BMI对不同分子亚型女性乳腺癌患者预后影响的回顾性研究

doi:10.11904/j.issn.1002-3070.2026.01.006

实用肿瘤学杂志 ›› 2026, Vol. 40 ›› Issue (1): 41-47.doi: 10.11904/j.issn.1002-3070.2026.01.006

BMI对不同分子亚型女性乳腺癌患者预后影响的回顾性研究

左婷婷^1,2, 于志福¹, 申展¹, 王忱玉¹, 朱博¹

1.中国医科大学肿瘤医院/辽宁省肿瘤医院辽宁省肿瘤防治办公室(沈阳 110042);
2.国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院癌症早诊早治办公室

收稿日期:2025-01-15 修回日期:2025-12-25 出版日期:2026-02-28 发布日期:2026-02-27
通讯作者: 朱博,E-mail:15998896991@163.com
作者简介:左婷婷,女,(1990—),硕士,主管医师,从事乳腺癌防控和生存分析相关的研究。

The impact of BMI on the prognosis of female breast cancer patients with different molecular subtype:A retrospective study

ZUO Tingting^1,2, YU Zhifu¹, SHEN Zhan¹, WANG Chenyu¹, ZHU Bo¹

1. Office of Cancer Prevention and Treatment,Cancer Hospital of China Medical University,Liaoning Cancer Hospital & Institute,Shenyang 110042,China;
2. Office of Cancer Screening,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College

Received:2025-01-15 Revised:2025-12-25 Online:2026-02-28 Published:2026-02-27

摘要/Abstract

摘要： 目的肥胖和分子亚型均是影响乳腺癌患者预后的重要因素,本文旨在探讨体重指数(body mass index,BMI)对不同分子亚型女性乳腺癌患者乳腺癌特异性死亡风险的影响。方法回顾性收集2016—2017年在辽宁省肿瘤医院首次确诊的乳腺癌患者病例信息,共纳入2 340例原发性、浸润性女性乳腺癌病例,通过随访获取生存结局信息。研究主要结局指标为乳腺癌特异性生存期(breast cancer-specific survival,BCSS)。对年龄、BMI、绝经状态、组织学分级、肿瘤分期、Ki-67表达水平及分子亚型进行单因素分析,采用Cox比例风险模型分析肥胖(BMI≥28 kg/m²)对不同分子亚型乳腺癌患者乳腺癌特异性死亡风险的影响。结果在2 340例乳腺癌患者中,肥胖女性343例,占14.7%。肥胖患者在Luminal A型和三阴性乳腺癌中的比例较高(P=0.005)。乳腺癌死亡170例,占7.3%。与非肥胖(BMI＜28 kg/m²)女性相比,肥胖女性乳腺癌死亡风险更高(HR=1.629,95% CI:1.118~2.375)。与Luminal A型患者相比,Luminal B型(HR=1.918,95% CI:1.236~2.975)、人表皮生长因子受体2(human epidermal growth factor receptor 2,HER2)过表达型(HR=2.119,95% CI:1.374~3.270)和三阴性乳腺癌(HR=2.114,95% CI:1.338~3.338)患者乳腺癌特异性死亡风险更高。在调整混杂因素后,肥胖可增加Luminal A型乳腺癌患者乳腺癌特异性死亡风险(HR=2.255,95% CI:1.338~3.802)。结论肥胖可能是影响Luminal A型乳腺癌患者预后的独立危险因素,而在其他分子亚型乳腺癌患者中,其预后影响未观察到统计学显著性。

关键词: 乳腺癌, 女性, 体重指数, 分子亚型, 预后

Abstract: Objective Both obesity and molecular subtypes are important factors affecting the prognosis of breast cancer patients.This article aimed to explore the impact of body mass index(BMI)on breast cancer-specific mortality risk in female breast cancer patients with different molecular subtypes. Methods Clinical data of breast cancer patients diagnosed for the first time at Liaoning Provincial Cancer Hospital from 2016 to 2017 were retrospectively collected,including a total of 2,340 cases of primary,invasive female breast cancer patients.Survival outcomes were obtained through follow-up.The primary outcome measure was breast cancer-specific survival(BCSS).Univariate analysis was conducted on age,BMI,menopausal status,histological grade,tumor stage,Ki-67 expression,and molecular subtype.The Cox proportional hazards model was used to analyze the impact of obesity(BMI≥28 kg/m²)on breast cancer-specific mortality risk in breast cancer patients with different molecular subtypes. Results Among 2,340 breast cancer patients,343 were obese,accounting for 14.7%.The proportion of obese patients was higher in luminal A and triple-negative breast cancer(P=0.005).There were 170 breast cancer deaths,accounting for 7.3%.Compared with non-obese patients(BMI<28 kg/m²)women,obese women had a higher risk of breast cancer mortality(HR=1.629,95% CI:1.118-2.375).Compared with luminal A patients,luminal B subtype(HR=1.918,95% CI:1.236-2.975),human epidermal growth factor receptor 2(HER2)overexpression(HR=2.119,95% CI:1.374-3.270),and triple-negative breast cancer(HR=2.114,95% CI:1.338-3.338)patients had a higher risk of breast cancer-specific mortality.After adjusting for confounding factors,obesity increased risk of breast cancer-specific mortality in patients with luminal A patients(HR=2.255,95% CI:1.338-3.802). Conclusion Obesity may be an independent risk factor for prognosis in patients with luminal A breast cancer,whereas no statistically significant association was observed in other molecular subtypes.

Key words: breast cancer, female, body mass index, molecular subtype, prognosis

中图分类号:

左婷婷, 于志福, 申展, 王忱玉, 朱博. BMI对不同分子亚型女性乳腺癌患者预后影响的回顾性研究[J]. 实用肿瘤学杂志, 2026, 40(1): 41-47.

ZUO Tingting, YU Zhifu, SHEN Zhan, WANG Chenyu, ZHU Bo. The impact of BMI on the prognosis of female breast cancer patients with different molecular subtype:A retrospective study[J]. Journal of Practical Oncology, 2026, 40(1): 41-47.

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BMI对不同分子亚型女性乳腺癌患者预后影响的回顾性研究

The impact of BMI on the prognosis of female breast cancer patients with different molecular subtype:A retrospective study

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