Association of adiposity, dysmetabolisms, and inflammation with aggressive breast cancer subtypes: a cross-sectional study
Association of adiposity, dysmetabolisms, and inflammation with aggressive breast cancer subtypes: a cross-sectional study
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DOI：
10.1007/s10549-016-3802-3
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发表时间：
2016-05-01
影响因子：
3.8
通讯作者：
Sant, Milena
中科院分区：
文献类型：
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作者：
Agresti, Roberto;Meneghini, Elisabetta;Sant, Milena
肥胖和代谢综合征是乳腺癌（BC）的风险和预后因素，并与慢性炎症有关。我们研究了不同BC亚型与肥胖、代谢障碍和炎症标志物之间的关系。我们分析了1779例原发性浸润性乳腺癌患者在一个单一的机构，为他们的人体测量和临床病理数据存档。通过ER、PR、HER 2和Ki 67的免疫组化染色对BC亚型进行分类，并通过多项Logistic回归评估其与研究标志物的关系。以管腔A作为参考，计算校正的比值比（OR）和95%置信区间（CI）。所有比管腔A更具侵袭性的亚型在年轻女性（< 45岁）中的发生率明显高于老年女性。绝经前，管腔B HER 2阴性肿瘤与腰围增大呈正相关，（OR 2.55，95% CI 1.53-4.24）和胰岛素抵抗（OR 1.90，95% CI 1.05-3.41）;管腔型B HER 2阳性肿瘤伴大腰围（OR 2.11，95% CI 1.03-4.35）和三阴性肿瘤伴超重（OR 3.04，95% CI 1.43-6.43）和高C反应蛋白（p趋势= 0.026）。在年龄< 65岁的绝经后女性中，腔型B HER 2阴性（OR 1.94，95% CI 1.16-3.24）和腔型B HER 2阳性肿瘤（OR 2.48，95% CI 1.16-5.27）与代谢综合征正相关。代谢障碍和炎症可能与不同的BC亚型有关。绝经前，三阴性癌症与肥胖和慢性炎症有关，侵袭性管腔亚型与腹部肥胖有关。绝经后，在年龄< 65岁的女性中，后一种亚型与代谢综合征有关。控制肥胖和代谢异常可以降低侵袭性BC亚型的风险，改善预后。
Obesity and metabolic syndrome are risk and prognostic factors for breast cancer (BC) and are associated with chronic inflammation. We investigated the association between distinct BC subtypes and markers of adiposity, dysmetabolisms, and inflammation. We analyzed 1779 patients with primary invasive BC treated at a single institution, for whom anthropometric and clinical-pathological data were archived. BC subtypes were classified by immunohistochemical staining of ER, PR, HER2, and Ki67, and their relations with the study markers were assessed by multinomial logistic regression. Adjusted odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated taking luminal A as reference. All subtypes more aggressive than luminal A were significantly more frequent in younger (< 45 years) than older women. Before menopause, luminal B HER2-negative tumors were positively associated with large waist (OR 2.55, 95 % CI 1.53-4.24) and insulin resistance (OR 1.90, 95 % CI 1.05-3.41); luminal B HER2-positive tumors with large waist (OR 2.11, 95 % CI 1.03-4.35) and triple-negative tumors with overweight (OR 3.04, 95 % CI 1.43-6.43) and high C-reactive protein (p trend = 0.026). In postmenopausal women aged < 65, luminal B HER2-negative (OR 1.94, 95 % CI 1.16-3.24) and luminal B HER2-positive tumors (OR 2.48, 95 % CI 1.16-5.27) were positively related with metabolic syndrome. Dysmetabolisms and inflammation may be related to different BC subtypes. Before menopause, triple-negative cancers were related to obesity and chronic inflammation, and aggressive luminal subtypes to abdominal adiposity. After menopause, in women aged < 65 these latter subtypes were related to metabolic syndrome. Control of adiposity and dysmetabolism can reduce the risk of aggressive BC subtypes, improving the prognosis.