Badwe R A, Fentiman I S, Millis R R, Gregory W M
ICRF Clinical Oncology Unit, Guy's Hospital, London, UK.
Br J Cancer. 1997;75(6):910-3. doi: 10.1038/bjc.1997.160.
To examine the relationship between body weight and vascular invasion (VI) around tumours in post-menopausal women with operable breast cancer, a retrospective study was conducted of 393 patients treated in a breast unit between 1987 and 1991. Weight was measured at the time of diagnosis. Vascular invasion was recorded as being present or absent. Vascular invasion was seen in slightly more of the 50 perimenopausal patients than in the 343 post-menopausal women (44% vs 36%). In the tumour specimens from post-menopausal patients weighing <50 kg, VI was observed in 11% compared with 45% of those weighing more than 80 kg (P= 0.02). Furthermore, the 5-year survival of those with VI was 74% compared with 91% for those without (P < 0.0001). Menopausal status and body weight may influence survival in patients with breast cancer, possibly as a result of the presence of unopposed circulating oestrogens at the time of surgery. Oestrogens may alter cohesiveness of breast cancer cells and modulate secretion of proteases, thereby influencing invasive potential. Excision of tumours in such an environment may have a deleterious impact on survival.
为研究绝经后可手术乳腺癌患者的体重与肿瘤周围血管侵犯(VI)之间的关系,对1987年至1991年间在一家乳腺科接受治疗的393例患者进行了一项回顾性研究。在诊断时测量体重。记录血管侵犯情况为存在或不存在。50例围绝经期患者中血管侵犯的发生率略高于343例绝经后女性(44%对36%)。在体重<50kg的绝经后患者的肿瘤标本中,观察到血管侵犯的比例为11%,而体重超过80kg的患者中这一比例为45%(P=0.02)。此外,有血管侵犯患者的5年生存率为74%,无血管侵犯患者为91%(P<0.0001)。绝经状态和体重可能影响乳腺癌患者的生存,这可能是由于手术时存在无对抗的循环雌激素。雌激素可能改变乳腺癌细胞的黏附性并调节蛋白酶的分泌,从而影响侵袭潜能。在这种环境下切除肿瘤可能对生存产生有害影响。