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目的:探讨肥胖对淋巴结阳性的乳腺癌患者预后的影响。方法:收集593例淋巴结阳性的女性乳腺癌患者的年龄、绝经状态、家族史、体质量指数(body mass index,BMI)、病理检查及临床治疗资料。用log-rank检验及COX回归分析分别进行影响总生存(overall survival,OS)的单因素和多因素分析;用卡方检验进行肥胖组与非肥胖组间临床病理特征的差异比较。结果:肥胖是影响淋巴结阳性乳腺癌预后的独立不良因素(P=0.003),是影响绝经前患者OS的独立不良预后因素(P=0.010),而对绝经后患者不存在这种影响;肥胖与肿瘤大小具有相关性(P<0.001)。结论:肥胖是影响淋巴结阳性的乳腺癌患者预后的不良因素,尤其是绝经前患者;肥胖患者的肿瘤直径较非肥胖患者的大,这可能是肥胖者预后不良的一个重要原因。
Objective: To investigate the effect of obesity on the prognosis of lymph node-positive breast cancer patients. METHODS: The age, menopausal status, family history, body mass index (BMI), pathology and clinical data of 593 women with node-positive breast cancer were collected. Univariate and multivariate analyzes of overall survival (OS) were performed by log-rank test and COX regression analysis, respectively. Chi-square test was used to compare the clinicopathological characteristics of obese and non-obese patients. Results: Obesity was an independent adverse factor affecting the prognosis of lymph node-positive breast cancer (P = 0.003), an independent adverse prognostic factor affecting OS in premenopausal patients (P = 0.010), but not in postmenopausal patients; obesity and Tumor size was correlated (P <0.001). Conclusion: Obesity is an adverse factor affecting the prognosis of patients with lymph node-positive breast cancer, especially in premenopausal patients. Obesity patients have larger tumor diameters than non-obese patients, which may be an important reason for obesity’s poor prognosis.