Association of Overweight and Inflammatory Indicators with Breast Cancer: A Cross-Sectional Study in Chinese Women

Figures & data

Table 1 Clinical and Pathological Characteristics of 383 Non-Cancer Patients and 358 Cancer Patients

Variable	Non-Cancer Cases (n=383) n (%)	Cancer Cases (n=358) n (%)	P value	FDR
Age (years)
≤30	66 (17.2)	8 (2.2)	<0.0001*	<0.0001*
31–60	287 (74.9)	226 (63.1)
>60	30 (7.8)	124 (34.6)
Menopause			0.0106*	0.0141*
No	285 (74.4)	164 (45.8)
Yes	98 (25.6)	194 (54.2)
Diabetes			0.0058*	0.0116*
No	371 (96.9)	314 (87.7)
Yes	12 (3.1)	44 (12.3)
BMI			0.1405	0.1405
<24 kg/m2	266 (69.5)	197 (55.0)
≥24 kg/m2	117 (30.5)	161 (45.0)
Tumor diameter (cm)	-
<2		147 (41.1)
2–5		190 (53.1)
>5		21 (5.9)
Histological grade	-
Class I–II		180 (62.7)
Class III		107 (37.3)
Ki-67+ (%)	-
<15		88 (24.6)
15–30		141 (39.4)
>30		129 (36.0)
Lymph node metastasis	-
No		217 (60.6)
Yes		141 (39.4)
Pathological staging	-
Phase I		102 (28.5)
Phase II		193 (53.9)
Phase III		63 (17.6)
ER	-
Negative		119 (33.2)
Positive		239 (66.8)
PR	-
Negative		169 (47.2)
Positive		189 (52.8)
Vessel tumor emboli	-
No		317 (88.5)
Yes		41 (11.5)
Pathological type	-
Preinvasive carcinoma		25 (7.0)
Invasive ductal carcinoma		295 (82.4)
Invasive lobular carcinoma		8 (2.2)
Mucinous adenocarcinoma		11 (3.1)
Other types		19 (5.3)
Molecular typing	-
Luminal type a		116 (32.4)
Luminal type b		76 (21.2)
Triple negative		70 (19.6)
Her2+HR+		47 (13.1)
Her2+HR-		49 (13.7)
Her2 grade	-
0/1+		124 (40.5)
2+		87 (28.4)
3+		95 (31.0)

Note: *P<0.05.

Abbreviations: ER, estrogen receptor; PR: progesterone receptor; Her2, human epidermal growth factor receptor 2.

Figure 1 A patient flow diagram in accordance with the international Standards for Reporting of Diagnostic Accuracy Studies (STARD) guidelines.

Table 2 The Correlation of Overweight on the Proportion of Non-Cancer or Cancer Cases

	Non-Cancer (%)	Cancer (%)	Total	χ^2	P value
BMI			741	16.422	<0.001*
<24 kg/m^2	266 (57.5)	197 (42.5)	463
≥24 kg/m^2	117 (42.1)	161 (57.9)	278

Note: *P<0.05.

Table 3 Correlation Between BMI and the Proportion of Non-Cancer or Cancer Cases

			BMI	Non-Cancer or Cancer
Spearman Rho	BMI	Correlation coefficient	1.000	0.149
		P value		<0.001*
		Number	582	582

Note: *P<0.05.

Table 4 Multivariate Logistic Regression Analysis of Putative-Risk Factors for Breast Cancer

Variable	B	SE	Wald χ^2	P value	FDR	OR	95% CI
BMI	0.412	0.162	6.430	0.011*	0.011*	1.510	1.098–2.076
Menopause	1.068	0.163	42.729	<0.001*	<0.001*	2.910	2.112–4.008
Diabetes	1.025	0.348	8.685	0.003*	0.005*	2.788	1.410–5.513

Note: *P<0.05.

Table 5 Correlation Between BMI and Peripheral Blood Inflammatory Indicators

	Nonoverweight Group Median (25%-75%) BMI<24 kg/m^2	Overweight Group Median (25%-75%) BMI≥24 kg/m^2	Z score	P value	FDR
WBC (10^9/L)	5.11 (4.34–6.04)	5.91 (4.98–6.97)	−6.973	<0.001*	<0.001*
NE (10^9/L)	3.00 (2.42–3.81)	3.59 (2.83–4.37)	−6.387	<0.001*	<0.001*
LY (10^9/L)	1.61 (1.27–1.93)	1.72 (1.40–2.14)	−3.678	<0.001*	<0.001*
PLT (10^9/L)	216 (181–257)	230 (193–273)	−2.904	0.004*	0.005*
hsCRP (mg/L)	0.50 (0.26–0.98)	1.21 (0.68–2.81)	−10.550	<0.001*	<0.001*
NLR	1.89 (1.47–2.50)	2.08 (1.57–2.68)	−2.704	0.007*	0.008*
PLR	135.14 (106.80–172.07)	132.08 (105.05–160.33)	−1.241	0.215	0.215
SII (10^9/L)	403.65 (289.49–566.73)	460.60 (345.79–604.39)	−3.447	0.001*	0.002*

Note: *P<0.05.

