College of Public Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou City, 450001, Henan Province, China.
School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China.
BMC Cancer. 2020 Jun 29;20(1):601. doi: 10.1186/s12885-020-07064-0.
Since body mass index (BMI) is a convincing risk factor for breast cancer, it is speculated to be associated with lymph node metastasis. However, epidemiological studies are inconclusive. Therefore, this study was conducted to investigate the effect of BMI on the lymph node metastasis risk of breast cancer.
Cohort studies that evaluating BMI and lymph node metastasis in breast cancer were selected through various databases including PubMed, PubMed Central (PMC), Web of science, the China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals (VIP) and Wanfang Data Knowledge Service Platform (WanFang) until November 30, 2019. The two-stage, random effect meta-analysis was performed to assess the dose-response relationship between BMI and lymph node metastasis risk. Between-study heterogeneity was assessed using I. Subgroup analysis was done to find possible sources of heterogeneity.
We included a total of 20 studies enrolling 52,904 participants. The summary relative risk (RR) (1.10, 95%CI: 1.06-1.15) suggested a significant effect of BMI on the lymph node metastasis risk of breast cancer. The dose-response meta-analysis (RR = 1.01, 95%CI: 1.00-1.01) indicated a positive linear association between BMI and lymph node metastasis risk. For every 1 kg/m increment of BMI, the risk of lymph node metastasis increased by 0.89%. In subgroup analyses, positive linear dose-response relationships between BMI and lymph node metastasis risk were observed among Asian, European, American, premenopausal, postmenopausal, study period less than 5 years, and more than 5 years groups. For every 1 kg/m increment of BMI, the risk of lymph node metastasis increased by 0.99, 0.85, 0.61, 1.44, 1.45, 2.22, and 0.61%, respectively.
BMI significantly increases the lymph node metastasis risk of breast cancer as linear dose-response reaction. Further studies are needed to identify this association.
由于体重指数（BMI）是乳腺癌的一个有说服力的风险因素，因此推测它与淋巴结转移有关。然而，流行病学研究尚无定论。因此，本研究旨在探讨 BMI 对乳腺癌淋巴结转移风险的影响。
通过 PubMed、PubMed Central（PMC）、Web of Science、中国国家知识基础设施（CNKI）、中国科学期刊（VIP）和万方数据知识服务平台（WanFang）等多种数据库，选择评估 BMI 和乳腺癌淋巴结转移的队列研究。采用两阶段、随机效应荟萃分析评估 BMI 与淋巴结转移风险之间的剂量-反应关系。采用 I 进行组间异质性评估。进行亚组分析以寻找可能的异质性来源。
共纳入 20 项研究，共纳入 52904 名参与者。汇总相对风险（RR）（1.10，95%CI：1.06-1.15）表明 BMI 对乳腺癌淋巴结转移风险有显著影响。剂量-反应荟萃分析（RR=1.01，95%CI：1.00-1.01）表明 BMI 与淋巴结转移风险之间呈正线性关系。BMI 每增加 1kg/m，淋巴结转移风险增加 0.89%。在亚组分析中，BMI 与淋巴结转移风险之间存在正线性剂量-反应关系，包括亚洲人、欧洲人、美国人、绝经前、绝经后、研究期少于 5 年和超过 5 年的人群。BMI 每增加 1kg/m，淋巴结转移风险分别增加 0.99、0.85、0.61、1.44、1.45、2.22 和 0.61%。
BMI 与乳腺癌淋巴结转移风险呈显著线性剂量-反应关系。需要进一步研究以确定这种关联。
