Titus-Ernstoff Linda, Troisi Rebecca, Hatch Elizabeth E, Hyer Marianne, Wise Lauren A, Palmer Julie R, Kaufman Raymond, Adam Ervin, Noller Kenneth, Herbst Arthur L, Strohsnitter William, Cole Bernard F, Hartge Patricia, Hoover Robert N
Department of Community and Family Medicine, Dartmouth Medical School, and the Norris Cotton Cancer Center, Lebanon, NH 03756, USA.
Epidemiology. 2008 Mar;19(2):251-7. doi: 10.1097/EDE.0b013e318163152a.
Animal studies suggest that prenatal exposure to the synthetic estrogen diethylstilbestrol (DES) causes epigenetic changes that may be transmitted to the next generation. Specifically, these studies show an elevated incidence of reproductive tumors in the female offspring of prenatally-exposed mice.
We assessed cancer and benign pathology diagnoses occurring in the offspring of women whose prenatal exposure to DES (or lack of exposure) was verified by medical record. Our data arose from 2 sources: the mothers' reports of cancers occurring in 8216 sons and daughters, and pathology-confirmed cancers and benign diagnoses self-reported by a subset of 793 daughters.
Although statistical power is limited, our data are consistent with no overall increase of cancer in the sons or daughters of women exposed in utero to DES. Based on pathology-confirmed diagnoses reported by the daughters, we saw no association between DES and risk of benign breast disease or reproductive tract conditions. Based on 3 cases, the incidence of ovarian cancer was higher than expected in the daughters of women exposed prenatally to DES.
Our data do not support an overall increase of cancer risk in the sons or daughters of women exposed prenatally to DES, but the number of ovarian cancer cases was greater than expected. While preliminary, this finding supports continued monitoring of these daughters.
动物研究表明，产前接触合成雌激素己烯雌酚（DES）会导致表观遗传变化，这些变化可能会传递给下一代。具体而言，这些研究显示，产前接触DES的小鼠雌性后代中生殖系统肿瘤的发病率有所上升。
我们评估了通过病历证实产前接触过DES（或未接触过）的女性后代中的癌症和良性病理诊断情况。我们的数据来自两个来源：母亲报告的8216名子女中发生的癌症，以及793名女儿子集自我报告的经病理证实的癌症和良性诊断。
尽管统计效力有限，但我们的数据表明，子宫内接触DES的女性的儿子或女儿中癌症总体上没有增加。根据女儿们报告的经病理证实的诊断，我们未发现DES与良性乳腺疾病或生殖道疾病风险之间存在关联。基于3例病例，产前接触DES的女性的女儿中卵巢癌的发病率高于预期。
我们的数据不支持产前接触DES的女性的儿子或女儿的癌症风险总体增加，但卵巢癌病例数高于预期。虽然这一发现是初步的，但支持对这些女儿继续进行监测。
