Division of Gynecologic Oncology, Department of Obstetrics & Gynecology and Women's Health, Montefiore Medical Center, and Albert Einstein Cancer Center and Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York.
Obstet Gynecol. 2014 Aug;124(2 Pt 1):300-306. doi: 10.1097/AOG.0000000000000381.
Obesity is an established risk factor for development of endometrial cancer. We hypothesized that obesity might also be associated with an earlier age at endometrial cancer diagnosis, because mechanisms that drive the obesity-endometrial cancer association might also accelerate tumorigenesis.
A retrospective chart review was conducted of all cases of endometrial cancer diagnosed from 1999 to 2009 at a large medical center in New York City. The association of body mass index (BMI) with age at endometrial cancer diagnosis, comorbidities, stage, grade, and radiation treatment was examined using analysis of variance and linear regression. Overall survival by BMI category was assessed using Kaplan-Meier method and the log-rank test.
A total of 985 cases of endometrial cancer were identified. The mean age at endometrial cancer diagnosis was 67.1 years (±11.9 standard deviation) in women with a normal BMI, whereas it was 56.3 years (±10.3 standard deviation) in women with a BMI greater than 50. Age at diagnosis of endometrioid-type cancer decreased linearly with increasing BMI (y=67.89-1.86x, R=0.049, P<.001). This association persisted after multivariable adjustment (R=0.181, P<.02). A linear association between BMI and age of nonendometrioid cancers was not found (P=.12). There were no differences in overall survival by BMI category.
Obesity is associated with earlier age at diagnosis of endometrioid-type endometrial cancers. Similar associations were not, however, observed with nonendometrioid cancers, consistent with different pathways of tumorigenesis.
II.
肥胖是子宫内膜癌发病的既定危险因素。我们假设肥胖也可能与子宫内膜癌的发病年龄更早有关，因为导致肥胖与子宫内膜癌相关的机制也可能加速肿瘤发生。
对纽约市一家大型医疗中心 1999 年至 2009 年期间诊断的所有子宫内膜癌病例进行了回顾性图表审查。使用方差分析和线性回归分析了体重指数（BMI）与子宫内膜癌诊断时年龄、合并症、分期、分级和放疗的关系。使用 Kaplan-Meier 方法和对数秩检验评估 BMI 类别与总生存率的关系。
共确定了 985 例子宫内膜癌病例。BMI 正常的女性子宫内膜癌诊断时的平均年龄为 67.1 岁（±11.9 标准差），而 BMI 大于 50 的女性为 56.3 岁（±10.3 标准差）。子宫内膜样型癌症的诊断年龄随 BMI 的增加呈线性下降（y=67.89-1.86x，R=0.049，P<.001）。这种关联在多变量调整后仍然存在（R=0.181，P<.02）。BMI 与非子宫内膜样癌症的年龄之间没有线性关联（P=.12）。BMI 类别与总生存率之间没有差异。
肥胖与子宫内膜样型子宫内膜癌的发病年龄更早有关。然而，与非子宫内膜样癌症并无类似关联，这与不同的肿瘤发生途径一致。
II 级。