Table 6 Comparison of Inflammatory Indicators in the Peripheral Blood of Non-Cancer and Cancer Patients

	Non-Cancer Median (25%-75%)	Cancer Median (25%-75%)	Z score	P value	FDR
WBC (10^9/L)	5.27 (4.46–6.38)	5.52 (4.67–6.57)	−2.057	0.040*	0.072
NE (10^9/L)	3.03 (2.45–3.95)	3.31 (2.65–4.23)	−2.838	0.005*	0.011*
LY (10^9/L)	1.66 (1.30–2.03)	1.64 (1.33–1.93)	−0.732	0.464	0.597
PLT (10^9/L)	223 (184–263)	219 (186–259)	−0.438	0.661	0.744
hsCRP (mg/L)	0.63 (0.27–1.32)	0.74 (0.39–1.78)	−3.245	0.001*	0.005*
NLR	1.87 (1.43–2.51)	2.01 (1.59–2.68)	−2.837	0.005*	0.011*
PLR	133.65 (105.58–170.00)	134.57 (105.91–164.33)	−0.183	0.855	0.855
SII (10^9/L)	404.87 (309.12–556.61)	444.26 (321.03–603.96)	−1.868	0.062	0.093
BMI (kg/m^2)	22.27(20.576–24.435)	23.44(21.50–25.78)	−4.722	<0.001*	<0.001*

Note: *P<0.05.

Table 7 Overweight and High Levels of Some Inflammatory Indicators are Putative-Risk Factors for Breast Cancer

	Optimal Cut-Off	AUC	Sensitivity (%)	Specificity (%)	P value	FDR
BMI (kg/m^2)	24.57	0.600	39	77	<0.001*	<0.001*
WBC (10^9/L)	4.95	0.544	68	42	0.040*	0.004*
NE (10^9/L)	2.96	0.560	67	48	0.005*	0.006*
hsCRP (mg/L)	0.34	0.569	81	32	0.001*	0.003*
NLR	1.85	0.560	62	49	0.005*	0.006*

Note: *P<0.05.

Figure 2 ROC curve of BMI (a) and WBC (b), NE (c), hsCRP (d), and NLR (e) in peripheral blood.

Table 8 Multivariate Logistic Regression Analysis of Inflammatory Indicators for Breast Cancer

Variable	B	SE	Wald χ^2	P value	FDR	OR	95% CI
WBC (>4.95×10^9/L)	0.113	0.217	0.270	0.603	0.603	1.119	0.732–1.711
NE (>2.96×10^9/L)	0.307	0.239	1.645	0.200	0.270	1.359	0.850–2.172
hsCRP (>0.34 mg/L)	0.541	0.173	9.732	0.002*	0.008*	1.718	1.223–2.413
NLR (>1.85)	0.226	0.177	1.628	0.202	0.270	1.254	0.886–1.776

Note: *P<0.05.

Table 9 Comparison of Inflammatory Indicators with the Size of Malignant Breast Tumors

	≤5 cm Median (25%-75%)	>5 cm Median (25%-75%)	Z score	P value	FDR
WBC (10^9/L)	5.50(4.62–6.55)	5.72(5.26–6.90)	−1.227	0.220	0.373
NE (10^9/L)	3.29(2.63–4.22)	4.01(3.02–4.50)	−1.638	0.102	0.272
LY (10^9/L)	1.64(1.33–1.94)	1.63(1.36–1.86)	−0.394	0.693	0.792
PLT (10^9/L)	219(186–258)	227(172–300)	−0.263	0.793	0.793
hsCRP (mg/L)	0.74(0.40–1.74)	1.99(0.46–5.40)	−2.054	0.040*	0.272
NLR	2.01(1.58–2.67)	2.17(1.92–2.99)	−1.791	0.073	0.272
PLR	133.74(106.08–162.76)	147.27(98.65–173.05)	−0.728	0.467	0.623
SII (10^9/L)	443.88(312.97–595.81)	456.21(343.69–710.24)	−1.192	0.233	0.373

Note: *P<0.05.