Bouguerra Hichem, Guissouma Hajer, Labidi Soumaya, Stambouli Nejla, Marrakchi Raja, Chouaib Salem, Ben Ammar Elgaaied Amel, Boussen Hammouda, Gati Asma
Laboratoire de Genetique, Immunologie et Pathologies Humaines, Departement de Biologie, Faculte des Sciences de Tunis, CAMPUS, Universite Tunis-El Manar, Tunis, Tunisie E-mail :
Asian Pac J Cancer Prev. 2014;15(16):6805-10. doi: 10.7314/apjcp.2014.15.16.6805.
Previous studies have suggested a link between obesity and breast cancer (BC). However, there is no universal consensus, especially in population based studies. Because only few studies have been conducted on African women, we aimed here to assess the relationship between BMI at time of diagnosis and the BC histopathological features among Tunisian patients according to menopausal status using a hospital-based prospective cohort study.
Clinical and pathological data were collected from 262 patients stratified on four groups according to their BMI. The relationship between BMI and histopathological features at diagnosis was analysed using univariate and multivariate analysis. Receiver-operating characteristic (ROC) curves were used to evaluate the performance of BMI in predicting of high tumor grade, in comparison to ki-67 index of proliferation.
Obesity was correlated with larger tumors, advanced grade and with ER-PR- Her2+ BC subtype. An association of BMI with tumor size and tumor grade was observed in both premenopausal and postmenopausal women. Additionally, a significant association between BMI and ER+, ER+PR+Her2+ and ER-PR-Her2+ status was revealed for premenopausal patients, while only ER+PR+Her2+ was associated with BMI for postmenopausal women. Finally, our results showed that compared to Ki67 proliferation index, BMI is a useful prognostic marker of high grade BC tumors.
These data are the first to show that in Tunisia obese women suffering from BC have significantly larger tumors and advanced tumor grade and that higher BMI might influence tumor characteristics and behavior.
先前的研究表明肥胖与乳腺癌（BC）之间存在联系。然而，尚未达成普遍共识，尤其是在基于人群的研究中。由于针对非洲女性的研究较少，我们在此旨在通过一项基于医院的前瞻性队列研究，根据绝经状态评估突尼斯患者诊断时的体重指数（BMI）与BC组织病理学特征之间的关系。
收集了262例患者的临床和病理数据，这些患者根据BMI分为四组。使用单因素和多因素分析来分析BMI与诊断时组织病理学特征之间的关系。与增殖的Ki-67指数相比，采用受试者操作特征（ROC）曲线来评估BMI在预测高肿瘤分级方面的性能。
肥胖与更大的肿瘤、更高的分级以及ER-PR-Her2+ BC亚型相关。在绝经前和绝经后女性中均观察到BMI与肿瘤大小和肿瘤分级之间存在关联。此外，绝经前患者的BMI与ER+、ER+PR+Her2+和ER-PR-Her2+状态之间存在显著关联，而绝经后女性中只有ER+PR+Her2+与BMI相关。最后，我们的结果表明，与Ki67增殖指数相比，BMI是高分级BC肿瘤的一个有用的预后标志物。
这些数据首次表明，在突尼斯，患有BC的肥胖女性肿瘤明显更大且肿瘤分级更高，并且更高的BMI可能会影响肿瘤特征和行为。
