Cintra Karine A, Mattar Andre, Joo Yong K, Melitto Alexandre, Gonzales Ricardo, Nonogaki Sueli, Soares Fernando A, Logullo Angela F, Gebrim Luiz H
Department of Gynecology, Federal University of Sao Paulo, UNIFESP, Rua Botucatu, 740, CEP 04023-900 Sao Paulo, SP, Brazil.
Department of Breast Medical Oncology, Perola Byington Hospital, Avenida Brigadeiro Luis Antonio, 683, CEP 01317-000 Sao Paulo, SP, Brazil.
World J Oncol. 2010 Jun;1(3):111-117. doi: 10.4021/wjon2010.06.224w. Epub 2010 May 19.
Epidemiological studies have reported positive associations between anthropometric measures and risk for developing breast cancers that express hormone receptors and associated mortality. However, the impact of nutritional status on the molecular response to endocrine therapy has yet to be described.
Body mass index (BMI), waist circumference (WC), hip circumference (HP), and waist-to-hip ratio (WHR) were measured in patients with invasive ductal carcinoma (IDC) before and after neoadjuvant treatment with either tamoxifen or anastrozole, and a possible correlation with prognostic factors, as estrogen receptor (ER), progesterone receptor (PgR), and proliferative index (Ki-67), was analyzed. Fifty-seven patients with palpable ER-positive IDC were randomized into three neoadjuvant treatment groups and received anastrozole or placebo or tamoxifen for twenty-one days. Biomarker status was obtained by comparing the immunohistochemical evaluation of samples collected before and after treatment, using the Allred scoring system. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS).
After treatment, the anastrozole group showed reduced ER and PgR expression (p < 0.05), and both the anastrozole and tamoxifen groups showed lower Ki-67 status. A significant reduction in PgR positivity (p < 0.05) was found in women with large WC and HC who were treated with anastrozole. Reduction in PgR positivity also tended to be associated with BMI (p = 0.09) in the anastrozole group. BMI, WC, HC and WHR correlated neither with biomarker levels in the tamoxifen and placebo groups nor with ER and Ki-67 status in the anastrozole group after primary endocrine treatment.
流行病学研究报告称，人体测量指标与表达激素受体的乳腺癌发生风险及相关死亡率之间存在正相关。然而，营养状况对内分泌治疗分子反应的影响尚未得到描述。
在接受他莫昔芬或阿那曲唑新辅助治疗前后，测量浸润性导管癌（IDC）患者的体重指数（BMI）、腰围（WC）、臀围（HP）和腰臀比（WHR），并分析其与雌激素受体（ER）、孕激素受体（PgR）和增殖指数（Ki-67）等预后因素的可能相关性。57例可触及的ER阳性IDC患者被随机分为三个新辅助治疗组，接受阿那曲唑或安慰剂或他莫昔芬治疗21天。通过使用奥尔雷德评分系统比较治疗前后采集样本的免疫组化评估结果，获得生物标志物状态。使用社会科学统计软件包（SPSS）进行统计分析。
治疗后，阿那曲唑组的ER和PgR表达降低（p < 0.05），阿那曲唑组和他莫昔芬组的Ki-67水平均降低。接受阿那曲唑治疗的WC和HC较大的女性中，PgR阳性率显著降低（p < 0.05）。在阿那曲唑组中，PgR阳性率的降低也倾向于与BMI相关（p = 0.09）。在初次内分泌治疗后，BMI、WC、HC和WHR与他莫昔芬组和安慰剂组的生物标志物水平均无相关性，与阿那曲唑组的ER和Ki-67状态也无相关性。
