体质量指数与乳腺癌病理特征相关性分析

Correlation between body mass index and pathological features of breast cancer

目的分析不同体质量指数(BMI)乳腺癌患者相关临床病理特征,探求BMI与乳腺癌发病相关因素。方法回顾性分析暨南大学第一附属医院2012年12月至2017年12月收治的335例初次确诊并接受手术治疗的乳腺癌患者临床资料,其中乳腺原位癌29例,乳腺浸润性癌306例。根据中国地区肥胖诊断标准及诊断乳腺癌时BMI不同分为3组,即BMI<24 kg/m^2组(低体重/正常体重)212例(其中原位癌19例,浸润性癌193例),24 kg/m^2≤BMI<28 kg/m^2组(超重)98例(其中原位癌10例,浸润性癌88例),BMI≥28 kg/m^2组(肥胖)25例(其中原位癌0例,浸润性癌25例),比较3组患者临床病理特征。结果浸润性乳腺癌组平均BMI(23.30±3.28)kg/m^2高于原位癌组平均BMI(22.31±2.51)kg/m^2,差异具有统计学意义。通过分析浸润性乳腺癌组ER状态、PR状态、HER-2状态、有无淋巴结转移、月经状态等病理特征,发现ER状态、PR状态、HER-2状态、Ki-67数值、有无脉管癌栓、有无淋巴结转移、分子分型、肿瘤大小、TNM分期等在三个不同BMI值组别间无统计学差异,但月经状态在这三组间有统计学差异(P<0.05),提示超重及肥胖可能与绝经后女性患者乳腺癌有关。结论浸润性乳腺癌组平均BMI值高于原位癌组,超重及肥胖与绝经后女性乳腺癌有关,通过测定BMI可以帮助我们快速筛查乳腺癌高危人群,为乳腺癌的预防及诊治提供科学依据。

Objective To analyze the clinicopathological characteristics of breast cancer patients with different body mass index(BMI),and to explore the correlation between BMI and breast cancer.Methods We performed a retrospective analysis of 335 breast cancer patients admitted to the First Affi liated Hospital of Jinan University from December 2012 to December 2017,including 29 cases of breast cancer in situ and 306 cases of invasive breast cancer.According to the diagnostic criteria of obesity and BMI of breast cancer in China,Three groups were divided according to body mass index(BMI)when breast cancer diagnosis:212 cases of BMI﹤24 kg/m^2(low weight/normal weight)(including 19 cases of carcinoma in situ and 193 cases of invasive cancer),98 cases of 24 kg/m^2≤BMI﹤28 kg/m^2(10 cases of carcinoma in situ and 88 cases of invasive cancer),and 25 cases of BMI≤28 kg/m^2(obesity)(including 0 cases of carcinoma in situ and 25 cases of invasive cancer).Compare the clinicopathological characteristics of 3 group.Results The average BMI of invasive breast cancer group was(23.30±3.28)kg/m^2,which was higher than that of in situ carcinoma group(22.31±2.51)kg/m^2.The diff erence was statistically signifi cant.By analyzing the pathological characteristics of ER,PR,HER-2,lymph node metastasis and menstrual status in invasive breast cancer group,we found that ER,PR,HER-2,Ki-67,vascular cancer thrombus,lymph node metastasis,molecular subtyping,tumor size and TNM staging were not found statistical signifi cance among the three groups with diff erent BMI values.But the menstrual status between the three groups had statistical diff erence(P﹤0.05),suggesting that overweight and obesity may be risk factors for breast cancer in postmenopausal women.Conclusions The average BMI value of invasive breast cancer group is higher than that of carcinoma in situ.Overweight and obesity are related to breast cancer in postmenopausal women.By measuring BMI,it can help us to quickly screen high-risk groups of breast cancer and provide scientifi c basis for prevention,diagnosis and treatment of breast cancer.