Serum lipids and outcome of early-stage breast cancer: Results of a prospective cohort study
Serum lipids and outcome of early-stage breast cancer: Results of a prospective cohort study
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DOI：
10.1007/s10549-005-6654-9
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发表时间：
2005-11-01
影响因子：
3.8
通讯作者：
Goodwin, PJ
中科院分区：
文献类型：
--
作者：
Bahl, M;Ennis, M;Goodwin, PJ
目的。早期乳腺癌患者的预后受胰岛素和身体质量指数（BMI）的影响。在胰岛素抵抗综合征（IRS）中，高水平的血清胰岛素和肥胖通常与血脂异常共存，但脂质对乳腺癌预后的影响尚不清楚。在这里，我们研究血清总胆固醇（TC）和甘油三酯（TG）水平是否影响乳腺癌的预后。患者和方法。研究人员从1989年7月至1996年6月收集了520名患有T1-T3期、N0-N1期、M0期乳腺癌的无已知高脂血症或糖尿病的妇女。基线时采集空腹血。前瞻性随访受试者，观察复发情况（局部、局部、远处）和死亡情况。采用Cox模型计算TC和TG水平对预后的影响。双侧显著性水平为0.025。TC与年龄（Spearman’s r = 0.44）、肿瘤分级低（p = 0.01）相关，TG与胰岛素（r = 0.43）、BMI （r = 0.45）相关。中位随访8.7年，TC和TG在调整年龄、肿瘤相关变量、BMI或空腹胰岛素水平前后与乳腺癌复发或死亡无关。在调整年龄、肿瘤相关变量和BMI的多变量分析中，发现TC对疾病复发有不利影响的趋势（4月HR复发率= 1.62,4月HR复发率= 1.62）。第1四分位数，双侧p = 0.03)。空腹TG与结果无关。多因素分析显示，TC越高，复发风险越高。这种潜在的联系应该在未来的研究中加以探讨。
Purpose. The prognosis of women with early-stage breast cancer is influenced by insulin and body mass index (BMI). High levels of serum insulin and obesity often coexist with dyslipidemia in the insulin resistance syndrome (IRS), but the contribution of lipids to breast cancer outcome is unclear. Here, we examine whether serum levels of total cholesterol (TC) and triglycerides (TG) influence breast cancer outcome.Patients and methods. A cohort of 520 women without known hyperlipidemia or diabetes, with stage T1-T3, N0-N1, M0 breast cancer, was assembled from July 1989 to June 1996. Fasting blood was collected at baseline. Subjects were followed prospectively, for recurrence (local, regional, distant) and death. Cox models were used to calculate the prognostic effect of TC and TG levels. Two-sided significance levels were set at 0.025.Results. TC was correlated with age (Spearman's r = 0.44) and low tumor grade (p = 0.01), while TG was correlated with insulin (r = 0.43) and BMI (r = 0.45). At a median follow-up of 8.7 years, TC and TG were not associated with breast cancer recurrence or death before of after adjustment for age, tumor-related variables, BMI or fasting insulin levels. In multivariate analysis adjusting for age, tumor-related variables and BMI, a trend towards an adverse effect of TC on disease recurrence was seen (HR recurrence = 1.62 for the 4th versus. 1st quartile, 2-sided p = 0.03).Conclusions. Fasting TG was not associated with outcome. A trend towards risk of recurrence was seen with higher TC in multivariate analysis. This potential association should be explored in future studies.