Sonke Gabe S, Chang Shine, Strom Sara S, Sweeney Anne M, Annegers J Fred, Sigurdson Alice J
Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA.
Oncol Res. 2007;16(8):383-7. doi: 10.3727/000000006783980928.
Some evidence exists to support the hypothesis that elevated levels of circulating maternal estrogens during early pregnancy may increase risk of testicular germ cell cancer. However, the results from studies evaluating maternal factors have been mixed. We evaluated maternal factors, particularly those associated with excess estrogen levels, as risk factors for testicular cancer. We conducted a hospital-based case-control study at The University of Texas M. D. Anderson Cancer Center in Houston, Texas of 144 testicular cancer patients diagnosed between 1990 and 1996 and 86 friend controls matched to cases on age, race, and state of residence. Risk factor data about the mother, the son, and the pregnancy were obtained from the mothers by telephone interviews and from the sons by self-administered questionnaires. Extreme nausea during the first trimester of pregnancy was associated with an elevated risk of testicular cancer [odds ratio (OR) = 2.0; 95% confidence interval (CI) = 1.0-3.9]. Adjustment for potential confounders slightly lowered this risk (OR = 1.8; 95% CI = 0.9-3.8). Risks were modestly increased for other factors that are proxy measures for maternal estrogens, including preterm delivery (OR = 2.2; 95% CI = 0.4-12.9), birth weight <3000 g (OR = 2.4: 95% CI = 0.7-8.1), and birth weight >4000 g (OR = 1.7; 95% CI = 0.9-3.2), albeit nonsignificantly so. Our finding that severe nausea was associated with increased testicular cancer risk adds evidence to support the in utero estrogen exposure hypothesis because nausea early in pregnancy is related to rising levels of circulating estrogens. For other factors, which are less direct measures of maternal estrogens, the modest associations found indicate a suggestive pattern in support of the excess estrogen hypothesis.
妊娠早期母体循环雌激素水平升高可能会增加睾丸生殖细胞癌的风险。然而，评估母体因素的研究结果并不一致。我们评估了母体因素，尤其是那些与雌激素水平过高相关的因素，作为睾丸癌的风险因素。我们在德克萨斯州休斯顿的德克萨斯大学MD安德森癌症中心进行了一项基于医院的病例对照研究，研究对象为1990年至1996年间确诊的144例睾丸癌患者以及86名在年龄、种族和居住州方面与病例匹配的朋友对照。通过电话访谈从母亲那里获取有关母亲、儿子和妊娠的风险因素数据，并通过自填问卷从儿子那里获取相关数据。妊娠头三个月出现严重恶心与睾丸癌风险升高相关[比值比（OR）= 2.0；95%置信区间（CI）= 1.0 - 3.9]。对潜在混杂因素进行调整后，这一风险略有降低（OR = 1.8；95% CI = 0.9 - 3.8）。对于其他作为母体雌激素替代指标的因素，风险适度增加，包括早产（OR = 2.2；95% CI = 0.4 - 12.9）、出生体重<3000 g（OR = 2.4：95% CI = 0.7 - 8.1）和出生体重>4000 g（OR = 1.7；95% CI = 0.9 - 3.2），尽管不显著。我们发现严重恶心与睾丸癌风险增加相关，这为支持子宫内雌激素暴露假说增添了证据，因为妊娠早期恶心与循环雌激素水平升高有关。对于其他并非母体雌激素直接测量指标的因素，所发现的适度关联表明存在支持雌激素过多假说的提示性模式。
