中心性肥胖对妇女乳腺癌发病的影响因素分析

Analysis of the influencing factors of central obesity on the incidence of breast cancer in women

目的 探讨中心性肥胖和妇女乳腺癌发病的关系。方法 选取2018-07-03-2021-03-19在南京医科大学附属无锡人民医院(229例)、南京医科大学第四临床医学院(188例)就诊的417例乳腺癌妇女作为病例组。按照年龄相差≤2岁、民族相同、性别相同的原则选择同期进行健康体检的人群417名作为对照组。应用横断面调查方法,对2组调查对象进行问卷调查和体格检查,并进行乳腺癌发病异质性的影响因素分析。结果 在绝经前妇女中,腰围水平高是雌激素受体(ER-),孕激素受体(PR-,OR=1.782,P=0.004),基底样型患者(OR=3.412,P<0.001)发病的危险因素;臀围水平高是(ER-,PR-)患者发病的危险因素(OR=1.561,P=0.007);腰臀比水平高是(ER+,ER-)患者发病的保护因素(OR=0.532,P=0.001);腰臀比水平高是(ER-,PR-;OR=1.522,P=0.016)、基底样型患者(OR=2.167,P=0.029)发病的危险因素。在绝经后妇女中,腰围水平高是(ER+,PR+)患者发病的危险因素(OR=1.231,P=0.041);臀围水平高对肿瘤异质性发病无影响;腰臀比水平高是(ER+,PR+;OR=1.140,P=0.047)、Luminal B患者(OR=1.230,P=0.027)发病的危险因素。结论 中心性肥胖会增加妇女绝经前及绝经后的乳腺癌发病。保持健康的腰围可以降低妇女绝经前后乳腺癌的风险。

Objective To investigate the relationship between central obesity and breast cancer in women.Methods Totally 417 breast cancer women who treated in Wuxi People’s Hospital(229 cases) and the Fourth Clinical Medical College(188 cases) of Nanjing Medical University from July 3,2018 to March 19,2021 were slected as the case group.According to the principle of no more than 2 years of age difference, the same nationality, and the same sex, 417 people who underwent physical examination at the same time were selected as the control group.Cross-sectional survey method was applied.Questionnaire survey and physical examination were conducted for the two groups of respondents.The influencing factors of breast cancer heterogeneity were analyzed.Results For inpremenopausal women, high waist circumference was a risk factor for the onset of ER-,PR-(OR=1.782,P=0.004) and basal pattern(OR=3.412,P<0.001);The high level of hip circumference was a risk factor for ER-,PR-patients(OR=1.561,P=0.007);The higher waist-to-hip ratio level was the protective factor for patients with(ER+,ER-;OR=0.532,P=0.001);High waist-to-hip ratio level is a risk factor for(ER-,PR-;OR=1.522,P=0.016) and patients with basal pattern(OR=2.167,P=0.029).For postmenopausal women, high waist circumference level was a risk factor for the onset of(ER+,PR+) patients(OR=1.231,P=0.041);High level of hip circumference had no effect on tumor heterogeneity(P>0.05);High waist-to-hip ratio level was a risk factor for(ER+,PR+;OR=1.140,P=0.047) and Luminal B patients(OR=1.230,P=0.027).Conclusions Central obesity can increase the incidence of breast cancer in premenopausal and postmenopausal women.Maintaining healthy waist circumference can reduce the risk of breast cancer before and after menopause.