Relationship between body mass index and the expression of hormone receptors or human epidermal growth factor receptor 2 with respect to breast cancer survival
Relationship between body mass index and the expression of hormone receptors or human epidermal growth factor receptor 2 with respect to breast cancer survival
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DOI：
10.1186/s12885-015-1879-4
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发表时间：
2015-11-06
期刊：
影响因子：
3.8
通讯作者：
Suh, Young Jin
中科院分区：
文献类型：
--
作者：
Jeon, Ye Won;Kang, Su Hwan;Suh, Young Jin
背景资料：乳腺癌诊断时的体重指数（BMI）与乳腺癌患者预后之间的关系仍存在争议。此外，BMI和预后之间的关联，就不同的乳腺癌subtypes.Methods：我们分析了41,021浸润性乳腺癌患者的数据，1988年1月至2008年2月从韩国乳腺癌登记（KBCR）数据库。采用Kaplan-Meier法和考克斯比例风险回归模型对所有患者和特定乳腺癌亚型的总生存期（OS）和乳腺癌特异性生存期（BCSS）进行分析。与正常体重个体相比，体重不足和肥胖个体的OS（风险比分别为1.23 [95%置信区间{CI}，1.05 - 1.44]和1.29 [1.13 - 1.48]）和BCSS（分别为1.26 [1.03 - 1.54]和1.21 [1.02 - 1.43]）更差。在雌激素受体（ER）和/或孕激素受体（PR）+/人表皮生长因子受体2（HER 2）-亚组中，肥胖个体的OS（1.48 [1.18 - 1.85]）和BCSS（1.31 [1.13 - 1.52]）比正常体重个体差。相反，在ER和PR-/HER 2+亚组中，体重不足的个体比正常体重的个体表现出更差的OS（1.68 [1.12至2.47]）和BCSS（1.79 [1.11至2.90]）。结论：我们观察到在所有乳腺癌患者中，诊断时的BMI与较差的OS和BCSS之间存在U形关系。然而，ER和/或PR+/HER 2-亚组中的肥胖和ER和PR-/HER 2+亚组中的体重过轻是不良预后因素。因此，诊断时的BMI和乳腺癌亚型应在各种治疗决策过程和监测计划中同时考虑。
Background: The association between body mass index (BMI) at the time of breast cancer diagnosis and the prognosis of breast cancer patients remains controversial. Furthermore, the association between BMI and prognosis with respect to different breast cancer subtypes is not clearly defined.Methods: We analyzed data from 41,021 invasive breast cancer patients between January 1988 and February 2008 from the Korean Breast Cancer Registry (KBCR) database. Overall survival (OS) and breast cancer-specific survival (BCSS) were analyzed using the Kaplan-Meier method and Cox's proportional hazard regression model among all patients and specific breast cancer subtypes with respect to BMI categories.Results: A U-shaped association between BMI and mortality was observed in the total cohort. Underweight and obese individuals exhibited worse OS (hazard ratio, 1.23 [95 % confidence interval {CI}, 1.05 to 1.44] and 1.29 [1.13 to 1.48], respectively) and BCSS (1.26 [1.03 to 1.54] and 1.21 [1.02 to 1.43], respectively) than normal-weight individuals. In the estrogen receptor (ER) and/or progesterone receptor (PR)+/human epidermal growth factor receptor 2 (HER2) - subgroup, obese individuals exhibited worse OS (1.48 [1.18 to 1.85]) and BCSS (1.31 [1.13 to 1.52]) than normal-weight individuals. Conversely, in the ER and PR-/HER2+ subgroup, underweight individuals exhibited worse OS (1.68 [1.12 to 2.47]) and BCSS (1.79 [1.11 to 2.90]) than normal-weight individuals.Conclusions: We observed a U-shaped relationship between BMI at diagnosis and poor OS and BCSS among all breast cancer patients. However, obesity in the ER and/or PR+/HER2-subgroup and underweight in the ER and PR-/HER2+ subgroup were poor prognostic factors. Therefore, BMI at diagnosis and breast cancer subtype should be considered simultaneously in various treatment decision processes and surveillance schedules.