体重指数（BMI）：与新西兰新诊断乳腺癌女性的临床病理因素及预后的关联

Body mass index (BMI): association with clinicopathological factors and outcome of women with newly diagnosed breast cancer in New Zealand.

作者信息

Robinson Bridget, Currie Margaret, Phillips Elisabeth, Dachs Gabi, Strother Matthew, Morrin Helen, Davey Val, Frampton Chris

机构信息

Canterbury Regional Cancer and Haematology Centre, Christchurch Hospital, Christchurch, Mackenzie Cancer Research Group, University of Otago Christchurch, Department of Medicine, University of Otago, Christchurch.

Mackenzie Cancer Research Group, University of Otago Christchurch, Department of Pathology, University of Otago, Christchurch.

出版信息

N Z Med J. 2017 Mar 3;130(1451):46-56.

PMID:28253244

Abstract

AIMS

To identify associations of obesity with breast cancer and its outcome in a New Zealand population, including those treated with adjuvant chemotherapy.

METHODS

Data was collated from four regional Breast Cancer Registers, Auckland, Waikato, Wellington and Christchurch, for all women with newly diagnosed breast cancer, with weight and height recorded. Associations of body mass index (BMI) with patient and tumour characteristics, and all-cause mortality were determined.

RESULTS

BMI was available for 5,458 new breast cancers, 27% of all registered. BMI was normal (18.5-24.9kg/m2) for 32.7%, overweight (25-29.9kg/m2) 31.1%, obese (>30kg/m2) 34.9% and 1.3% underweight (<18.5kg/m2). Median age was 55 years. Higher BMI was associated with non-European ethnicity, post-menopausal status, screen-detection, older age and tumours with higher grade, greater size and positive progesterone receptors. Mean survival for women younger than 56 years was 18.0 years for normal BMI and 14.8 years for BMI >35 (p=0.055, Log-rank). Women younger than 56 years treated with adjuvant chemotherapy had lower survival if obese compared with normal BMI (p=0.055, Log-rank).

CONCLUSIONS

High BMI was associated with larger tumours, of higher grade, progesterone receptor positive and post-menopausal status. Obese pre-menopausal women treated with adjuvant chemotherapy had a trend to poorer outcome.

摘要

目的

确定肥胖与新西兰人群乳腺癌及其预后的关联，包括接受辅助化疗的患者。

方法

从奥克兰、怀卡托、惠灵顿和克赖斯特彻奇四个地区的乳腺癌登记处收集所有新诊断乳腺癌女性的数据，并记录体重和身高。确定体重指数（BMI）与患者及肿瘤特征以及全因死亡率之间的关联。

结果

5458例新发乳腺癌患者有BMI数据，占所有登记患者的27%。BMI正常（18.5 - 24.9kg/m²）的占32.7%，超重（25 - 29.9kg/m²）的占31.1%，肥胖（>30kg/m²）的占34.9%，体重过轻（<18.5kg/m²）的占1.3%。中位年龄为55岁。较高的BMI与非欧洲族裔、绝经后状态、筛查发现、年龄较大以及肿瘤分级较高、体积较大和孕激素受体阳性有关。56岁以下女性中，BMI正常者的平均生存期为18.0年，BMI>35者为14.8年（p = 0.055，对数秩检验）。56岁以下接受辅助化疗的女性中，肥胖者与BMI正常者相比生存期较低（p = 0.055，对数秩检验）。