Lazarev Irina, Flaschner Maayan, Geffen David B, Ariad Samuel
Department of Oncology, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel E-mail :
Asian Pac J Cancer Prev. 2014;15(18):7533-7. doi: 10.7314/apjcp.2014.15.18.7533.
Breast cancer (BC) is the most frequent cancer type, and the leading cause of death from cancer among women in Israel. The Bedouin-Arab (BA) population in southern Israel is characterized by a high rate of consanguinity, common hereditary disorders, and transition from a semi-nomadic, traditional society to a more sedentary and urbanized society. In this hospital-based study, the demographic and the clinicopathological characteristics of BC in BA were compared with Jewish patients.
85 BA patients treated at the Soroka Medical Center, Beer Sheba, during the years 2004-2012, were studied and compared with 180 consecutive Jewish patients treated during the year 2007. Clinicopathological features compared included age, menopausal state, number of births, a history of BC in first-degree relatives, tumor size (T), extent of lymph- node involvement (N), distant metastases (M), stage, grade, estrogen and progesterone receptor (ER/PR), and Her2 status. Types of treatment, relapse rate and site, as well as outcome were also studied. Cox's regression models were applied for studying disease-free, and overall survival.
Compared with Jewish patients, BA patients were younger (average age 49±12 yrs vs 59±13, p<0.001), had a lower rate of BC in first-degree relatives (p<0.001), and a larger number of births (6±4.2 vs 2.5±1.9, p<0.001). BA patients had larger tumors (p=0.02), more extensive lymph-node involvement (p=0.002), and more advanced stage (p=0.003). Grade, ER, PR, and Her2 status were similar in the two ethnic groups. Relapse type was most commonly systemic in BA patients (p=0.05), and loco-regional in Jewish patients (p=0.02). Median survival was 63, and 35 months for Jewish and BA patients, respectively (log-rank test, p=0.02). In Cox multivariate analysis, stage and PR status (HR-0.14, p<0.0001; HR-3.11, p=0.046), but not ethnicity, influenced overall survival.
BC presents a decade earlier, and with more advanced disease in BA compared with Jewish patients. Biologic parameters including grade, ER, PR, and Her2 status were similar in both groups. Although prognosis was worse in BA than in Jewish patients, it was affected only by stage and PR status, but not by ethnicity.
乳腺癌（BC）是最常见的癌症类型，也是以色列女性癌症死亡的主要原因。以色列南部的贝都因 - 阿拉伯（BA）人群的特点是近亲结婚率高、常见遗传性疾病以及从半游牧、传统社会向更定居和城市化社会的转变。在这项基于医院的研究中，将BA人群中BC的人口统计学和临床病理特征与犹太患者进行了比较。
对2004年至2012年期间在贝尔谢巴的索罗卡医疗中心接受治疗的85名BA患者进行了研究，并与2007年接受治疗的180名连续犹太患者进行了比较。比较的临床病理特征包括年龄、绝经状态、生育次数、一级亲属的BC病史、肿瘤大小（T）、淋巴结受累程度（N）、远处转移（M）、分期、分级、雌激素和孕激素受体（ER/PR）以及Her2状态。还研究了治疗类型、复发率和部位以及预后。应用Cox回归模型研究无病生存期和总生存期。
与犹太患者相比，BA患者更年轻（平均年龄49±12岁 vs 59±13岁，p<0.001），一级亲属中BC的发生率较低（p<0.001），生育次数较多（6±4.2次 vs 2.5±1.9次，p<0.001）。BA患者的肿瘤更大（p = 0.02），淋巴结受累更广泛（p = 0.002），分期更晚（p = 0.003）。两个种族群体的分级、ER、PR和Her2状态相似。BA患者的复发类型最常见为全身性（p = 0.05），而犹太患者为局部区域性（p = 0.02）。犹太患者和BA患者的中位生存期分别为63个月和35个月（对数秩检验，p = 0.02）。在Cox多变量分析中，分期和PR状态（HR - 0.14，p<0.0001；HR - 3.11，p = 0.046）而非种族影响总生存期。
与犹太患者相比，BA人群中的BC发病早十年，且疾病更晚期。两组的生物学参数包括分级、ER、PR和Her2状态相似。尽管BA患者的预后比犹太患者差，但仅受分期和PR状态影响，而不受种族影响。
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