Tan Xin, Huang Danju, Zhang Fan, Zhao Yingzhu, Tan Mingjian, Li Hongwan, Zhang Hengyu, Wang Ke, Li Huimeng, Liu Dequan, Guo Rong, Tang Shicong
Department of Breast Surgery, the Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Kunming, China.
Department of Radiotherapy, the Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Kunming, China.
Gland Surg. 2021 Jan;10(1):23-34. doi: 10.21037/gs-20-488.
Overweight and obesity have become a major health issue in the past 30 years. Several studies have already shown that obesity is significantly associated with a higher risk of developing breast cancer. However, few studies have assessed the prognostic value of the body mass index (BMI) in Asian populations. The purpose of this study was to retrospectively analyze the impact of BMI on the prognosis of breast cancer in overweight, under 160 cm tall patients from southern China.
We retrospectively analyzed data from 525 breast cancer patients diagnosed between 2003 to 2010 in a multi-center of China. After applying the exclusion criteria, 315 patients with complete data were retained. Their clinical and pathological characteristics were compared using the chi-square test. Survival analysis was performed with the Kaplan-Meier method. Univariate and multivariate analyses were performed using Cox regression to calculate hormone receptor status, HER-2 status, lymph node status, age, BMI and tumor size hazard ratio (HR), and 95% confidence intervals (95% CI).
There was a strong correlation between BMI and age in the baseline feature analysis (P=0.001). After grouping the patients according to the molecular type of cancer, we found that in Luminal A and B, the BMI was related to age (P=0.002, P=0.010). The disease-free survival (DFS) and overall survival (OS) of patients with different BMI were not significantly different. This conclusion was also reached by pairwise comparison of subgroups. There was no significant difference in recurrence in patients from different BMI groups. We did not find a critical weight threshold associated with higher risk of recurrence. There were no statistically significant differences in treatment among the three BMI groups of overweight patients.
We found that the BMI of Chinese breast cancer patients is related to age but not prognosis.
在过去30年中，超重和肥胖已成为一个主要的健康问题。多项研究已表明，肥胖与患乳腺癌的较高风险显著相关。然而，很少有研究评估体重指数（BMI）在亚洲人群中的预后价值。本研究的目的是回顾性分析BMI对中国南方身高低于160 cm的超重乳腺癌患者预后的影响。
我们回顾性分析了2003年至2010年在中国多中心诊断的525例乳腺癌患者的数据。应用排除标准后，保留了315例数据完整的患者。使用卡方检验比较他们的临床和病理特征。采用Kaplan-Meier方法进行生存分析。使用Cox回归进行单因素和多因素分析，以计算激素受体状态、HER-2状态、淋巴结状态、年龄、BMI和肿瘤大小的风险比（HR）以及95%置信区间（95%CI）。
在基线特征分析中，BMI与年龄之间存在强相关性（P = 0.001）。根据癌症分子类型对患者进行分组后，我们发现，在Luminal A和B型中，BMI与年龄相关（P = 0.002，P = 0.010）。不同BMI患者的无病生存期（DFS）和总生存期（OS）无显著差异。通过亚组的两两比较也得出了这一结论。不同BMI组患者的复发情况无显著差异。我们未发现与较高复发风险相关的临界体重阈值。超重患者的三个BMI组在治疗方面无统计学显著差异。
我们发现中国乳腺癌患者的BMI与年龄相关，但与预后无关。
