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目的:评价体重指数(BMI)与乳腺癌预后的关系。方法:回顾性分析672例乳腺癌患者的临床病例资料及随访信息,根据BMI分为超重肥胖组(BMI≥25.0 kg/m2)与正常组(BMI<25.0 kg/m~2)。Kaplan-Me ie r法比较两组生存差异,非条件Logis tic回归分析不同BMI分组乳腺癌OS的相关因素。结果:456例患者纳入分析,超重肥胖组(286例)与正常组(170例)一般临床病理特征差异无统计学意义(P<0.05)。中位随访60.9个月,两组无病生存时间(DFS)及总生存时间(OS)差异无统计学意义(P=0.927、0.336)。年龄、月经状态、ER及HER2等与不同BMI分类乳腺癌的OS无关。BMI分类不影响新辅助化疗病理性完全缓解(pCR)率,但与新辅助化疗ER阳性乳腺癌的DFS(P=0.013)及OS(P=0.022)有关。超重肥胖组生存较差(OR=0.16,95%CI:0.03~0.93,P=0.042)。内分泌治疗亚组中超重肥胖组病例生存风险降低(OR=0.077,95%CI:0.08~0.714,P=0.024)。结论:BMI≥25.0 kg/m~2是ER阳性乳腺癌新辅助化疗后DFS和OS的危险因素,可能与内分泌治疗获益不足有关。
Objective: To evaluate the relationship between body mass index (BMI) and the prognosis of breast cancer. Methods: Clinical data and follow-up information of 672 breast cancer patients were retrospectively analyzed. According to BMI, they were divided into overweight and obesity group (BMI≥25.0 kg / m2) and normal group (BMI <25.0 kg / m2). Kaplan-Meier method was used to compare the two groups of survival differences, non-conditional Logistic regression analysis of different BMI group breast cancer OS related factors. Results: 456 patients were included in the analysis. There was no significant difference in the clinicopathological features between the overweight and obesity group (n = 286) and the normal group (n = 170) (P <0.05). The median follow-up was 60.9 months. There was no significant difference in DFS and OS between the two groups (P = 0.927,0.336). Age, menstrual status, ER and HER2, etc. have nothing to do with the OS of breast cancer with different BMI classification. The BMI classification did not affect the rate of neoadjuvant chemotherapy-induced complete remission (pCR) but was associated with DFS (P = 0.013) and OS (P = 0.022) in neoadjuvant chemotherapy-positive breast cancer. The overweight and obesity group had poorer survival (OR = 0.16, 95% CI: 0.03-0.93, P = 0.042). Survival risk was lower in the overweight and obesity group (OR = 0.077, 95% CI: 0.08-0.714, P = 0.024) in the endocrine therapy subgroup. Conclusion: BMI≥25.0 kg / m ~ 2 is a risk factor for DFS and OS after neoadjuvant chemotherapy in patients with ER positive breast cancer, which may be related to the insufficiency of endocrine therapy.