Tworoger Shelley S, Eliassen A Heather, Sluss Patrick, Hankinson Susan E
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
J Clin Oncol. 2007 Apr 20;25(12):1482-8. doi: 10.1200/JCO.2006.07.6356. Epub 2007 Mar 19.
Epidemiologic studies suggest that prolactin is associated with breast cancer risk in older women. Because of limited prospective data, particularly in younger women, we examined whether prolactin concentrations were associated with breast cancer risk among women 42 to 55 years (68% premenopausal) from the Nurses' Health Study (NHS), and then conducted a pooled analysis of three studies.
The analysis included 377 cases of breast cancer diagnosed after blood draw and before June 2000; two controls were matched per case on age, menopausal status at blood draw and diagnosis, fasting status, and time of day and month of blood collection. These data were pooled with two previously published data sets from the NHS and NHSII cohorts (n = 1,539 cases, 2,681 controls; ages 32 to 70 years).
Prolactin was modestly associated with an increased breast cancer risk (relative risk [RR], top v bottom quartile = 1.3; 95% CI, 0.9 to 1.9; P for trend = .12). Risk estimates did not vary by menopausal status, tumor invasiveness, or estrogen receptor (ER) status. In the pooled analysis, the overall RR was 1.3 (95% CI, 1.1 to 1.6; P for trend = .002), and did not vary by menopausal status (P for interaction = .95). The risk was strongest for women with ER+ tumors (RR = 1.6; 95% CI, 1.2 to 2.0; P for trend < .001). Correcting for within-person variability, the RR comparing the median of the top versus the bottom prolactin quartile increased from 1.3 to 1.7 for all women and from 1.5 to 2.1 for ER+ cases.
These data, in conjunction with experimental studies, indicate that prolactin likely is important in breast cancer etiology, particularly ER+ tumors, over a wide range of ages.
流行病学研究表明，催乳素与老年女性患乳腺癌的风险相关。由于前瞻性数据有限，尤其是在年轻女性中，我们研究了来自护士健康研究（NHS）的42至55岁女性（68%为绝经前女性）中催乳素浓度是否与患乳腺癌风险相关，然后对三项研究进行了汇总分析。
分析纳入了377例在采血后至2000年6月前确诊的乳腺癌病例；每例病例匹配两名对照，对照在年龄、采血时和诊断时的绝经状态、空腹状态以及采血的日期和时间方面与病例进行匹配。这些数据与之前发表的来自NHS和NHSII队列的两个数据集（n = 1539例病例，2681例对照；年龄32至70岁）进行了汇总。
催乳素与患乳腺癌风险适度增加相关（相对风险[RR]，最高四分位数与最低四分位数相比 = 1.3；95%置信区间，0.9至1.9；趋势P值 = 0.12）。风险估计值在绝经状态、肿瘤侵袭性或雌激素受体（ER）状态方面没有差异。在汇总分析中，总体RR为1.3（95%置信区间，1.1至1.6；趋势P值 = 0.002），且在绝经状态方面没有差异（交互作用P值 = 0.95）。对于ER阳性肿瘤的女性，风险最强（RR = 1.6；95%置信区间，1.2至2.0；趋势P值 < 0.001）。校正个体内变异性后，所有女性中比较催乳素最高四分位数中位数与最低四分位数中位数的RR从1.3增加到1.7，ER阳性病例从1.5增加到2.1。
这些数据与实验研究一起表明，催乳素在广泛的年龄范围内可能在乳腺癌病因中起重要作用，尤其是在ER阳性肿瘤中。
