乳腺密度、BMI、年龄、绝经状态与乳腺癌相关性分析

Analysis on the correlation between mammographic density,BMI,age,menopausal status and breast cancer

目的：探讨乳腺密度是否是乳腺癌患病的危险因素及其与年龄、身高体重指数、绝经状态的相关性。方法：回顾性分析544例乳腺钼靶受检者的临床资料,其中227例经病理检测确诊为乳腺癌,317例乳房体检无阳性发现。将受检者分为≤35岁、35岁-45岁、45岁-55岁、≥55岁4个年龄段;按照BI-RADS标准,将乳腺密度分成≤25%、25%-50%、51%-75%及〉75%共4个等级;BMI值分为正常（〈24 kg/m2）、超重（24-27 kg/m2）、肥胖（≥27 kg/m2）3个等级进行统计分析。结果：乳腺癌组与正常对照组乳腺密度的构成比有统计学差异（χ2=10.952,P=0.012）,乳腺密度〉51%时,患乳腺癌的风险将逐步上升（OR=2.512-2.684,95%CI：1.044-6.142,P〈0.05）;乳腺密度与年龄、BMI呈负相关（r=-0.620、r=-0.251,P〈0.001）;乳腺癌组BMI值高于对照组（Z=-2.218,P=0.027）,差异在绝经后更显著（Z=-3.076,P=0.002）,乳腺癌组绝经妇女的BMI值高于同组未绝经者（Z=-3.09,P=0.002）。结论：乳腺密度是乳腺癌发病的危险因素,且与年龄、身高体重指数、绝经状态等有相关性。

Objective： To explore whether mammographic density is one of risk factors of breast cancer and its correlation between age,body mass index（ BMI） and menopausal status. Methods： The clinical data of 544 patients who received digital mammography were analyzed retrospectively,227 patients wee diagnosed as breast cancer definitely by pathological examination,317 patients had no positive discover by breast examination. The patients were divided into four age groups： ≤35- year- old group,35- 45- year- old group,45- 55-year- old group and ≥55- year- old group; according to BI- RADS standard,mammographic density was divided into four grades： ≤25%,25%- 50%,51%- 75% and 75%; the patients were divided into three groups according to BMI value： normal weight group（ 24 kg /m2）,overweight group（ 24-27 kg/m2） and obesity group（ ≥27 kg/m2）. Results： There was statistically significant difference in the proportion of mammographic density between breast cancer group and control group（ χ2= 10. 952,P = 0. 012）,the risk of breast cancer increased when mammographic density was greater than 51%（ OR = 2. 512- 2. 684,95% CI： 1. 044- 6. 142,P〈0. 05）. Mammographic density was negatively correlated with age and BMI（ r =- 0. 620,P〈0. 001; r =- 0. 251,P〈0. 001）; BMI in breast cancer group was statistically significantly higher than that in control group（ Z =- 2. 218,P = 0. 027）,the difference was more significant during postmenopausal period（ Z =- 3. 076,P = 0. 002）,BMI of postmenopausal women in breast cancer group was statistically significantly higher than that of premenopausal women（ Z =- 3. 09,P = 0. 002）. Conclusion： Mammographic density is a risk factor of breast cancer,which is correlated with age,BMI and menopausal status.