乳腺癌患者术后一年骨质疏松的相关因素分析
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摘要
目的探讨乳腺癌患者术后1年合并骨质疏松症的相关因素。方法选取41例乳腺癌术后1年合并骨质疏松症患者为骨质疏松组(OP组),年龄53~75岁;56例骨密度正常的乳腺癌患者为非骨质疏松组(NOP组),年龄46~64岁。采用美国GE公司产的双能X线骨密度仪测定入组患者左侧股骨颈、腰椎1-4(L1-4)骨密度,并分析其与年龄、体重指数(BMI)、生产、绝经、绝经年限、雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(HER-2)等的相关性。结果 OP组年龄、体重指数(BMI)、绝经及绝经年限与NOP组比较,差异有统计学意义(P<0.05),而两组雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(HER-2)阳性及是否生产之间比较无明显差异(P>0.05)。相关性分析显示腰椎BMD与BMI呈正相关,而与年龄、绝经年限呈负相关。结论乳腺癌妇女骨质疏松症患病率较高,年龄、绝经年限、BMI为影响骨质疏松的关键因素。
Objective To identify the related factors of osteoporosis in breast cancer women 1-year after the surgery. Methods Forty-one breast cancer patients 1-year after surgery aged from 53 to 75 years old with osteoporosis were selected. Fifty-six breast cancer patients 1-year after surgery aged from 46 to 64 years old with normal bone mineral density( BMD) were selected in the control group. BMD of the lumbar spine and the left femoral neck was detected using dual-energy X-ray absorptiometry( GE,USA). The correlation analysis among age,BMI,reproductive history,postmenopausal time,ER,PR,HER-2,and BMD was performed. Results There was significant difference in age,BMI,and postmenopausal time between OP group and NOP group( P < 0. 05). However,there was no difference in ER,PR,HER-2,and reproductive history between the two groups( P > 0. 05).Correlation analysis indicated that BMD was positively correlated with BMI, but was negatively correlated with age and postmenopausal time. Conclusion The prevalence of osteoporosis in women with breast cancer is high. The main influential factors are age,BMI,and postmenopausal time.
Objective To identify the related factors of osteoporosis in breast cancer women 1-year after the surgery. Methods Forty-one breast cancer patients 1-year after surgery aged from 53 to 75 years old with osteoporosis were selected. Fifty-six breast cancer patients 1-year after surgery aged from 46 to 64 years old with normal bone mineral density( BMD) were selected in the control group. BMD of the lumbar spine and the left femoral neck was detected using dual-energy X-ray absorptiometry( GE,USA). The correlation analysis among age,BMI,reproductive history,postmenopausal time,ER,PR,HER-2,and BMD was performed. Results There was significant difference in age,BMI,and postmenopausal time between OP group and NOP group( P < 0. 05). However,there was no difference in ER,PR,HER-2,and reproductive history between the two groups( P > 0. 05).Correlation analysis indicated that BMD was positively correlated with BMI, but was negatively correlated with age and postmenopausal time. Conclusion The prevalence of osteoporosis in women with breast cancer is high. The main influential factors are age,BMI,and postmenopausal time.
引文
[1]徐小玉,朱海波,王玲.内分泌治疗对乳腺癌患者骨密度影响的研究进展.中国骨质疏松杂志,2013,19(10):1104-1107.Xu XY,Zhu HB,Wang L.Research progress of the effect of endocrine therapy on bone mineral density in patients with breast cancer.Chin J Osteoporos,2013,19(10):1104-1107.(in Chinese)
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[8]毛未贤,张萌萌,高远,等2043例35-79岁女性骨密度与绝经年限、体重指数的相关性.中国妇幼保健,2016,31(10):2123-2125.Mao WX,Zhang MM,Gao Y,et al.Correlation between bone mineral density and menopausal age and body mass index in 204335-79 year old women.Maternal and Child Health Care of China,2016,31(10):2123-2125.(in Chinese)
[9]Jemtland R,Holden M,Reppe S,et al.Molecular disease map of bone characterizing the postmenopausal osteoporosisphenotype.J Bone Miner Res,2011,26(8):1793-1801.
[10]Pinzon R.The clinical profile and risk factors of postmenopausal lumbar osteoporosis.International Journal of Rheumatic Diseases,2010,13:171.
[11]曹晶,江霞.2型糖尿病患者骨密度水平及其相关性的分析.医学综述,2014,20(11):2078-2080.Cao J,Jiang X.Analysis of the level and influencing factors of bone mineral density in patienis with type 2 diabetes.Medical Recapitulate,2014,20(11):2078-2080.(in Chinese)
[12]唐卓,秦爱平,赵新兰,等.绝经后2型糖尿病患者慢性并发症与骨质疏松症关系临床研究.现代生物医学进展,2013,13(15):2955-2958.Tang Z,Qin AP,Zhao X,et al.Relationship between chronic complications and osteoporosis among postmenopausal women with type 2 diabetes.Mellitus Progress in Modern Biomedicine,2013,13(15):2955-2958.(in Chinese)
[13]Hulka BS,Moorman PG.Breast Cancer:hormones and other risk factors.Maturitas,2008,61(1-2):203-213.
