Weir H K, Marrett L D, Kreiger N, Darlington G A, Sugar L
Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada.
Int J Cancer. 2000 Aug 1;87(3):438-43. doi: 10.1002/1097-0215(20000801)87:3<438::aid-ijc20>3.0.co;2-1.
The present case-control study was undertaken to investigate the association between exposure to maternal hormones and risk of testicular germ-cell cancer by histologic subgroups. Cases were males, aged 16 to 59 years, diagnosed with testicular germ-cell cancer in Ontario between 1987 and 1989. Histologic review was performed on all eligible cases for the purpose of categorizing cases as seminoma or non-seminoma (the latter classified 2 ways, with and without tumors containing seminoma). Risk factor data were collected on 502 cases, 346 case mothers, 975 age-matched controls, and 522 control mothers. Exogenous hormone exposure was associated with elevated risk (OR = 4.9, 95% CI 1.7-13.9). Several additional risk factors were associated with risk of testicular cancer: bleeding and threatened miscarriage (OR = 0.6, 95% CI 0.3-1.0), maternal cigarette smoking (12+ cigarettes/day OR = 0.6, 95% CI 0. 4-1.0). pre-term birth (OR = 1.6, 95% CI 1.0-2.5), and treatment for undescended testicle (OR = 8.0, 95% CI 3.2-20.0). First births were associated with elevated risk (OR = 1.7, 95% CI 1.0-2.8) among mothers below the age of 24 years at conception. There was little evidence that risk factors differed by histologic subgroup. We found evidence that exposure to maternal hormones, particularly estrogens, is associated with testicular germ-cell cancer risk. Not only does exposure to elevated levels (exogenous hormone use, pre-term birth, and first births among young mothers) increase risk but also exposure to relatively lower levels (heavy cigarette consumption and, perhaps, bleeding and threatened miscarriage) may decrease cancer risk.
本病例对照研究旨在按组织学亚组调查母体激素暴露与睾丸生殖细胞癌风险之间的关联。病例为1987年至1989年间在安大略省诊断为睾丸生殖细胞癌的16至59岁男性。对所有符合条件的病例进行组织学检查，目的是将病例分类为精原细胞瘤或非精原细胞瘤（后者以两种方式分类，有或无包含精原细胞瘤的肿瘤）。收集了502例病例、346例病例母亲、975例年龄匹配对照和522例对照母亲的危险因素数据。外源性激素暴露与风险升高相关（比值比=4.9，95%可信区间1.7-13.9）。其他几个危险因素与睾丸癌风险相关：出血和先兆流产（比值比=0.6，95%可信区间0.3-1.0）、母亲吸烟（每天12支以上香烟比值比=0.6，95%可信区间0.4-1.0）、早产（比值比=1.6，95%可信区间1.0-2.5）以及隐睾治疗（比值比=8.0，95%可信区间3.2-20.0）。初产与受孕时年龄低于24岁的母亲中风险升高相关（比值比=1.7，95%可信区间1.0-2.8）。几乎没有证据表明危险因素在组织学亚组之间存在差异。我们发现有证据表明母体激素暴露，尤其是雌激素暴露，与睾丸生殖细胞癌风险相关。不仅高水平暴露（外源性激素使用、早产和年轻母亲的初产）会增加风险，而且相对低水平暴露（大量吸烟以及可能的出血和先兆流产）可能会降低癌症风险。
