Newman S C, Lees A W, Jenkins H J
Department of Psychiatry, Mackenzie Health Sciences Centre, University of Alberta, Edmonton, Canada.
Int J Epidemiol. 1997 Jun;26(3):484-90. doi: 10.1093/ije/26.3.484.
Epidemiological studies have demonstrated that obesity and low oestrogen receptor level adversely affect survival from breast cancer. Few studies have examined the joint effects of these variables.
A cohort study was conducted in which 1169 breast cancer patients from the Northern Alberta Breast Cancer Registry were followed for an average of 4.4 years. A number of variables related to breast cancer incidence and prognosis were studied. Body mass index (BMI) was used as a proxy measure of obesity.
A Cox regression analysis resulted in a final model with terms for size of tumour, number of positive axillary nodes, oestrogen receptor level, BMI, and age at diagnosis, plus an interaction term for node status and BMI. Having relatively less oestrogen receptor increased the hazard ratio by 1.8 (95% CI: 1.4-2.3); for woman with no positive nodes, being in the highest quartile of BMI increased the hazard ratio by 2.5 (95% CI: 1.2-5.2) compared to the lowest quartile.
BMI and oestrogen receptor level independently influence survival from breast cancer, but BMI affects survival only in patients with no positive axillary nodes.
流行病学研究表明，肥胖和低雌激素受体水平会对乳腺癌患者的生存产生不利影响。很少有研究探讨这些变量的联合影响。
开展了一项队列研究，对来自北阿尔伯塔乳腺癌登记处的1169例乳腺癌患者进行了平均4.4年的随访。研究了一些与乳腺癌发病率和预后相关的变量。体重指数（BMI）被用作肥胖的替代指标。
Cox回归分析得出了一个最终模型，其中包含肿瘤大小、腋窝阳性淋巴结数量、雌激素受体水平、BMI和诊断时年龄等项，以及淋巴结状态和BMI的交互项。雌激素受体水平相对较低会使风险比增加1.8（95%置信区间：1.4 - 2.3）；对于无阳性淋巴结的女性，BMI处于最高四分位数时的风险比与最低四分位数相比增加了2.5（95%置信区间：1.2 - 5.2）。
BMI和雌激素受体水平独立影响乳腺癌患者的生存，但BMI仅对无腋窝阳性淋巴结的患者的生存有影响。
