Correlation of body mass index and leptin with tumor size and stage of disease in hormone-dependent postmenopausal breast cancer: preliminary results and therapeutic implications
Correlation of body mass index and leptin with tumor size and stage of disease in hormone-dependent postmenopausal breast cancer: preliminary results and therapeutic implications
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DOI：
10.1007/s00109-010-0611-8
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发表时间：
2010-07-01
影响因子：
4.7
通讯作者：
Mantovani, Giovanni
中科院分区：
文献类型：
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作者：
Maccio, Antonio;Madeddu, Clelia;Mantovani, Giovanni
肥胖被认为是绝经后女性雌激素依赖性乳腺癌最重要的风险和预后因素。脂肪因子，特别是瘦素，是肥胖和相关代谢紊乱影响乳腺癌风险及其预后的发病机制的中心。本前瞻性观察研究旨在探讨体重指数（BMI）、血清瘦素和促炎细胞因子水平与乳腺癌预后因素之间的关系。在这项研究中，98名绝经后和82名绝经前ER阳性乳腺癌患者参加了研究。在同一研究期间，同时招募了221名对照受试者。妇女在手术前、任何手术和全身治疗前接受基线测量。从病理报告中提取肿瘤的病理特征。在储存的空腹血液标本中测定瘦素和促炎细胞因子。绝经后乳腺癌患者的BMI、瘦素和白细胞介素6与肿瘤病理分级（pT）和TNM分期显著相关。多因素回归分析显示，BMI和瘦素是pT和TNM分期的独立预测变量，而IL-6不是。我们的研究结果似乎表明瘦素在绝经后雌激素阳性乳腺癌的发病机制中具有双重作用。事实上，瘦素反映了脂肪总量，这与芳香酶活性和随后的雌激素水平相关。进一步的研究是必要的，以澄清瘦素和白细胞介素-6在乳腺癌发生中的作用，并确定新的治疗选择，除了使用芳香化酶抑制剂，选择性地作用于脂肪因子驱动的途径。
Obesity is considered the most important risk and prognostic factor for estrogen-dependent breast cancer in postmenopausal women. Adipokines, in particular leptin, are at the center of the etiopathogenetic mechanisms by which obesity and related metabolic disorders influence breast cancer risk and its prognosis. The present prospective observational study aims to investigate the relationship between body mass index (BMI), serum levels of leptin and proinflammatory cytokines, and breast cancer prognostic factors. In the study, 98 postmenopausal and 82 premenopausal patients with ER-positive breast cancer participated. During the same study period, 221 control subjects were simultaneously recruited. Women underwent baseline measurements pre-operatively, before any surgical and systemic treatments. Pathologic characteristics of tumors were abstracted from pathology reports. Leptin and proinflammatory cytokines were assayed in stored fasting blood specimens. In postmenopausal breast cancer patients, BMI, leptin, and interleukin-6 significantly correlated with pathological tumor classification (pT) and TNM stage. Multivariate regression analysis showed that BMI and leptin, but not interleukin-6, were independent predictive variables of pT and TNM stage. Our results seem to suggest a twofold role of leptin in the etiopathogenesis of postmenopausal estrogen-positive breast cancer. Indeed, leptin reflects the total amount of fat mass, which correlates to aromatase activity and subsequent estrogens levels. Further studies are warranted to clarify the role of leptin and interleukin-6 in breast carcinogenesis and identify new therapeutic options, beyond the use of aromatase inhibitors, acting selectively on adipokine-driven pathways.