Huang Kui, Whelan Elizabeth A, Ruder Avima M, Ward Elizabeth M, Deddens James A, Davis-King Karen E, Carreón Tania, Waters Martha A, Butler Mary Ann, Calvert Geoffrey M, Schulte Paul A, Zivkovich Zachary, Heineman Ellen F, Mandel Jack S, Morton Roscoe F, Reding Douglas J, Rosenman Kenneth D
National Institute for Occupational Safety and Health, 4676 Columbia Parkway, Cincinnati, OH 45226, USA.
Cancer Epidemiol Biomarkers Prev. 2004 Oct;13(10):1583-8.
Glioma is the most common primary malignant brain tumor in adults, responsible for 75% of adult primary malignant brain tumors, yet aside from its association with ionizing radiation, its etiology is poorly understood. Sex differences in brain tumor incidence suggest that hormonal factors may play a role in the etiology of these tumors, but few studies have examined this association in detail. The objective of this study was to explore the role of reproductive factors in the etiology of glioma in women.
As part of a population-based case-control study, histologically confirmed primary glioma cases (n = 341 women) diagnosed between January 1, 1995 and January 31, 1997 were identified through clinics and hospitals in four Midwest U.S. states. Controls (n = 527 women) were randomly selected from lists of licensed drivers and Health Care Finance Administration enrollees. In-person interviews with subjects (81%) or their proxies (19%) collected reproductive history and other exposure information.
Glioma risk increased with older age at menarche (P for trend = 0.009) but only among postmenopausal women. Compared with women who never breast-fed, women who breast-fed >18 months over their lifetime were at increased risk of glioma (odds ratio, 1.8; 95% confidence interval, 1.1-2.9). Women who reported using hormones for symptoms of menopause had a decreased risk of glioma compared with women who never used such hormones (odds ratio, 0.7; 95% confidence interval, 0.5-1.1).
These results support the hypothesis that reproductive hormones play a role in the etiology of glioma among women.
胶质瘤是成人中最常见的原发性恶性脑肿瘤，占成人原发性恶性脑肿瘤的75%，然而，除了与电离辐射有关外，其病因尚不清楚。脑肿瘤发病率的性别差异表明，激素因素可能在这些肿瘤的病因中起作用，但很少有研究详细探讨这种关联。本研究的目的是探讨生殖因素在女性胶质瘤病因中的作用。
作为一项基于人群的病例对照研究的一部分，通过美国中西部四个州的诊所和医院，确定了1995年1月1日至1997年1月31日期间经组织学确诊的原发性胶质瘤病例（n = 341名女性）。对照组（n = 527名女性）从持牌司机名单和医疗保健财务管理局登记者中随机选取。对受试者（81%）或其代理人（19%）进行面对面访谈，收集生殖史和其他暴露信息。
初潮年龄较大的女性患胶质瘤的风险增加（趋势P值 = 0.009），但仅在绝经后女性中。与从未哺乳的女性相比，一生中哺乳超过18个月的女性患胶质瘤的风险增加（比值比，1.8；95%置信区间，1.1 - 2.9）。报告使用激素治疗更年期症状的女性与从未使用此类激素的女性相比，患胶质瘤的风险降低（比值比，0.7；95%置信区间，0.5 - 1.1）。
这些结果支持生殖激素在女性胶质瘤病因中起作用这一假设。
