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目的探讨体重指数(BMI)及临床特征对不同生理阶段乳腺癌复发转移的影响。方法回顾性收集四川省肿瘤医院1999年至2010年收治的女性原发性乳腺癌743例。根据绝经状态和年龄将患者划分为育龄期、围绝经期、绝经后3组,分析影响各组乳腺癌无病生存期(DFS)的因素。结果多因素分析发现,高BMI(23.0~29.9 kg/m2)和低BMI(<18.5kg/m2)均能降低绝经后患者的DFS(HR_高BMI=2.60,95%CI:1.06~6.37;HR低BMI=6.92,95%CI:1.93~24.81);三阴降低围绝经和绝经后患者的DFS(HR=4.78,95%CI:1.06~21.58;HR=2.64,95%CI:1.33~5.28);淋巴结转移数≥4个降低育龄患者的DFS(HR=4.08,95%CI:1.52~10.97)。结论 BMI及三阴对不同生理阶段乳腺癌预后均有影响,尤其是高低BMI均能降低患者的无病生存期,提示患者应保持适当体重,减少复发转移风险。
Objective To investigate the effect of body mass index (BMI) and clinical features on the recurrence and metastasis of breast cancer in different physiological stages. Methods Retrospectively collected 743 cases of primary breast cancer in Sichuan Cancer Hospital from 1999 to 2010. According to the menopausal status and age, the patients were divided into three groups: childbearing age, perimenopause and postmenopausal women. The factors influencing the disease-free survival (DFS) of breast cancer in each group were analyzed. Results Multivariate analysis showed that high BMI (23.0-29.9 kg / m2) and low BMI (<18.5 kg / m2) all reduced DFS in postmenopausal patients (HR_High BMI = 2.60,95% CI: 1.06 ~ 6.37; HR low BMI = 6.92, 95% CI: 1.93 to 24.81); Sanyin decreased DFS in perimenopausal and postmenopausal patients (HR = 4.78, 95% CI: 1.06-21.58; HR = 2.64, 95% CI: 1.33-5.28 ); The number of lymph node metastases ≥ 4 reduce the DFS of patients of childbearing age (HR = 4.08,95% CI: 1.52 ~ 10.97). Conclusion BMI and Sanyin affect the prognosis of different stages of breast cancer, especially high and low BMI can reduce the patient’s disease-free survival, suggesting that patients should maintain the appropriate weight and reduce the risk of recurrence and metastasis.