Sturgeon Susan R, Potischman Nancy, Malone Kathleen E, Dorgan Joanne F, Daling Janet, Schairer Cathy, Brinton Louise A
Department of Biostatistics and Epidemiology, University of Massachusetts, 715 North Pleasant Street, Arnold House 407, Amherst, MA 01003-9304, USA.
Cancer Causes Control. 2004 Feb;15(1):45-53. doi: 10.1023/B:CACO.0000016574.79728.11.
High levels of serum estrogens and androgens have been convincingly linked with an increased risk of breast cancer among postmenopausal women. By contrast, the role of blood levels of these hormones in the etiology of premenopausal breast cancer is not well understood. In a case-control study, we sought to examine associations between levels of serum estradiol, sex-hormone binding globulin (SHBG), dehydroepiandrosterone (DHEA), testosterone, androstenedione and progesterone and risk of premenopausal breast cancer. Cases of breast cancer under age 45 were identified using rapid ascertainment systems in Seattle/Puget Sound, Washington and control subjects were identified from the same area through random digit dialing methods. A total of 169 eligible breast cancer cases and 195 control subjects donated blood (either before or six or more weeks after surgery) and were interviewed using a standardized questionnaire. The fully adjusted risk ratios and 95% confidence intervals for the highest versus lowest tertiles of estradiol, according to menstrual cycle phase, were 3.10 (0.8-12.7) for early follicular, 0.54 (0.2-1.7) for late follicular and 0.60 (0.3-1.4) for luteal. Risks for highest versus lowest quartiles of SHBG and androgens were 0.81 (0.4-1.6) for SHBG, 2.42 (1.1-5.2) for DHEA, 1.12 (0.6-2.5) for testosterone, and 1.33 (0.6-2.8) for androstenedione. For luteal progesterone, the RR for the highest versus lowest tertile was 0.55 (0.2-1.4). In summary, we did not find a convincing association between serum SHBG, estradiol, testosterone or androstenedione and premenopausal breast cancer risk. Observed differences between cases and controls subjects in serum levels of DHEA and luteal phase progesterone should be investigated further in large prospective studies.
血清雌激素和雄激素水平高已被确凿地证明与绝经后女性患乳腺癌风险增加有关。相比之下，这些激素的血液水平在绝经前乳腺癌病因中的作用尚不清楚。在一项病例对照研究中，我们试图研究血清雌二醇、性激素结合球蛋白（SHBG）、脱氢表雄酮（DHEA）、睾酮、雄烯二酮和孕酮水平与绝经前乳腺癌风险之间的关联。45岁以下乳腺癌病例通过华盛顿州西雅图/普吉特海湾的快速确诊系统确定，对照对象通过随机数字拨号方法从同一地区确定。共有169例符合条件的乳腺癌病例和195名对照对象献血（手术前或手术后六周或更长时间），并使用标准化问卷进行访谈。根据月经周期阶段，雌二醇最高三分位数与最低三分位数的完全调整风险比和95%置信区间，卵泡早期为3.10（0.8 - 12.7），卵泡晚期为0.54（0.2 - 1.7），黄体期为0.60（0.3 - 1.4）。SHBG和雄激素最高四分位数与最低四分位数的风险分别为：SHBG为0.81（0.4 - 1.6），DHEA为2.42（1.1 - 5.2），睾酮为1.12（0.6 - 2.5），雄烯二酮为1.33（0.6 - 2.8）。对于黄体期孕酮，最高三分位数与最低三分位数的风险比为0.55（0.2 - 1.4）。总之，我们未发现血清SHBG、雌二醇、睾酮或雄烯二酮与绝经前乳腺癌风险之间存在令人信服的关联。病例组与对照组血清DHEA水平和黄体期孕酮水平的观察差异应在大型前瞻性研究中进一步调查。
