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目的探讨不同绝经状态下,体重指数(BMI)与中国女性三阴型乳腺癌发病风险的关系及对应的敏感界值。方法采用匹配病例对照研究设计,病例和对照按年龄和绝经状态1∶2匹配,于2010年至2014年序贯收集四川省肿瘤医院391名原发性三阴型乳腺癌新发病例,同期收集成都市妇女儿童中心医院社区来源的健康对照782名。采用结构式问卷调查收集研究对象的一般人口学特征、身高、体重、生殖生育因素、现患及既往疾病史等信息。在不同绝经状态下,采用不同BMI分类标准(WHO四分类、亚洲四分类、中国四分类)估计BMI水平与三阴型乳腺癌的关联度,统计方法采用Logistic回归分析。结果调整了年龄、初潮年龄、初产年龄、初潮和初产年龄的时间间隔等信息后,WHO二分类划分标准提示,高BMI与绝经前、后TNBC发病呈正相关(aOR_(绝经前)=2.19,95%CI:1.40~3.43;aOR_(绝经后)=2.05,95%CI:1.29~3.27)。绝经前TNBC,WHO四分类中超重(BMI:25.0~29.9 kg/m~2)和肥胖(BMI≥30.0 kg/m2)的aOR分别为:1.97(95%CI:1.23~3.15)和5.45(95%CI:1.07~27.74);绝经后TNBC,中国四分类中肥胖(BMI≥28.0 kg/m~2)的a OR为2.14(95%CI:1.02~4.48)。连续性BMI的趋势分析显示,不同绝经状态下随着BMI增高乳腺癌发病风险增大(Pfor trend<0.05)。结论对于中国女性,高BMI是三阴型乳腺癌发病的危险因素,且绝经前后应采用不同的BMI敏感界值(BMI绝经前≥25.0kg/m2,BMI绝经后≥28kg/m2)来估计三阴型乳腺癌的发病风险。
Objective To investigate the relationship between body mass index (BMI) and the risk of developing triple-negative breast cancer in Chinese women at different postmenopausal states and their corresponding sensitive thresholds. Methods Matched case-control study design, cases and controls according to age and menopausal status 1: 2 matching, sequential collection of 391 cases of primary triple-negative breast cancer in Sichuan Cancer Hospital from 2010 to 2014, the same period collected Chengdu Women and Children Center Hospital community source of 782 healthy controls. A structured questionnaire was used to collect demographic characteristics, height, weight, reproductive reproductive factors, prevalence and past medical history of the study subjects. In different menopause, different BMI classification criteria (WHO four categories, four Asian classification, China four classification) to estimate the level of BMI associated with triple negative breast cancer, statistical methods using Logistic regression analysis. Results After adjusting for information such as age, age at first trimester, age at first birth, time between initial menarche and first trimester, the WHO dichotomous criteria suggested that high BMI was positively correlated with TNBC before and after menopause (aOR_ (premenopausal) = 2.19 , 95% CI: 1.40 to 3.43; aOR_ (postmenopausal) = 2.05, 95% CI: 1.29 to 3.27). The aOR of overweight (BMI: 25.0-29.9 kg / m ~ 2) and obesity (BMI≥30.0 kg / m2) in prenatal TNBC and WHO classification were 1.97 (95% CI: 1.23-3.15) and 5.45 % CI: 1.07-27.74); postmenopausal TNBC, a OR of 2.14 (95% CI: 1.02-4.48) in obesity (BMI≥28.0 kg / m ~ 2) The trend analysis of continuous BMI showed that the incidence of breast cancer increased with increasing BMI in different menopausal states (Pfor trend <0.05). Conclusions For Chinese women, high BMI is a risk factor for the development of triple-negative breast cancer and different BMI sensitivity thresholds (BMI> 25.0 kg / m 2 before BMI and ≥28 kg / m 2 BMI after menopause) should be estimated before and after menopause The incidence of negative breast cancer risk.