Lindblad M, García Rodríguez L A, Chandanos E, Lagergren J
Unit of Oesophageal and Gastric Research, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Br J Cancer. 2006 Jan 16;94(1):136-41. doi: 10.1038/sj.bjc.6602906.
Oesophageal and gastric adenocarcinoma share an unexplained male predominance, which would be explained by the hypothesis that oestrogens are protective in this respect. We carried out a nested case-control study of hormone replacement therapy (HRT) among 299 women with oesophageal cancer, 313 with gastric cancer, and 3191 randomly selected control women, frequency matched by age and calendar year in the General Practitioners Research Database in the United Kingdom. Data were adjusted for age, calendar year, tobacco smoking, alcohol consumption, body mass index, hysterectomy, and upper gastrointestinal disorders. Among 1 619 563 person-years of follow-up, more than 50% reduced risk of gastric adenocarcinoma was found among users of HRT compared to nonusers (odds ratio (OR), 0.48, 95% confidence interval (CI) 0.29-0.79). This inverse association appeared to be stronger for gastric noncardia (OR 0.34, 95% CI 0.14-0.78) and weaker for gastric cardia tumours (OR 0.68, 95% CI 0.23-2.01). There was no association between HRT and oesophageal adenocarcinoma (OR 1.17, 95% CI 0.41-3.32).
食管癌和胃癌都存在一种无法解释的男性优势现象，雌激素在这方面具有保护作用这一假说或许可以对此做出解释。我们在英国全科医生研究数据库中开展了一项巢式病例对照研究，纳入了299例食管癌女性患者、313例胃癌女性患者以及3191例随机选取的对照女性，按照年龄和日历年份进行频数匹配。对数据进行了年龄、日历年份、吸烟、饮酒、体重指数、子宫切除术以及上消化道疾病等因素的校正。在1619563人年的随访中，与未使用者相比，激素替代疗法（HRT）使用者患胃腺癌的风险降低了50%以上（比值比（OR）为0.48，95%置信区间（CI）为0.29 - 0.79）。这种负相关在胃非贲门癌中似乎更强（OR为0.34，95%CI为0.14 - 0.78），而在胃贲门肿瘤中则较弱（OR为0.68，95%CI为0.23 - 2.01）。HRT与食管腺癌之间无关联（OR为1.17，95%CI为0.41 - 3.32）。
