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[1]陈莉娜,于治灏,王 欣.肥胖对保乳治疗乳腺癌患者预后的影响分析[J].天津医科大学学报,2017,23(03):208-213.
　CHEN Li-na,YU Zhi-hao,WANG Xin. ?Effect of obesity on prognosis of breast cancer patients treated with breast conserving therapy [J].Journal of Tianjin Medical University,2017,23(03):208-213.
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肥胖对保乳治疗乳腺癌患者预后的影响分析(PDF)
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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
23卷
期数:
2017年03期
页码:
208-213
栏目:
临床医学
出版日期:
2017-05-18

文章信息/Info

Title:

?Effect of obesity on prognosis of breast cancer patients treated with breast conserving therapy

文章编号:
1006-8147(2017)03-0208-06
作者:
陈莉娜; 于治灏; 王 欣
(天津医科大学肿瘤医院乳腺肿瘤一科,国家肿瘤临床医学研究中心,天津市“肿瘤防治”重点实验室,天津市恶性肿瘤临床医学研究中心，乳腺癌防治教育部重点实验室,天津 300060)
Author(s):

CHEN Li-na;  YU Zhi-hao;  WANG Xin

（The First Department of Breast Cancer, Cancer Institude and Hospital, Tianjin Medical University, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy , Tianjin,s Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Ministry of Education, Tianjin 300060, China)

关键词:
乳腺癌' target="_blank" rel="external">">乳腺癌; 保乳治疗; 体质指数; 局部复发; 远处转移; 死亡
Keywords:
breast cancer; breast conserving therapy; obesity; body mass index;  local recurrence;  distant metastasis; mortality
分类号:
R737.9
DOI:
-
文献标志码:
A
摘要:
目的：分析不同体质指数（BMI）保乳治疗的乳腺癌患者临床病理特征及预后。方法：回顾性分析 716例行保乳治疗的乳腺癌患者的临床资料，根据诊断乳腺癌时 BMI不同分3组，即BMI<24 kg/m2组（正常体质量）384例，，24 kg/m2≤ BMI <28 kg/m2组（超重）237例，BMI ≥28 kg/m2组（肥胖）95例，比较3组患者临床病理特征及生存情况。结果：716例患者中， BMI ≥28 kg/m2的患者诊断乳腺癌时年龄偏大，且绝经患者所占比例较大，其肿瘤较大，易出现腋窝淋巴结转移，病期多较晚，切缘阳性的患者所占比例也较大。另外，BMI ≥28 kg/m2的患者中未完成化疗及放疗的比例较其他两组高。BMI<24 kg/m2、24 kg/m2≤ BMI <28 kg/m2、BMI ≥28 kg/m2的患者5年无局部复发生存率分别为92.7%、91.1%、76.8%（P < 0.001），5年无远处转移生存率为93.5%、86.9%、77.9%（P <0.001），5年总生存率分别为96.9%、92.4%、89.5%（P = 0.006）。多因素分析显示，与BMI ≥28 kg/m2的患者相比，BMI <24 kg/m2组及24 kg/m2≤ BMI <28 kg/m2组患者局部复发风险显著降低，但死亡风险均未明显下降；此外，BMI <24 kg/m2的患者与BMI ≥28 kg/m2的患者相比，远处转移风险明显降低。结论：BMI ≥28 kg/m2的患者行保乳术后5年局部复发及远处转移风险较高，但5年死亡风险并未增加。
Abstract:
?Objective: To analyze the prognosis of breast cancer patients receiving breast conserving treatment according to their body mass index (BMI). Methods: Clinical data of 716 patients with breast conserving therapy were analyzed retrospectively. According to BMI when breast cancer was diagnosed, three groups were defined: 384 cases were with BMI <24 kg/m2(normal weight group), 237 cases were 24 kg/m2≤ BMI <28 kg/m2 (overweight group) and 95 cases were BMI ≥28 kg/m2(obesity group). Clinicopathological characteristics and survival of the three groups were compared. Results: Patients with BMI ≥28 kg/m2 tended to have larger tumors, positive lymph nodes metastasis and advanced disease. Moreover, the proportion of patients with positive margins was also higher in patients with BMI ≥28 kg/m2. In addition, more patients with BMI ≥28 kg/m2 did not undergo chemotherapy or radiotherapy, compared with other two groups. The 5-year local recurrence-free survival were 92.7%，91.1%，76.8% for patients with BMI <24 kg/m2, 24≤ BMI <28 kg/m2, BMI ≥28 kg/m2, respectively (P < 0.001). Five-year distant metastasis-free survival were 93.5%, 86.9%, 77.9% for patients with BMI<24 kg/m2, 24≤BMI<28 kg/m2, BMI ≥28 kg/m2, respectively (P < 0.001). Five-year overall survival were 96.9%, 92.4%, 89.5% for patients with BMI<24 kg/m2, 24≤ BMI <28 kg/m2, BMI ≥28 kg/m2, respectively (P = 0.006). Multivariate analysis showed that 5-year local recurrence risks significantly decreased in patients with BMI<24 kg/m2 and 24≤ BMI <28 kg/m2 compared with that of patients with BMI ≥28 kg/m2, while the risk of breast cancer mortality did not significantly decrease. Besides, the risk of metastasis in patients with BMI <24 kg/m2 significantly decreased as compared to that of patients with BMI≥28 kg/m2. Conclusion: The risks of 5-year local recurrence and distant metastasis in obese patients (BMI ≥28 kg/m2) after breast conserving treatment are relatively high, while the risk of mortality within 5 years may not significantly increase.

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备注/Memo

备注/Memo:

基金项目 国家自然科学基金资助项目（81472472）

作者简介 陈莉娜（1983-），女，硕士在读，研究方向：乳腺肿瘤外科学；通信作者：王欣, E-mail: wangxin@tjmuch.com。

更新日期/Last Update: 2017-05-18