Tworoger Shelley S, Lee I-Min, Buring Julie E, Hankinson Susan E
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Am J Epidemiol. 2008 Jan 15;167(2):211-8. doi: 10.1093/aje/kwm278. Epub 2007 Nov 3.
Androgens have been implicated in increasing ovarian cancer risk; however, results from prospective studies have been inconclusive. The authors examined whether plasma concentrations of testosterone, androstenedione, dehydroepiandrosterone, and dehydroepiandrosterone sulfate were associated with risk of epithelial ovarian cancer in a nested-case control study, using data from three prospective cohort studies: the Nurses' Health Study (NHS), Nurses' Health Study II (NHSII), and the Women's Health Study (WHS). The present analysis comprised 224 cases (161 from the NHS/NHSII and 63 from the WHS) and 603 controls (matched at a ratio of 1:3 for the NHS/NHSII and 1:2 for the WHS), with follow-up of up to 14 years. Women ranged in age from 34 years to 72 years (mean age = 56 years). The authors did not observe any associations between plasma androgen levels and risk of ovarian cancer. For example, comparing the top quartile with the bottom quartile, the relative risk was 0.74 (95% confidence interval: 0.44, 1.25; p-trend = 0.34) for testosterone and 0.76 (95% confidence interval: 0.45, 1.30; p-trend = 0.65) for androstenedione. There was a suggestion that dehydroepiandrosterone and dehydroepiandrosterone sulfate were inversely associated with ovarian cancer risk among postmenopausal women (for top quartile vs. bottom, relative risks were 0.65 and 0.70, respectively). Overall, these results do not support a positive association between circulating androgen levels and ovarian cancer risk.
雄激素被认为会增加卵巢癌风险;然而,前瞻性研究的结果尚无定论。作者在一项巢式病例对照研究中,利用三项前瞻性队列研究的数据,即护士健康研究(NHS)、护士健康研究II(NHSII)和妇女健康研究(WHS),研究了血浆睾酮、雄烯二酮、脱氢表雄酮和硫酸脱氢表雄酮浓度与上皮性卵巢癌风险之间的关联。本分析包括224例病例(161例来自NHS/NHSII,63例来自WHS)和603例对照(NHS/NHSII按1:3匹配,WHS按1:2匹配),随访时间长达14年。女性年龄在34岁至72岁之间(平均年龄 = 56岁)。作者未观察到血浆雄激素水平与卵巢癌风险之间存在任何关联。例如,将最高四分位数与最低四分位数进行比较,睾酮的相对风险为0.74(95%置信区间:0.44, 1.25;p趋势 = 0.34),雄烯二酮的相对风险为0.76(95%置信区间:0.45, 1.30;p趋势 = 0.65)。有迹象表明,绝经后女性中脱氢表雄酮和硫酸脱氢表雄酮与卵巢癌风险呈负相关(最高四分位数与最低四分位数相比,相对风险分别为0.65和0.70)。总体而言,这些结果不支持循环雄激素水平与卵巢癌风险之间存在正相关。