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外源性雌激素可能是全球激素受体阳性乳腺癌发病率居高不下且不断上升的原因。

Xenoestrogens may be the cause of high and increasing rates of hormone receptor positive breast cancer in the world.

作者信息

Dey Subhojit, Soliman Amr S, Merajver Sofia D

机构信息

Department of Epidemiology, School of Public Health, University of Michigan, 109 Observatory Street, Ann Arbor, MI 48109, USA.

出版信息

Med Hypotheses. 2009 Jun;72(6):652-6. doi: 10.1016/j.mehy.2008.10.025. Epub 2009 Jan 19.

Abstract

Breast cancer rates are higher in the Western or industrialized world when compared to Africa or Asia. Within the developing world, breast cancer rates are higher in urban areas where people have a more Westernized lifestyle. In addition, there has been a steady increase in the breast cancer incidence across the world. It is already a known fact that the proportion of hormone receptor positive breast cancer cases is higher in the developed world. Evidence from developed countries also shows that most of the increase in breast cancer incidence has been due to an increase in hormone receptor positive breast cancer. Most of the breast cancer incidence can be explained by environmental factors and genetic causes. However, all known risk factors of breast cancer can explain only 30-50% of breast cancer incidence. In the past decade, a number of compounds that affect female hormone homeostasis have been discovered. These xenoestrogens have been shown to cause breast cancer and also induce the expression of hormone receptors in vitro and in vivo. Given the high use of substances containing xenoestrogens in developed regions of the world and their increasing use in urban parts of the developing world, xenoestrogens could be the important cause of high and increasing rates of hormone receptor positive breast cancer across the world. New research in the area of mammary stem cells provides added indication of the probable time period of exposure to xenoestrogens with chronic exposure later in life leading to hormone receptor positive breast cancer and most probable reason behind increasing breast cancer incidence.

摘要

与非洲或亚洲相比,西方或工业化国家的乳腺癌发病率更高。在发展中国家,城市地区的乳腺癌发病率更高,因为那里的人们生活方式更西化。此外,全球乳腺癌发病率一直在稳步上升。发达国家激素受体阳性乳腺癌病例的比例更高,这已是一个众所周知的事实。来自发达国家的证据还表明,乳腺癌发病率的增加主要是由于激素受体阳性乳腺癌病例的增加。大多数乳腺癌发病率可以用环境因素和基因原因来解释。然而,所有已知的乳腺癌风险因素只能解释30%至50%的乳腺癌发病率。在过去十年中,人们发现了一些影响女性激素稳态的化合物。这些外源性雌激素已被证明会导致乳腺癌,并且在体外和体内都会诱导激素受体的表达。鉴于世界发达地区含外源性雌激素物质的高使用量以及其在发展中国家城市地区的使用量不断增加,外源性雌激素可能是全球激素受体阳性乳腺癌发病率居高不下且不断上升的重要原因。乳腺干细胞领域的新研究进一步表明了接触外源性雌激素的可能时间段,即生命后期的长期接触会导致激素受体阳性乳腺癌,这也是乳腺癌发病率上升最可能的原因。

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