The Effect Of Fasting Hyperglycemia On The Recurrence Of Breast Cancer In Women

Objective: Recently, with the improvement of living standards, it is increasing of the morbidity of diabetes mellitus, which seriously affects human bings health. Breast cancer is one of the most common malignancies for women and its incidence is also raising year by year, which is an important cause to lead to female mortality. Diabetes mellitus was not only a risk factor for breast cancer, but also an important factor in poor prognosis of breast cancer in many studies. However, the impaired glucose metabolism was often ignored, which has been existed for a long time before diabetes mellitus was diagnosed. There were few studies about the effect of impaired fasting glucose level(not reach the diagnostic criteria of diabetes mellitus) on the prognosis of female breast cancer. In this study, the effect of elevated fasting plasma glucose(including diabetes mellitus and impaired fasting glucose) on the recurrence of breast cancer was discussed in women.Methods: According to the inclusion and exclusion criteria, 180 cases of female patients with breast cancer were collected from Record Room of The Fourth Hospital of Hebei Medical University. All the patient's age, height,weight, menstruation, ALT, AST, total bilirubin, direct bilirubin, indirect bilirubin, serum creatinine, urea nitrogen, FPG(fasting plasma glucose), past medical history(especially the history of diabetes mellitus), breast mass operation time, tumor diameter, immunohistochemistry(ER, PR, p53) and the date of recurrence in recurrence group were recorded. Depending on whether relapse, the patients were divided into the recurrence and control groups;according to the state of fasting plasma glucose, patients were divided into normal fasting plasma glucose group, impaired fasting glucose group and diabetes mellitus group; according to body mass index, patients were dividedinto normal weight group, overweight group and obese group. Database was established and SPSS17.0 statistical software was used for statistical analysis.Results:1 The fasting plasma glucose and BMI were significantly higher in recurrence group than that in control group. However, there was no significant difference in age, ALT, AST, total bilirubin, direct bilirubin, indirect bilirubin,serum creatinine, urea nitrogen, hypertension ratio and menstruation status between these two groups.2 The patients in the recurrence group were divided into normal fasting plasma glucose group, impaired fasting glucose group and diabetes mellitus group according to fasting plasma glucose. There was no significant difference in Disease-free survival(DFS) after breast cancer operation among these three groups.3 There was no significant difference in tumor diameter and positive expression of ER, PR and P53 among normal fasting plasma glucose group,impaired fasting glucose group and diabetes mellitus group.4 The proportion of postoperative recurrence was significantly higher in impaired fasting glucose group and diabetes mellitus group compared with normal fasting plasma glucose group, but there was no significant difference in the proportion of postoperative recurrence between impaired fasting glucose group and diabetes mellitus group.5 The proportion of postoperative recurrence was significantly higher in obese group compared with normal body weight group. There was no significant difference in this proportion not only between normal weight group and overweight group but also between overweight group and obese group.6 After adjusting effect of BMI and age, the impaired fasting glucose and diabetes mellitus were the risk factors of postoperative recurrence in female patients with breast cancer.Conclusion:1 The risk of recurrence was increased in breast cancer women who were fasting hyperglycemia and overweight.2 After adjusting factors of BMI and age, the impaired fasting glucose and diabetes mellitus were also the risk factors of breast cancer recurrence.Concerning postoperative prognosis of women with breast cancer, not only diabetes mellitus, but also the impaired fasting glucose of breast cancer patients should be paid attention.