Kristensen Anne Bjerrum, Hare-Bruun Helle, Høgdall Claus Kim, Rudnicki Martin
*Department of Obstetrics and Gynecology, Odense University Hospital, Svendborg; †Research Centre for Prevention and Health, Capital Region of Denmark, Glostrup; and §Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Int J Gynecol Cancer. 2017 Feb;27(2):281-288. doi: 10.1097/IGC.0000000000000874.
To evaluate the influence of body mass index (BMI) on endometrial tumor pathology, stage and complication rate and to identify individual prognostic factors, such as BMI, in types I and II endometrial cancer.
Register study included all Danish women who underwent surgery for uterine cancer or atypical endometrial hyperplasia (International Classification of Diseases-10 codes D070, DC549) 2005 to 2012 (n = 6003).
Impact of BMI on type I and II endometrial cancer survival.
Danish Gynecological Cancer Database data on women with type I and II endometrial cancer were retrieved. Kaplan-Meier plot was used to illustrate differences in survival in relation to BMI. Log-rank test was used to demonstrate difference between the curves. Cox regression hazard model was used to estimate hazard ratios (HR) of the effect of BMI on overall survival.
Four thousand three hundred thirty women were included. Women with type I cancer had a significantly better overall survival compared with those with type II cancer. Low BMI was associated with increased mortality in type I (HR, 2.07; 95% confidence interval [CI], 1.20-3.55), whereas in type II both low (HR, 1.68; 95% CI, 1.03-2.74) and high BMI (BMI, 30-35: HR, 1.54; 95% CI, 1.01-2.26 and BMI >40: HR, 2.15; 95% CI, 1.12-4.11) were significantly associated with increased mortality.
Abnormal BMI is associated with increased mortality in subtypes of endometrial cancer. Underweight was associated with increased overall mortality in both types I and II, whereas obesity only disclosed a significant impact on overall mortality in type II.
评估体重指数（BMI）对子宫内膜肿瘤病理、分期及并发症发生率的影响，并确定I型和II型子宫内膜癌的个体预后因素，如BMI。
登记研究纳入了2005年至2012年期间接受子宫癌或非典型子宫内膜增生手术的所有丹麦女性（国际疾病分类-10编码D070、DC549）（n = 6003）。
BMI对I型和II型子宫内膜癌生存率的影响。
检索丹麦妇科癌症数据库中I型和II型子宫内膜癌女性的数据。采用Kaplan-Meier曲线来说明BMI与生存率的差异。采用对数秩检验来证明曲线之间的差异。采用Cox回归风险模型来估计BMI对总生存率影响的风险比（HR）。
纳入4330名女性。I型癌症女性的总生存率明显高于II型癌症女性。低BMI与I型癌症死亡率增加相关（HR，2.07；95%置信区间[CI]，1.20 - 3.55），而在II型癌症中，低BMI（HR，1.68；95% CI，1.03 - 2.74）和高BMI（BMI，30 - 35：HR，1.54；95% CI，1.01 - 2.26以及BMI > 40：HR，2.15；95% CI，1.12 - 4.11）均与死亡率增加显著相关。
BMI异常与子宫内膜癌亚型死亡率增加相关。体重过轻与I型和II型癌症的总死亡率增加相关，而肥胖仅对II型癌症的总死亡率有显著影响。
