유방암에서 복부 CT를 이용해 계측한 피하 지방과 복부 지방이 유방암 수용체 상태에 미치는 영향

Abstract

Purpose: Pre-existing obesity and postoperative weight gain are related to a poor prognosis of breast cancer. Few studies have investigated the association between obesity and biological receptor status, pathological predictors and clinical outcomes in breast cancer by using abdominal adipose tissue measurement. The aim of this study is to explore the relation between biological receptor status of breast cancer and regional distribution of obesity. Methods: Abdominal computed tomography (CT) was performed for staging workup in 237 breast cancer patients. Total abdominal adipose tissue (TAAT), visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and visceral/subcutaneous ratio (V/S ratio) were measured from abdominal CT, and were compared with biological receptor status according to the menopausal status. Results: Estrogen receptor (ER) negative breast cancer in pre-menopausal women showed significantly larger SAT compared with ER+ breast cancer (p=0.04). On the other hand, in post-menopausal women, SAT was larger in ER+ compared with ER- (p=0.02). Progesterone receptor (PR) status showed similar propensity in pre- and post-menopausal women (p<0.01, p<0.01). Larger SAT was measured in tumor larger than 2cm (p<0.01). In multivariate logistic regression models, SAT was only positively correlated with PR+ status among post-menopausal women. (2nd tertile-OR: 3.59, 95% CI: 1.27-10.15, p=0.02, 3rd tertile-OR: 18.87, 95% CI: 3.51-101.38, p<0.01). Conclusion: According to SAT, conflict ER and PR status was observed between pre- and post-menopausal women. Larger SAT have a higher proportion of PR+ in post-menopausal women.