Study On The Relationship Between The Expression Of Estrogen Receptor In Breast Cancer And Non-alcoholic Fatty Liver Disease

Objective:To explore the relationship between the expression of estrogen receptor(ER)in breast cancer pathological tissue and non-alcoholic fatty liver disease(NAFLD),to provide theoretical basis for the pathogenesis of breast cancer complicated with NAFLD,and to provide direction for the prevention and intervention of NAFLD caused by endocrine therapy in patients with ER positive breast cancer.Methods:Collected 645 newly diagnosed breast cancer patients who were hospitalized in the Department of Breast Surgery of Sichuan Provincial People’s Hospital from January 2019 to December 2019,and included a total of 617 female patients who underwent breast cancer pathological tissue Immunohistochemical staining and had complete data before chemotherapy.440 patients with positive expression of ER were included in the study group,and 177patients with negative expression of ER were taken as the control group.NAFLD,was diagnosed by abdominal ultrasound or abdominal CT,including NAFLD(n=100)and non-NAFLD(n=517).General demographic data and biochemical indicators were collected for correlation analysis.Results:(1)There were 64 cases of NAFLD in the ER-positive expression group of breast cancer,36 cases of NAFLD in the ER-negative expression group,the prevalence of NAFLD in the ER-positive expression group was 14.55%,and the prevalence of NAFLD in the ER-negative expression group was 20.34%,There was no significant difference between the two groups(P>0.05).(2)There was significant difference in the positive expression of ER in breast cancer pathological tissues before and after menopause(P=0.000).According to the stratified chi-square test before and after menopause,there was a significant difference in the prevalence of NAFLD between ER positive expression group and ER negative expression group in premenopausal breast cancer(P=0.004),OR=0.320,95%CI(0.142～0.721).In postmenopausal breast cancer patients,there was no significant difference in the prevalence of NAFLD between ER positive expression group and ER negative expression group(P>0.05).OR=1.070,95%CI(0.616～1.857).(3)In patients with BMI≥24kg/m2,there was significant difference in menopausal.BMI and the positive expression of ER in breast cancer pathological tissues between NAFLD group and non-NAFLD group(P<0.05).Incorporating menopausal,BMI,and breast cancer pathological tissue ER expression for multiple logistic regression analysis,the risk of NAFLD in postmenopause patients is 2.656 times that in premenopause patients(P=0.001),OR=2.657,95%CI(1.455～4.852);The risk of NAFLD with positive ER expression in breast cancer pathological tissues was 0.509 times that of ER-negative expression in breast cancer pathological tissues(P=0.034),OR=0.509,95%CI(0.273～0.951).(4)In breast cancer patients with NAFLD,there was significant difference in age between ER positive expression group and ER negative expression group in breast cancer pathological tissue.Conclusion:(1)In postmenopausal women with breast cancer,the positive expression of ER in breast cancer pathological tissue decreased.(2)In premenopausal women with breast cancer,the positive expression of ER in the pathological tissues of breast cancer is a protective factor for NAFLD.(3)In overweight or obese women with breast cancer,the positive expression of ER in breast cancer pathological tissues is a protective factor for NAFLD.(4)In the woman patients with breast cancer complicated with NAFLD,the patients with positive expression of ER in breast cancer pathological tissues had a later age ofNAFLD.