via Sempreboni, 5, 37024 Negrar (Verona), Italy.
Br J Cancer. 2014 Mar 4;110(5):1133-8. doi: 10.1038/bjc.2014.2. Epub 2014 Jan 21.
Obesity is an independent adverse prognostic factor in early breast cancer patients, but it is still controversial whether obesity may affect adjuvant endocrine therapy efficacy. The aim of our study (ancillary to the two clinical trials Gruppo Italiano Mammella (GIM)4 and GIM5) was to investigate whether the circulating oestrogen levels during treatment with the aromatase inhibitor letrozole are related to body mass index (BMI) in postmenopausal women with breast cancer.
Plasma concentration of oestrone sulphate (ES) was evaluated by radioimmunoassay in 370 patients. Plasma samples were obtained after at least 6 weeks of letrozole therapy (steady-state time). Patients were divided into four groups according to BMI. Differences among the geometric means (by ANOVA and ANCOVA) and correlation (by Spearman's rho) between the ES levels and BMI were assessed.
Picomolar geometric mean values (95% confidence interval, n=patients) of circulating ES during letrozole were 58.6 (51.0-67.2, n=150) when BMI was <25.0 kg m(-2); 65.6 (57.8-74.6, n=154) when 25.0-29.9 kg m(-2); 59.3 (47.1-74.6, n=50) when 30.0-34.9 kg m(-2); and 43.3 (23.0-81.7, n=16) when ≥35.0 kg m(-2). No statistically significant difference in terms of ES levels among groups and no correlation with BMI were observed.
Body mass index does not seem to affect circulating oestrogen levels in letrozole-treated patients.
肥胖是早期乳腺癌患者独立的不良预后因素，但肥胖是否会影响辅助内分泌治疗疗效仍存在争议。我们的研究（作为两项临床试验意大利乳腺癌研究组（GIM）4和GIM5的辅助研究）旨在调查绝经后乳腺癌女性在使用芳香化酶抑制剂来曲唑治疗期间循环雌激素水平是否与体重指数（BMI）相关。
采用放射免疫分析法评估370例患者的硫酸雌酮（ES）血浆浓度。血浆样本在来曲唑治疗至少6周（稳态期）后采集。患者根据BMI分为四组。评估ES水平与BMI之间的几何均数差异（通过方差分析和协方差分析）及相关性（通过Spearman相关系数）。
来曲唑治疗期间循环ES的皮摩尔几何均数（95%置信区间，n =患者数）在BMI <25.0 kg/m²时为58.6（51.0 - 67.2，n = 150）；在25.0 - 29.9 kg/m²时为65.6（57.8 - 74.6，n = 154）；在30.0 - 34.9 kg/m²时为59.3（47.1 - 74.6，n = 50）；在≥35.0 kg/m²时为43.3（23.0 - 81.7，n = 16）。各亚组间ES水平无统计学显著差异，且与BMI无相关性。
体重指数似乎不影响来曲唑治疗患者的循环雌激素水平。
