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目的探讨体质指数与三阴型乳腺癌预后的关系。方法收集2003-2010年四川省肿瘤医院收治的三阴型乳腺癌患者101例,根据体质指数值(BMI)分为正常组(<24 kg/m2)和超重肥胖组(≥24 kg/m2),采用χ2检验比较两组间的临床病理特征差异;用Cox比例风险回归分析BMI与总生存和无病生存风险比(HR)。合并2000-2014年关于肥胖与三阴型乳腺癌预后的研究文献6篇,共4 446名病例,采用Rev Man 5.0软件进行数据分析,计算合并风险比(HR合并)及其95%CI。结果本次随访研究发现正常组和超重肥胖组患者的总生存和无病生存风险无统计学意义(HROS=0.632,POS=0.0.501;HRDFS=0.934,PDFS=0.873);Meta分析结果显示,肥胖与三阴型乳腺癌的HROS合并=1.02,95%CI:0.97~1.08;HRDFS合并=1.01,95%CI:0.96~1.07。结论现有的研究尚不支持BMI改变三阴型乳腺癌预后的假设,但尚存在随访期短,人群代表性局限的问题。
Objective To explore the relationship between body mass index and the prognosis of triple negative breast cancer. Methods 101 patients with triple-negative breast cancer admitted to Sichuan Cancer Hospital from 2003 to 2010 were divided into normal group (<24 kg / m2) and overweight and obesity group (≥24 kg / m2) according to body mass index (BMI) . The difference of clinicopathological features between the two groups was compared by Chi-square test. The BMI was compared with the overall survival and disease-free survival risk (HR) by Cox proportional hazards regression analysis. A total of 4 446 articles were collected from 2000 to 2014 on the prognosis of obesity and triple-negative breast cancer. Data were analyzed using RevMan 5.0 software to calculate the combined risk (HR) and its 95% CI. Results The follow-up study found that there was no statistically significant difference between the two groups (HROS = 0.632, POS = 0.0501; HRDFS = 0.934, PDFS = 0.873) in patients with normal and overweight and obesity. Meta analysis showed that, HROS merger between obesity and triple-negative breast cancer = 1.02, 95% CI: 0.97 to 1.08; HRDFS combined = 1.01, 95% CI: 0.96 to 1.07. Conclusion The existing research does not support the hypothesis that BMI can change the prognosis of triple-negative breast cancer. However, there are still some problems such as short follow-up period and limited representative population.