de Decker Laure, Campone Mario, Retornaz Frederique, Berrut Gilles, Kabeshova Anastasia, Molinié Florence, Beauchet Olivier
Department of Therapeutic, EA 1156-12, Division of Geriatric Medicine, Nantes University Hospital, Nantes, France.
Ouest Cancer Institut, UMR-INSERM U892, Nantes, France.
PLoS One. 2014 May 21;9(5):e98127. doi: 10.1371/journal.pone.0098127. eCollection 2014.
Breast cancer with oestrogen receptor expression is common in older women. Several factors, such as age and reproductive hormone exposure, have been associated with oestrogen receptor expression in breast cancer. However, the association between comorbidities and the oestrogen receptor expression has been poorly studied. We hypothesized that there was an association between burden comorbidity and breast cancer with oestrogen receptor expression in older women.
To determine whether oestrogen receptor expression in breast cancer was associated with burden comorbidity in community-dwelling women.
A total of 1,707 women with breast cancer registered on the list of a breast cancer registry were included. The recorded data included: age, Charlson Comorbidity Index score≥1, breast cancer characteristics (coded according to the International Classification of Diseases for Oncology), and breast cancer pathological stage (the pathological-tumour-node-metastasis, Scarff Bloom Richardson, and hormonal status of oestrogen receptor, progesterone receptor, and human epidermal growth factor receptor).
Breast cancer with oestrogen receptor expression was identified in 1,378 patients (80·7%). The fully-adjusted logistic regression showed that oestrogen receptor expression was associated with Charlson Comorbidity Index score≥1 (odds ratio [OR] = 1·91,95%confidence interval [CI] = [1.01-3.61], P = 0·048), progesterone receptor expression (OR = 16·64, 95%CI = [11.62-23.81], P<0·001), human epidermal growth factor receptor (OR = 0·54, 95%CI = [0.34-0.84], P = 0·007), age (OR = 1.02, 95%CI = [1.00-1.03], P = 0.008), Scarff Bloom Richardson grade II and grade III (OR = 0·21with 95%CI = [0.10-0.44] and OR = 0·06 with 95%CI = [0.03-0.12], P<0·001).
Our findings provide new data showing an independent positive association between burden comorbidity and breast cancer with oestrogen receptor expression. This result confirms that evaluation of oestrogen receptor expression in breast cancer should not be limited to hormonal factors stratified by age.
雌激素受体表达阳性的乳腺癌在老年女性中很常见。年龄和生殖激素暴露等多种因素与乳腺癌中的雌激素受体表达有关。然而,合并症与雌激素受体表达之间的关联研究较少。我们推测老年女性中合并症负担与雌激素受体表达阳性的乳腺癌之间存在关联。
确定社区居住女性中乳腺癌的雌激素受体表达是否与合并症负担有关。
纳入了1707名登记在乳腺癌登记册上的乳腺癌女性患者。记录的数据包括:年龄、查尔森合并症指数评分≥1、乳腺癌特征(根据国际肿瘤疾病分类编码)以及乳腺癌病理分期(病理肿瘤-淋巴结-转移、斯卡夫-布卢姆-理查森分级以及雌激素受体、孕激素受体和人表皮生长因子受体的激素状态)。
1378例患者(80.7%)被鉴定为雌激素受体表达阳性的乳腺癌。完全调整后的逻辑回归显示,雌激素受体表达与查尔森合并症指数评分≥1相关(比值比[OR]=1.91,95%置信区间[CI]=[1.01-3.61],P=0.048)、孕激素受体表达相关(OR=16.64,95%CI=[11.62-23.81],P<0.001)、人表皮生长因子受体相关(OR=0.54,95%CI=[0.34-0.84],P=0.007)、年龄相关(OR=1.02,95%CI=[1.00-1.03],P=0.008)、斯卡夫-布卢姆-理查森二级和三级相关(OR分别为0.21,95%CI=[0.10-0.44];OR为0.06,95%CI=[0.03-0.12],P<0.001)。
我们的研究结果提供了新的数据,显示合并症负担与雌激素受体表达阳性的乳腺癌之间存在独立的正相关。这一结果证实,乳腺癌中雌激素受体表达的评估不应局限于按年龄分层的激素因素。