肥胖与乳腺癌患者腋窝淋巴结状态的相关性研究

Impact of obesity on axillary lymph node status in breast cancer patients

目的 ：肥胖和乳腺癌密切相关,但其与腋窝淋巴结状态的关系尚不清楚。本文探讨了肥胖与乳腺癌患者腋窝淋巴结状态的相关性。方法：入组306例乳腺癌患者,根据体质指数（body mass index,BMI）分组,回顾性分析患者BMI与肿瘤病理特征,尤其与腋窝淋巴结状态之间的关系。结果：患者平均年龄48岁（范围21~81岁）,平均BMI 25.1,在确诊乳腺癌时54.4%（n=166）的患者BMI正常,45.6%（n=140）的患者BMI≥25。入组患者中,59.6%无腋窝淋巴结转移,40.4%有腋窝淋巴结转移。肥胖组（BMI≥25）腋窝淋巴结切除数量大于正常体重组（BMI〈25.0）,分别为（20.4±11.4）个和（18.1±10.5）个,差异有统计学意义（P〈0.01）。腋窝淋巴结转移的数量在正常体重组、肥胖组分别为（3.15±6.1）、（3.7±6.4）个（P〉0.05）。正常体重组中有、无淋巴结转移的患者比例分别是39.2%和60.8%;肥胖组中分别为41.4%和58.6%（P〉0.05）,有、无淋巴结转移与BMI没有相关性。结论：肥胖乳腺癌患者中切除的腋窝淋巴结数量较正常体重者多,但是发生淋巴结转移的患者比例、淋巴结转移数量与BMI之间均没有相关性。

Objective：Although many studies have shown association of obesity and breast cancer,the association with the axillary lymph node status is not clear. We examined the relationship of the axillary lymph node status and obesity and other possible factors in breast cancer patients. Methods：In this retrospective cohort study, 306 breast cancer patients were included. Patients were grouped according to their body mass index（BMI） values at the time of diagnosis. We analyzed the relationship between BMI and patient and tumor characteristics,especially axillary lymph node status. Results：The median patient age was 48 years （range 21-81）. Median BMI of the patients was 25.1 and 54.4%（N = 166）of them had normal BMI,45.6%（n = 140）were BMI 〉 25. Of the patients,59.6% had no lymph node metastasis, and 40.4% had lymph node metastasis. The total number of lymph nodes removed was higher in the obese group （BMI〉~ 25）and this difference was statistically significant （20.4 ＋ 11.4 vs. 18.1 _＋ 10.5,P 〈 0.01）. However,there was no statistically significant correlation between the number of metastatic lymph nodes and BMI（P 〉 0.05）. Conclusion：The number of dissected lymph nodes was higher in obese patients but there was no correlation between metastatic lymph node number and BMI.