[14]Slemenda CW,Turner CH,Peacock M,et al.The genetics of proximal femur geometry,distribution of bone mass and bone mineral density.Osteoporos Int,1996,6(2):178-182.
[15]Bryce J,Bauer M,Hadji P.Aromatase inhibitor-associated bone loss.Oncol Nurs Forum,2011,38(3):273-276.
[2]李惠平,刘晓光.乳腺癌患者骨丢失的管理.肿瘤防治研究,2012,39(6):619-622.Li HP,Liu XG.Management of bone loss in patients with breast cancer.Cancer Prevention and Control Research,2012,39(6):619-622.(in Chinese)
[3]中华医学会骨质疏松和骨矿盐疾病分会.原发性骨质疏松症诊治指南(2011年).中华骨质疏松和骨矿盐疾病杂志,2011,4(1):2-17.Chinese Medical Association.Guidelines for diagnosis and treatment of primary osteoporosis.Chin J Osteoporosis&Bone Miner Res,2011,4(1):2-17.(in Chinese)
[4]李茂蓉,黄薇,欧小虹,等.绝经后非糖尿病妇女骨质疏松症影响因素的Logistic回归和ROC曲线分析.中国骨质疏松杂志,2016,22(5):540-544.Li MR,Huang W,Ou XH,et al.Analysis of influential factors of osteoporosis in postmenopausal women without diabetes with logistic regression and ROC curve.Chin J Osteoporos,2016,22(5):540-544.(in Chinese)
[5]唐厚梅,顾小红,刘迎春.重庆市4 587例健康体检者骨密度测定及结果分析.国际检验医学杂志,2013,34(11):1397.Tang HM,Gu XH,Liu YC.Bone mineral density detection of4587 people who had taken physical examination in Chongqing and the results analysis.International Journal of Laboratory Medicine,2013,34(11):1397.(in Chinese)
[6]李辉,刘唯,黄碧,等.长沙市社区女性骨骼健康现状及相关因素的调查.实用预防医学,2010,17(2):209-212.Li H,Liu W,Huang B,et al Survey of bone health status its related factors among community women in Changsha.Practical Preventive Medicine,2010,17(2):209-212.(in Chinese)
[7]Meczekalski B,Czyzyk A.New forms of estrogenotherapy in postmenopausal osteoporosis.Pol Merkur Lekarski,2009,27:77-80.
[8]毛未贤,张萌萌,高远,等2043例35-79岁女性骨密度与绝经年限、体重指数的相关性.中国妇幼保健,2016,31(10):2123-2125.Mao WX,Zhang MM,Gao Y,et al.Correlation between bone mineral density and menopausal age and body mass index in 204335-79 year old women.Maternal and Child Health Care of China,2016,31(10):2123-2125.(in Chinese)
[9]Jemtland R,Holden M,Reppe S,et al.Molecular disease map of bone characterizing the postmenopausal osteoporosisphenotype.J Bone Miner Res,2011,26(8):1793-1801.
[10]Pinzon R.The clinical profile and risk factors of postmenopausal lumbar osteoporosis.International Journal of Rheumatic Diseases,2010,13:171.
[11]曹晶,江霞.2型糖尿病患者骨密度水平及其相关性的分析.医学综述,2014,20(11):2078-2080.Cao J,Jiang X.Analysis of the level and influencing factors of bone mineral density in patienis with type 2 diabetes.Medical Recapitulate,2014,20(11):2078-2080.(in Chinese)
[12]唐卓,秦爱平,赵新兰,等.绝经后2型糖尿病患者慢性并发症与骨质疏松症关系临床研究.现代生物医学进展,2013,13(15):2955-2958.Tang Z,Qin AP,Zhao X,et al.Relationship between chronic complications and osteoporosis among postmenopausal women with type 2 diabetes.Mellitus Progress in Modern Biomedicine,2013,13(15):2955-2958.(in Chinese)
[13]Hulka BS,Moorman PG.Breast Cancer:hormones and other risk factors.Maturitas,2008,61(1-2):203-213.
[14]Slemenda CW,Turner CH,Peacock M,et al.The genetics of proximal femur geometry,distribution of bone mass and bone mineral density.Osteoporos Int,1996,6(2):178-182.
[15]Bryce J,Bauer M,Hadji P.Aromatase inhibitor-associated bone loss.Oncol Nurs Forum,2011,38(3):273-276.