Bao Jean, Borja Nicholas, Rao Madhu, Huth James, Leitch A Marilyn, Rivers Aeisha, Wooldridge Rachel, Rao Roshni
Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas, 75390-9155.
Cancer Med. 2015 Apr;4(4):500-6. doi: 10.1002/cam4.388. Epub 2015 Jan 30.
Triple-negative breast cancer (TNBC) is an uncommon but aggressive subtype of breast cancer. Obesity has been associated with an increased risk of breast cancer and worse prognosis. Some studies suggest that obese patients are less likely to achieve pathologic complete response (pCR) to neoadjuvant chemotherapy (NCT) and experience worse overall survival. Ki-67 is a proliferation marker that correlates with tumor aggressiveness. The goal of this study was to examine the impact of weight change during NCT for TNBC on pathologic response and Ki-67 reduction. Retrospective review identified 173 TNBC patients treated between 2004 and 2011. Data were collected on patient demographics, pre- and post-NCT body mass index (BMI), Ki-67, and pCR. Data analysis was performed using the two-tailed Student's t-test, analysis of variance (ANOVA), and Fisher's exact test. Sixty-six patients met final study criteria. Forty-three patients lost weight during chemotherapy and 23 gained weight. Patients in the weight gain group were significantly younger (P = 0.0013). There was no significant difference between the two groups in terms of Ki-67 reduction (P = 0.98) or pCR (P = 0.58). When patients were separated into normal weight (BMI<25 kg/m(2) ), overweight (BMI ≥ 25 and <30 kg/m(2) ), and obese (BMI ≥ 30 kg/m(2) ), there was no significant difference in Ki-67 among those groups either before or after NCT. The degree of obesity did not have a significant impact on Ki-67 reduction. Weight change during NCT does not appear to correlate with Ki-67 change or achieving pCR in TNBC. This may reflect the nature of this subtype of breast cancer that is less responsive to the hormonal effects that adipose tissue exerts on cancer cell proliferation.
三阴性乳腺癌（TNBC）是一种不常见但侵袭性强的乳腺癌亚型。肥胖与乳腺癌风险增加及预后较差有关。一些研究表明，肥胖患者对新辅助化疗（NCT）达到病理完全缓解（pCR）的可能性较小，且总生存期较差。Ki-67是一种与肿瘤侵袭性相关的增殖标志物。本研究的目的是探讨TNBC患者在NCT期间体重变化对病理反应和Ki-67降低的影响。回顾性分析确定了2004年至2011年间接受治疗的173例TNBC患者。收集了患者的人口统计学数据、NCT前后的体重指数（BMI）、Ki-67和pCR。使用双尾学生t检验、方差分析（ANOVA）和Fisher精确检验进行数据分析。66例患者符合最终研究标准。43例患者在化疗期间体重减轻，23例体重增加。体重增加组的患者明显更年轻（P = 0.0013）。两组在Ki-67降低（P = 0.98）或pCR（P = 0.58）方面无显著差异。当患者分为正常体重（BMI<25 kg/m²）、超重（BMI≥25且<30 kg/m²）和肥胖（BMI≥30 kg/m²）时，NCT前后这些组之间的Ki-67也无显著差异。肥胖程度对Ki-67降低没有显著影响。TNBC患者在NCT期间的体重变化似乎与Ki-67变化或实现pCR无关。这可能反映了这种乳腺癌亚型的性质，即对脂肪组织对癌细胞增殖所施加的激素效应反应较小。
