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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)是女性最常見的惡性腫瘤,肥胖癥與BC的發(fā)生率和死亡率相關(guān)并且血清中高濃度的胰島素可能對癌癥發(fā)生率產(chǎn)生負面影響。在本研究當中,我們調(diào)查了幾個人體測量和新陳代謝濃度參數(shù)是否會在BC分子亞型之間發(fā)生變化。符合條件的病例是于2009年一月和2013年十二月康復的991例非轉(zhuǎn)移性的BC患者。 檢測了人體測量的、臨床的和免疫組織化學的特征。建立了多變量邏輯回歸模型以評價HER2陽性BC風險,(a)三陽性(TP)與管腔A、管腔B進行比較,三陰性(TN)和(b) HER2-強化組與管腔A、管腔B和與年齡有關(guān)的TN管腔A進行比較。在經(jīng)絕后的患者當中,經(jīng)調(diào)整的多變量分析顯示與管腔B(分別OR=0.48,OR=0.49)相比時高BMI和高腰圍與TP亞型呈負相關(guān)。相反,當與管腔A和TN(分別OR=2.47,OR=3.15)相比時胰島素抵抗指數(shù)對于TP是一個危險因素。我們的研究結(jié)果顯示出高腹部脂肪在絕經(jīng)后婦女特定BC分子亞型發(fā)展過程中的潛在作用。此外,這些還佐證了胰島素抵抗在HER2陽性BC發(fā)展過程中的潛在作用,盡管這種作用在激素受體共表達時似乎更強,顯示出這兩個BC亞型在病原學中的差異,