Travis Ruth C, Key Timothy J, Allen Naomi E, Appleby Paul N, Roddam Andrew W, Rinaldi Sabina, Egevad Lars, Gann Peter H, Rohrmann Sabine, Linseisen Jakob, Pischon Tobias, Boeing Heiner, Johnsen Nina Føns, Tjønneland Anne, Overvad Kim, Kiemeney Lambertus, Bueno-de-Mesquita H Bas, Bingham Sheila, Khaw Kay-Tee, Tumino Rosario, Sieri Sabina, Vineis Paolo, Palli Domenico, Quirós José Ramón, Ardanaz Eva, Chirlaque Maria-Dolores, Larrañaga Nerea, Gonzalez Carlos, Sanchez Maria-José, Trichopoulou Antonia, Bikou Chrysa, Trichopoulos Dimitrios, Stattin Pär, Jenab Mazda, Ferrari Pietro, Slimani Nadia, Riboli Elio, Kaaks Rudolf
Cancer Research UK Epidemiology Unit, University of Oxford, Oxford, United Kingdom.
Int J Cancer. 2007 Sep 15;121(6):1331-8. doi: 10.1002/ijc.22814.
We examined the hypothesis that serum concentrations of circulating androgens and sex hormone binding globulin (SHBG) are associated with risk for prostate cancer in a case-control study nested in the European Prospective Investigation into Cancer and Nutrition (EPIC). Concentrations of androstenedione, testosterone, androstanediol glucuronide and SHBG were measured in serum samples for 643 prostate cancer cases and 643 matched control participants, and concentrations of free testosterone were calculated. Conditional logistic regression models were used to calculate odds ratios for risk of prostate cancer in relation to the serum concentration of each hormone. After adjustment for potential confounders, there was no significant association with overall risk for prostate cancer for serum total or free testosterone concentrations (highest versus the lowest thirds: OR, 1.02; 95% CI, 0.73-1.41 and OR, 1.07, 95% CI, 0.74-1.55, respectively) or for other androgens or SHBG. Subgroup analyses showed significant heterogeneity for androstenedione by cancer stage, with a significant inverse association of androstenedione concentration and risk for advanced prostate cancer. There were also weak positive associations between free testosterone concentration and risk for total prostate cancer among younger men and risk for high-grade disease. In summary, in this large nested case-control study, concentrations of circulating androgens or SHBG were not strongly associated with risk for total prostate cancer. However, our findings are compatible with a positive association of free testosterone with risk in younger men and possible heterogeneity in the association with androstenedione concentration by stage of disease; these findings warrant further investigation.
在一项嵌套于欧洲癌症与营养前瞻性调查（EPIC）中的病例对照研究中，我们检验了循环雄激素和性激素结合球蛋白（SHBG）的血清浓度与前列腺癌风险相关的假设。对643例前列腺癌病例和643名匹配的对照参与者的血清样本测量了雄烯二酮、睾酮、硫酸雄甾二醇和SHBG的浓度，并计算了游离睾酮的浓度。使用条件逻辑回归模型计算每种激素血清浓度与前列腺癌风险的比值比。在对潜在混杂因素进行调整后，血清总睾酮或游离睾酮浓度（最高三分位数与最低三分位数相比：比值比分别为1.02；95%置信区间为0.73 - 1.41和比值比为1.07，95%置信区间为0.74 - 1.55）或其他雄激素或SHBG与前列腺癌总体风险均无显著关联。亚组分析显示，按癌症分期，雄烯二酮存在显著异质性，雄烯二酮浓度与晚期前列腺癌风险呈显著负相关。在年轻男性中，游离睾酮浓度与前列腺癌总体风险以及高级别疾病风险之间也存在微弱的正相关。总之，在这项大型嵌套病例对照研究中，循环雄激素或SHBG的浓度与前列腺癌总体风险并无强烈关联。然而，我们的研究结果与游离睾酮在年轻男性中与风险呈正相关以及按疾病分期与雄烯二酮浓度的关联可能存在异质性相符；这些发现值得进一步研究。
