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体脂变化与乳腺癌手术后疾病进展之间的关系受绝经状态的调节。

Association between changes in body fat and disease progression after breast cancer surgery is moderated by menopausal status.

机构信息

Department of Nursing, Fu Jen Catholic University, New Taipei City, Taiwan.

Department of Internal Medicine, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.

出版信息

BMC Cancer. 2017 Dec 18;17(1):863. doi: 10.1186/s12885-017-3869-1.

Abstract

BACKGROUND

Obesity is linked to poor disease outcomes in breast cancer patients. However, this link was mostly based on body weight or BMI rather than body-fat. The purpose of this study was to evaluate the relationship between body-fat gain and disease progression in Taiwanese women after breast cancer surgery and how this relationship is influenced by menopausal status.

METHODS

Body fat percentage was measured 1 day before and 6 months after surgery in 131 women with stages 0-III breast cancer. Disease outcomes (metastasis and death) were assessed by chart review and telephone contact 7 to 8 years after diagnosis. These data were analyzed by multivariate Cox proportional hazard model analysis.

RESULTS

The percentage of women with over 5% gain in body-fat was 56% for premenopausal and 42% for postmenopausal. Rates of distant metastasis and all-cause mortality were 17.6 and 9.9%, respectively over the follow-up period. Distant metastases were predicted in postmenopausal but not premenopausal women with breast cancer by increased body fat percentage (HR = 1.3, p = 0.035), after controlling other potential covariates, including disease severity, estrogen receptor expression, progesterone receptors expression, age, and exercise habit before diagnosis. Survival was not significantly associated with body-fat percentage gains.

CONCLUSIONS

Our results suggest that increased body fat percentage 6 months after breast surgery is an important predictor of distant metastasis in postmenopausal Taiwanese women with breast cancer. Clinicians may need to measure patients' body fat periodically. Our findings should be validated in studies with a longer follow-up time.

摘要

背景

肥胖与乳腺癌患者的不良疾病结局有关。然而,这种关联主要基于体重或 BMI,而不是体脂肪。本研究旨在评估台湾女性乳腺癌手术后体脂肪增加与疾病进展的关系,以及绝经状态如何影响这种关系。

方法

对 131 例 0-III 期乳腺癌女性在手术前 1 天和手术后 6 个月测量体脂肪百分比。通过病历回顾和诊断后 7-8 年的电话联系评估疾病结局(转移和死亡)。这些数据通过多变量 Cox 比例风险模型分析进行分析。

结果

术前体脂肪增加 5%以上的女性中,绝经前为 56%,绝经后为 42%。随访期间,远处转移和全因死亡率分别为 17.6%和 9.9%。在控制其他潜在混杂因素,包括疾病严重程度、雌激素受体表达、孕激素受体表达、年龄和诊断前的运动习惯后,远处转移仅在绝经后乳腺癌女性中预测到体脂肪百分比增加(HR=1.3,p=0.035)。生存与体脂肪百分比增加无显著相关性。

结论

我们的研究结果表明,乳腺癌手术后 6 个月体脂肪百分比增加是台湾绝经后女性远处转移的重要预测因素。临床医生可能需要定期测量患者的体脂肪。我们的研究结果需要在随访时间更长的研究中进一步验证。

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