Trichopoulos Dimitrios, Adami Hans-Olov, Ekbom Anders, Hsieh Chung-Cheng, Lagiou Pagona
Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA.
Int J Cancer. 2008 Feb 1;122(3):481-5. doi: 10.1002/ijc.23303.
Risk factors for breast cancer--documented by intensive epidemiological investigations and viewed in the context of general principles of carcinogenesis--can be integrated to an etiologic model comprising 3 principal components: the likelihood of breast cancer occurrence depends on the number of mammary tissue-specific stem cells, which is determined in early life; all growth-enhancing mammotropic hormones affect the rate of expansion of initiated clones; and while a pregnancy stimulates the replication of already initiated cells, it conveys long-term protection through differentiation of mammary tissue-specific stem cells. This perspective accommodates much of what is known about the epidemiology and natural history of breast cancer and highlights the role of early life in the origin of this cancer.
乳腺癌的风险因素——通过深入的流行病学调查记录，并结合癌症发生的一般原则来看——可以整合到一个病因模型中，该模型包含三个主要组成部分：乳腺癌发生的可能性取决于乳腺组织特异性干细胞的数量，这在生命早期就已确定；所有促进生长的促乳激素都会影响已启动克隆的扩增速率；虽然怀孕会刺激已启动细胞的复制，但它通过乳腺组织特异性干细胞的分化提供长期保护。这一观点涵盖了许多已知的关于乳腺癌流行病学和自然史的内容，并突出了生命早期在这种癌症起源中的作用。
