Yan Meiying, Wang Jingxuan, Xuan Qijia, Dong Tieying, He Juan, Zhang Qingyuan
Department of Medical Oncology, The Third Affiliated Hospital of Harbin Medical University, Harbin, China.
Department of Medical Oncology, The Third Affiliated Hospital of Harbin Medical University, Harbin, China.
Clin Breast Cancer. 2017 Jun;17(3):195-203. doi: 10.1016/j.clbc.2016.12.004. Epub 2016 Dec 24.
To investigate the relationship between tamoxifen-associated nonalcoholic fatty liver disease (NAFLD) and survival outcomes in patients with breast cancer.
Patients with early-stage invasive breast cancer after curative resection from January 2009 to June 2011 were selected. A total of 646 patients who were treated with tamoxifen were included. Patients diagnosed with NAFLD on ultrasonography were classified into the NAFLD and non-NAFLD groups.
The NAFLD group included 221 patients, and the non-NAFLD group included 425 patients. Patients in the NAFLD group had significantly higher body mass index than those in the non-NAFLD group (P < .001). Disease-free survival was significantly longer in the non-NAFLD group than the NAFLD group (P = .006). However, there were no significant statistical differences between these 2 groups on overall survival (P = .387). With regard to body mass index, total cholesterol, triglyceride, low-density lipoprotein cholesterol, alanine aminotransferase, and high-density lipoprotein cholesterol, the optimal cutoff points were 21.06, 4.28, 1.22, 3.13, 27.50 and 1.29, respectively, which can be identified as risk factors for distinguishing patients who developed NAFLD from those who did not (P < .05). Moreover, a risk score ≥ 3 indicated a high risk of development of NAFLD (odds ratio, 3.03; 95% confidence interval, 1.11-8.28; P = .037).
NAFLD development had a negative effect on survival outcomes of patients with breast cancer. The risk score created ≥ 3 had a high-level risk of developing NAFLD, and it might be used for physicians to evaluate each patient and give instructive advice for further treatment.
探讨他莫昔芬相关的非酒精性脂肪性肝病（NAFLD）与乳腺癌患者生存结局之间的关系。
选取2009年1月至2011年6月行根治性切除术后的早期浸润性乳腺癌患者。共纳入646例接受他莫昔芬治疗的患者。经超声诊断为NAFLD的患者被分为NAFLD组和非NAFLD组。
NAFLD组包括221例患者，非NAFLD组包括425例患者。NAFLD组患者的体重指数显著高于非NAFLD组（P <.001）。非NAFLD组的无病生存期显著长于NAFLD组（P =.006）。然而，这两组在总生存期方面无显著统计学差异（P =.387）。关于体重指数、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、丙氨酸氨基转移酶和高密度脂蛋白胆固醇，最佳截断点分别为21.06、4.28、1.22、3.13、27.50和1.29，这些可被确定为区分发生NAFLD患者与未发生患者的危险因素（P <.05）。此外，风险评分≥3表明发生NAFLD的风险较高（比值比，3.03；95%置信区间，1.11 - 8.28；P =.037）。
NAFLD的发生对乳腺癌患者的生存结局有负面影响。创建的风险评分≥3时有发生NAFLD的高风险，它可能有助于医生评估每位患者并为进一步治疗提供指导性建议。
