Grill Sabine, Yahiaoui-Doktor Maryam, Dukatz Ricarda, Lammert Jacqueline, Ullrich Mirjam, Engel Christoph, Pfeifer Katharina, Basrai Maryam, Siniatchkin Michael, Schmidt Thorsten, Weisser Burkhard, Rhiem Kerstin, Ditsch Nina, Schmutzler Rita, Bischoff Stephan C, Halle Martin, Kiechle Marion
Department of Gynecology and Center for Hereditary Breast and Ovarian Cancer, Klinikum Rechts der Isar, Technical University of Munich (TUM) and Comprehensive Cancer Center Munich (CCCM), Ismaninger Str. 22, 81675, Munich, Germany.
Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Haertelstrasse 16-18, 04107, Leipzig, Germany.
Arch Gynecol Obstet. 2017 Dec;296(6):1135-1144. doi: 10.1007/s00404-017-4546-y. Epub 2017 Oct 3.
The aim of this analysis in a pilot study population was to investigate whether we can verify seemingly harmful lifestyle factors such as nicotine and alcohol indulgence, obesity, and physical inactivity, as well as a low socioeconomic status for increased cancer prevalence in a cohort of BRCA 1 and 2 mutation carriers.
The analysis data are derived from 68 participants of the lifestyle intervention study LIBRE-1, a randomized, prospective trial that aimed to test the feasibility of a lifestyle modification in BRCA 1 and 2 mutation carriers. At study entry, factors such as medical history, lifestyle behavior, and socioeconomic status were retrospectively documented by interview and the current BMI was determined by clinical examination. The baseline measurements were compared within the cohort, and presented alongside reference values for the German population.
Study participants indicating a higher physical activity during their adolescence showed a significantly lower cancer prevalence (p = 0.019). A significant difference in cancer occurrence was observed in those who smoked prior to the disease, and those who did not smoke (p < 0.001). Diseased mutation carriers tended to have a lower BMI compared to non-diseased mutation carriers (p = 0.079), whereas non-diseased revealed a significantly higher physical activity level than diseased mutation carriers (p = 0.046).
The present data in this small cohort of 68 mutation carriers suggest that smoking and low physical activity during adolescence are risk factors for developing breast cancer in women with BRCA1 or BRCA2 mutation. Further data of the ongoing LIBRE 2 study are necessary to confirm these findings in a larger cohort of 600 mutation carriers.
本分析针对一项试点研究人群,旨在调查我们是否能够证实一些看似有害的生活方式因素,如沉溺于尼古丁和酒精、肥胖、缺乏身体活动,以及社会经济地位低下,是否会导致携带BRCA 1和2基因突变的队列中癌症患病率增加。
分析数据来自生活方式干预研究LIBRE-1的68名参与者,这是一项随机、前瞻性试验,旨在测试BRCA 1和2基因突变携带者生活方式改变的可行性。在研究开始时,通过访谈回顾性记录病史、生活方式行为和社会经济地位等因素,并通过临床检查确定当前的体重指数。在队列中比较基线测量值,并与德国人群的参考值一起呈现。
表明青春期身体活动较多的研究参与者癌症患病率显著较低(p = 0.019)。在患病前吸烟的人和不吸烟的人之间观察到癌症发生率有显著差异(p < 0.001)。与未患病的突变携带者相比,患病的突变携带者BMI往往较低(p = 0.079),而未患病者的身体活动水平明显高于患病的突变携带者(p = 0.046)。
这一由68名突变携带者组成的小队列中的现有数据表明,青春期吸烟和缺乏身体活动是携带BRCA1或BRCA2基因突变女性患乳腺癌的危险因素。需要正在进行的LIBRE 2研究的进一步数据,以在600名突变携带者的更大队列中证实这些发现。