论文部分内容阅读
目的 :评价肥胖与女性乳腺癌预后相关因素的关联。方法 :检索PubMed、Cochrane Library、Web of Science、中国学术期刊全文数据库、中国生物医学文献服务系统和万方数据库中有关肥胖与乳腺癌预后相关因素的高质量队列研究和病例-对照研究,更新至2012年12月。应用RevMan5.0进行Meta分析。结果 :共检索获得相关文献2 002篇,按照纳入和排除标准最终纳入8篇文献。Meta分析结果显示,肥胖组与非肥胖组的淋巴结转移阳性率差异有统计学意义(比值比为0.89,95%可信区间为0.85~0.93,P<0.000 01),肿瘤最大径>2 cm的比例差异有统计学意义(比值比为0.60,95%可信区间为0.42~0.85,P=0.004),肿瘤病理分级为3级的比例差异也有统计学意义(比值比为0.88,95%可信区间为0.79~0.99,P=0.003)。将体质量指数分级标准及预后相关因素相同的文献进行亚组分析,除3篇英文文献提示肥胖组与非肥胖组的雌激素受体阳性率(比值比为0.63,95%可信区间为0.41~0.98,P=0.04)和雌激素受体阴性率(比值比为1.58,95%可信区间为1.02~2.44,P=0.04)差异有统计学意义以外,其余预后相关因素均与肥胖无关。结论 :在未考虑体质量指数分级标准的情况下,肥胖可能对乳腺癌患者的预后起负性作用。将体质量指数分级标准及预后相关因素相同的文献进行亚组分析的结果提示,肥胖对不同国家及不同种族乳腺癌患者预后的影响可能不尽相同。
OBJECTIVE: To evaluate the association of obesity with the prognostic factors of breast cancer in women. METHODS: High-quality cohort studies and case-control studies of obesity and breast cancer prognostic factors in PubMed, Cochrane Library, Web of Science, Chinese Academic Journal Full-text Database, Chinese Biomedical Literature Service System and Wanfang Database were searched and updated to December 2012. RevMan5.0 Meta analysis. Results: A total of 2 002 related articles were retrieved and finally 8 articles were included according to inclusion and exclusion criteria. Meta analysis showed that the positive rate of lymph node metastasis in obesity group and non-obesity group was statistically significant (odds ratio 0.89, 95% CI 0.85-0.93, P <0.000 01), tumor diameter> 2 cm The difference was statistically significant (odds ratio 0.60, 95% confidence interval 0.42-0.85, P = 0.004), and there was also a statistically significant difference in the proportion of tumor grade 3 (odds ratio 0.88, 95% confidence Interval was 0.79 ~ 0.99, P = 0.003). Subgroup analyzes of the literature with the same criteria for the classification of body mass index and related prognostic factors were used, except for the three English literature suggesting estrogen receptor positive rates in obese and nonobese groups (odds ratio 0.63; 95% confidence interval 0.41 ~ 0.98, P = 0.04) and estrogen receptor negative rate (odds ratio 1.58, 95% confidence interval 1.02 ~ 2.44, P = 0.04), the other prognostic factors were unrelated to obesity. CONCLUSIONS: Obesity may have a negative effect on the prognosis of breast cancer patients without considering the grading criteria for body mass index. The results of subgroup analysis of the literature with the same grading standards of body mass index and prognostic factors suggest that the effects of obesity on the prognosis of breast cancer patients of different countries and ethnicities may not be the same.