Study On Risk Factors Of Benign Breast Diseases’ Cancerization

BACKGROUNDBenign breast disease(BBD) is the most common breast disease in women,which account for more than 75% of total breast disease.Benign proliferation breast disease’s(BPBD) detection rate is 15%-20% among our country’s childbearing age women and the detection rate reach up to 50%-70% in breast specialist outpatient.BPBD’s mobidity rise year by year and is becoming the most annoying disease of women.Many epidemiological studies indicate that women with benign breast disease are at increased risk for developing breast cancer. As the high incidence of the BBD and its role in breast carcinogenesis,people put more and more emphasis on it in recent years.Investigation of its risk factor and the mechanism of its higher cancerization risk can provide new target for BPBD patients’breast cancer prevetion,in the mean time,can lay foundation for.the explore ofbreast cancer’s genesis and development.Benign breast disease includes a varity of breast diseases.The histologic category of benign breast disease associated with the relative risk for breast cancer is nonproliferative disease,proliferative disease without atypia and atypical hyperplasia,whose relative risk for breast cancer raised gradually.Now the consensus is nonproliferative disease patients’breast cancer risk is the same as healthy people,but BPBD patients’breast cancer risk elevated significantly compare with nonproliferative disease patients.Investigate the reason why BPBD’s cancerization risk is higher than nonproliferative breast disease can provide scientific basis for BPBD patients’health guidance.It can also lay the foundation for primary prevention of breast cancer.There are many risk factors for breast cancer,our study found that demographic characteristic,lifestyle and diet,anthropometry indicators such as height and weight were related to breast cancer risk.As the transform from normal to cancer,these factors may also have relationship with higher cancerization risk of BPBD.So this study will analysis the correlation of these factors and benign breast diseases’cancerization risk.Risk factor for breast cancer can divided into adjustable factors and unadjustable risk factors. The former include diet,obesity and so on,we can interfere them as our will.The latter include family history,age and factors that we can not change.Obviously,adjustable factors are more important in clinical works.Investigate the adjustable factors that leading to the rise of BPBD’s cancerization,especially the molecular level adjustable factors,can provide guidance and target for BPBD patients’cancer prevention.Obesity is one of breast cancer’s adjustable risk factor.it is also the most deeply investigated factor in molecular level.Most scholars believe that obesity may increase breast cancer risk. Obesity is a kind of systematic inflammational diseases. Fatty tissue can reserve fatty and has important endocrine function, can secret some kinds of peptide hormone. Epidemiological study and basic research show that, adipocytokines are the molecular link between obesity and cancer. Adiponectin is the only adipocytokine that decreased with the development of obesity. More and more studies show that adiponectin may play a vital role in obesity caused cancer.It is related to the breast cancer risk,can influence the progress of breast cancer.Our study also showed that adiponectin is a protective factor of breast cancer in the subgroup of postmenopause women. In consideration of adiponectin’s function in breast cancer carcinogenesis,we speculate it is the moleculer level reason of BPBD patients’higher cancerization rate.Adiponectin in circulating system is not the same. There are different forms of adiponectin in serum,which is low molecular weight adiponectin(LMWAPN) medium molecular weight adiponectin (MMWAPN) and high molecular weight adiponectin (HMWAPN). The three forms have different biological activities, receptor affinity, etc. HMW adiponectin has its specificity in insulin sensitivity,inflammation, cardiovascular disease and tumor. A 1167 pairs case-control study conducted by our group found that serum total adiponectin had no relationship with breast cancer risk,meanwhile,breast cancer patients had low serum HMW adiponectin levels compared with their matched controls.Our study indicated that different isoforms of adiponectin played different roles in breast tissue,HMW adiponectin may be the most important isoform of adiponectin as to breast diseases.So it is very important to explore the relationship between plasm HWM adiponectin. total adiponectin. HMWadiponectin/total adiponectin ratio and benign breast disease.In conclusion,this study aims at explore whether demographic characteristic,lifestyle and diet,anthropometry indicators,serum total adiponectin,HMW adiponectin,HMW/total adiponectin ratio is the reason of benign proliferative breast diseases’high cancerization risk compaired with nonproliferative disease,and then provide direction for primary prevention of breast cancer.Objective1. Explore whether environmental factors are the reason for benign proliferative breast diseases’higher cancerization risk compaired with nonproliferative disease,analysis the interaction of these factors and provide theory foundation for the prevention of benign proliferative breast diseases’cancerization.2. Investigate the difference of serum total adiponectin, HMW adiponectin, HMW/total adiponectin ratio level between benign proliferative brest diseases and nonproliferative disease,discuss wether they are the reason for benign proliferative breast diseases’higher cancerization risk,provide molecular targets for the prevention of BPBD patients’cancerization.Research Methods1. Case-control studyThis study chooses 23 hospitals in 11 provinces as research centers, patients who had pathological confirmed benign breast disease as subjects.They are divided into benign proliferative brest diseases group and nonproliferative disease group according to their pathology results. Basic questionnaire data was acquired by a face-to-face questionnaire survey. B-mode ultrasound scanning,mammography and pathology results was collected from the corresponding medical documents.2. The ELISA test of total adiponectin and HMW aidponectinUse the test kit for human total adiponectin and HMW adiponectin to test the level of serum total adiponectin and HMW adiponectin.3. Statistical analysisSPSS22.0 software was used to analyze all datas For continuous numerical variables, we used the paired t test to analyze. Classification variables were analysed by Chi-square test. Univariate and multivariate logistic regression analysis was used for correlation analysis between the factors and BPBD cancerization.Analyze the binary data by univariate Logistic regression analysis.The multivariate Logistic regression analysis was conducted if necessary.Use multiplicative model to analyse the interaction between risk factors of BPBD cancerization.Results1. The charictristics of basic investigation of two groupsThere are 416 subjects in BPBD group,the mean age of BPBD subjects are 45.58 (±7.62) years old; there are 166 subjects in nonproliferative disease group,the mean age of nonproliferative disease group subjects are 45.53 (±7.54) years old.2. Analysis of benign breast disease cancerization riskBy univariate analysis, we find central obesity(waist-hip ratio>0.85) is the risk factor of BBD cancerization.often drink tea and high HMW/total adiponectin ratio is the protective factor of BBD cancerization. In the multiple binary logistic regression analyses,central obesity(waist-hipratio>0.85)(P=0.041 OR=12.566,95%CI,:1.105-142.861) is the independent risk factor for BBD cancerization,high HMW/total adiponectin ratio(P=0.018, OR=0.605,95%CI 0.399-0.916)is the independent protective factor for.BBD cancerization.3. Interaction analysisAsα=0.05,central obesity(waist-hip ratio≥0.85) and tea have positive interaction (P=0.020, OR= 1.227,95%CI:1.032-1.458)Conclusion1.Central obesity(waist-hip ratio≥0.85),infrequent tea drinking can rise the cancerization risk of benign breast disease.2.Different forms of adiponectin may play different roles in benign proliferative breast diseases’cancerization risk. The circulating total and HMW adiponectin levels are not related to cancerization risk. Higher HMW/total adiponectin level is a reason for nonproliferative breast diseases’lower cancerization risk compaired to benign proliferative breast disease.