Donegan W L, Johnstone M F, Biedrzycki L
Am J Clin Oncol. 1983 Feb;6(1):19-24.
The poor prognosis of obese women with carcinoma of the breast has yet to find a satisfactory explanation. It is suspected that the hormonal milieu of these patients may favor tumor growth. This investigation explored the relationship between obesity, urinary estrogen excretion, and tumor estrogen receptors (ER) in women treated with mastectomy for carcinoma of the breast. The ER levels determined from the primary cancers of 129 women treated with mastectomy were compared with the obesity index (O.I.) of these patients, i.e., weight in pounds/height in inches. In addition, 24-hour total urinary estrogen determinations were performed in 30 postmenopausal women and compared with their O.I. and ER. A weak direct correlation was found between ER and O.I. in postmenopausal women. The urinary estrogens of postmenopausal women were correlated directly with obesity index, but no relationship could be established between urinary estrogens and the ER content of breast cancers. It is concluded that the excess estrogen production of obese women may be responsible for their poor prognosis by promoting tumor growth. The high tumor ER concentrations associated with obesity suggest a high frequency of hormonally sensitive tumors.
肥胖女性乳腺癌预后较差，这一现象尚未找到令人满意的解释。据推测，这些患者的激素环境可能有利于肿瘤生长。本研究探讨了接受乳腺癌乳房切除术的女性中肥胖、尿雌激素排泄与肿瘤雌激素受体（ER）之间的关系。将129例接受乳房切除术的女性原发性癌症所测定的ER水平与其肥胖指数（O.I.），即体重（磅）/身高（英寸）进行比较。此外，对30名绝经后女性进行了24小时尿总雌激素测定，并将其与她们的O.I.和ER进行比较。绝经后女性的ER与O.I.之间存在微弱的正相关。绝经后女性的尿雌激素与肥胖指数直接相关，但尿雌激素与乳腺癌的ER含量之间未发现相关性。结论是，肥胖女性雌激素产生过多可能通过促进肿瘤生长导致其预后较差。与肥胖相关的高肿瘤ER浓度表明激素敏感肿瘤的发生率较高。
