Blackmore Kristina M, Lesosky Maia, Barnett Heidi, Raboud Janet M, Vieth Reinhold, Knight Julia A
Samuel Lunenfeld Research Institute, Mount Sinai Hospital, 60 Murray Street, Box 18, Toronto, Ontario, Canada M5T3L9.
Am J Epidemiol. 2008 Oct 15;168(8):915-24. doi: 10.1093/aje/kwn198. Epub 2008 Aug 27.
Evidence has emerged for a role of vitamin D in the development of breast cancer, and there is some suggestion that its antiproliferative effect is greater in hormone-receptor-positive cells. Few epidemiologic studies have considered the association between vitamin D and hormone-receptor-defined breast cancer, and the results are conflicting. Considering 759 cases and 1,135 controls from a case-control study (Ontario, Canada, 2003-2005), the authors examined the association between vitamin D intake at specific ages and combined estrogen-receptor- (ER) and progesterone-receptor- (PR) defined breast cancer. While increased intake of vitamin D (from the sun and diet) was most consistently associated with a significantly reduced risk of ER+/PR+ tumors (e.g., odds ratio = 0.76, 95% confidence interval: 0.59, 0.97 for use of cod liver oil during adolescence), comparable nonsignificant associations were found for receptor-negative (ER-/PR-) (odds ratio = 0.74, 95% confidence interval: 0.53, 1.04) and mixed (ER+/PR-) (odds ratio = 0.79, 95% confidence interval: 0.51, 1.22) tumors. This study suggests that vitamin D is associated with a reduced risk of breast cancer regardless of ER/PR status of the tumor. Future studies with a larger number of receptor-negative and mixed tumors are required.
有证据表明维生素D在乳腺癌发展过程中发挥作用,并且有迹象显示其抗增殖作用在激素受体阳性细胞中更强。很少有流行病学研究考虑维生素D与激素受体定义的乳腺癌之间的关联,结果也相互矛盾。作者针对一项病例对照研究(加拿大安大略省,2003 - 2005年)中的759例病例和1135名对照,研究特定年龄段维生素D摄入量与雌激素受体(ER)和孕激素受体(PR)联合定义的乳腺癌之间的关联。虽然维生素D摄入量增加(来自阳光和饮食)最一致地与ER+/PR+肿瘤风险显著降低相关(例如,青少年时期使用鱼肝油的优势比 = 0.76,95%置信区间:0.59,0.97),但对于受体阴性(ER-/PR-)(优势比 = 0.74,95%置信区间:0.53,1.04)和混合性(ER+/PR-)(优势比 = 0.79,95%置信区间:0.51,1.22)肿瘤也发现了类似的非显著关联。这项研究表明,无论肿瘤的ER/PR状态如何,维生素D都与降低乳腺癌风险相关。未来需要对更多受体阴性和混合性肿瘤进行研究。