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Breast cancer (BC) is the most common malignant tumor in women, obesity is associated with increased BC incidence and mortality and high levels of circulating insulin may negatively impact on cancer incidence. In the present study, we investigated whether the strength of several anthropometric and metabolic parameters varies between BCmolecular subtypes. Eligible cases were 991 non-metastatic BC patients recruited between January 2009 and December 2013. Anthropometric, clinical and immunohistochemical features were measured. Multivariate logistic regression models were built to assess HER2 positive BC risk, comparing (a) triple positive (TP) with luminal A, luminal B and triple negative (TN) and (b) HER2-enriched group with luminal A, luminal B and TN. luminal A in relation to age. Among postmenopausal patients, the adjusted multivariate analysis showed that high BMI and high waist circumference were inversely correlated to TP subtype when compared to luminal B (OR = 0.48 and OR = 0.49, respectively). Conversely, HOMA-IR was a risk factor for TP when compared to luminal A and TN (OR = 2.47 and OR = 3.15, respectively). Our findings suggest a potential role of higher abdominal fat in the development of specific BC molecular subtypes in postmenopausal women. Moreover, they support a potential role of insulin resistance in the development of HER2 positive BC, although this role appears to be stronger when hormone receptors are co-expressed, suggesting a difference in the etiology of these two BC subtypes.
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乳腺癌(BC)是女性最常见的恶性肿瘤,肥胖症与BC的发生率和死亡率相关并且血清中高浓度的胰岛素可能对癌症发生率产生负面影响。在本研究当中,我们调查了几个人体测量和新陈代谢浓度参数是否会在BC分子亚型之间发生变化。符合条件的病例是于2009年一月和2013年十二月康复的991例非转移性的BC患者。 检测了人体测量的、临床的和免疫组织化学的特征。建立了多变量逻辑回归模型以评价HER2阳性BC风险,(a)三阳性(TP)与管腔A、管腔B进行比较,三阴性(TN)和(b) HER2-强化组与管腔A、管腔B和与年龄有关的TN管腔A进行比较。在经绝后的患者当中,经调整的多变量分析显示与管腔B(分别OR=0.48,OR=0.49)相比时高BMI和高腰围与TP亚型呈负相关。相反,当与管腔A和TN(分别OR=2.47,OR=3.15)相比时胰岛素抵抗指数对于TP是一个危险因素。我们的研究结果显示出高腹部脂肪在绝经后妇女特定BC分子亚型发展过程中的潜在作用。此外,这些还佐证了胰岛素抵抗在HER2阳性BC发展过程中的潜在作用,尽管这种作用在激素受体共表达时似乎更强,显示出这两个BC亚型在病原学中的差异,