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体质指数和绝对淋巴细胞计数可预测韩国乳腺癌患者的无病生存。

Body mass index and absolute lymphocyte count predict disease-free survival in Korean breast cancer patients.

机构信息

Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.

Department of Surgery, Sacred Heart Hospital, Hallym University, Dongtan, Republic of Korea.

出版信息

Br J Cancer. 2021 Jul;125(1):119-125. doi: 10.1038/s41416-021-01391-0. Epub 2021 Apr 19.

Abstract

BACKGROUND

Our study evaluated the association between body mass index (BMI) and absolute lymphocyte count (ALC) in breast cancer patients and healthy females. Additionally, we determined the prognostic value of these factors in breast cancer.

METHODS

We retrospectively identified 1225 primary invasive breast cancer patients and 35,991 healthy females. Factors including BMI and complete blood count associated with disease-free survival (DFS) were assessed using a multi-variable Cox proportional hazard model.

RESULTS

BMI and ALC were positively correlated in breast cancer patients and healthy females (both P < 0.001). In multi-variable analysis, overweight or obese participants had worse DFS (hazards ratio [HR], 1.98; 95% confidence interval [CI], 1.34-2.92; P = 0.001) than underweight or normal-weight individuals, but patients with high ALC had better DFS than those with low ALC (HR, 0.43; 95% CI, 0.29-0.65; P < 0.001). After risk stratification according to BMI/ALC, high-risk patients with high BMI/low ALC had worse DFS than others (HR, 2.48; 95% CI, 1.70-3.62; P < 0.001).

CONCLUSIONS

BMI and ALC were positive correlated, but their effect on breast cancer prognosis was opposite. Patients with high BMI/low ALC had worse DFS than others. Underlying mechanisms for effect of BMI/ALC on breast cancer prognosis should be studied in the future.

摘要

背景

本研究评估了体质量指数(BMI)与乳腺癌患者和健康女性绝对淋巴细胞计数(ALC)之间的关系。此外,我们还确定了这些因素在乳腺癌中的预后价值。

方法

我们回顾性地确定了 1225 例原发性浸润性乳腺癌患者和 35991 例健康女性。使用多变量 Cox 比例风险模型评估与无病生存(DFS)相关的 BMI 和全血细胞计数等因素。

结果

乳腺癌患者和健康女性的 BMI 和 ALC 呈正相关(均 P<0.001)。多变量分析显示,超重或肥胖患者的 DFS 较差(风险比 [HR],1.98;95%置信区间 [CI],1.34-2.92;P=0.001),而低 ALC 的患者DFS 优于高 ALC 的患者(HR,0.43;95%CI,0.29-0.65;P<0.001)。根据 BMI/ALC 进行风险分层后,高 BMI/低 ALC 的高危患者的 DFS 比其他患者差(HR,2.48;95%CI,1.70-3.62;P<0.001)。

结论

BMI 和 ALC 呈正相关,但对乳腺癌预后的影响相反。高 BMI/低 ALC 的患者的 DFS 比其他患者差。未来应研究 BMI/ALC 对乳腺癌预后影响的潜在机制。

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