Boyd N F, Stone J, Martin L J, Jong R, Fishell E, Yaffe M, Hammond G, Minkin S
Division of Epidemiology and Statistics, Ontario Cancer Institute, 610 University Avenue, Toronto, Ontario, Canada M5G 1K9.
Br J Cancer. 2002 Oct 7;87(8):876-82. doi: 10.1038/sj.bjc.6600537.
Radiologically dense breast tissue (mammographic density) is strongly associated with risk of breast cancer, but the biological basis for this association is unknown. In this study we have examined the association of circulating levels of hormones and growth factors with mammographic density. A total of 382 subjects, 193 premenopausal and 189 postmenopausal, without previous breast cancer or current hormone use, were selected in each of five categories of breast density from mammography units. Risk factor information, anthropometric measures, and blood samples were obtained, and oestradiol, progesterone, sex hormone binding globulin, growth hormone, insulin-like growth factor-I and its principal binding protein, and prolactin measured. Mammograms were digitised and measured using a computer-assisted method. After adjustment for other risk factors, we found in premenopausal women that serum insulin-like growth factor-I levels, and in postmenopausal women, serum levels of prolactin, were both significantly and positively associated with per cent density. Total oestradiol and progesterone levels were unrelated to per cent density in both groups. In postmenopausal women, free oestradiol (negatively), and sex hormone binding globulin (positively), were significantly related to per cent density. These data show an association between blood levels of breast mitogens and mammographic density, and suggest a biological basis for the associated risk of breast cancer.
乳腺钼靶密度高的乳腺组织与乳腺癌风险密切相关,但这种关联的生物学基础尚不清楚。在本研究中,我们检测了激素和生长因子的循环水平与乳腺钼靶密度之间的关联。从乳腺钼靶检查单位选取了382名受试者,分为绝经前193名和绝经后189名,这些受试者既往无乳腺癌史且目前未使用激素。获取了危险因素信息、人体测量数据和血样,并检测了雌二醇、孕酮、性激素结合球蛋白、生长激素、胰岛素样生长因子-I及其主要结合蛋白以及催乳素。乳腺钼靶片经数字化处理后采用计算机辅助方法进行测量。在对其他危险因素进行校正后,我们发现绝经前女性血清胰岛素样生长因子-I水平以及绝经后女性血清催乳素水平均与密度百分比显著正相关。两组中总雌二醇和孕酮水平与密度百分比均无关。在绝经后女性中,游离雌二醇(呈负相关)和性激素结合球蛋白(呈正相关)与密度百分比显著相关。这些数据表明乳腺有丝分裂原的血液水平与乳腺钼靶密度之间存在关联,并提示了乳腺癌相关风险的生物学基础。