Department of Epidemiology and Public Health, Imperial College, London, United Kingdom.
Cancer Epidemiol Biomarkers Prev. 2010 Oct;19(10):2562-9. doi: 10.1158/1055-9965.EPI-10-0447. Epub 2010 Aug 27.
The etiologies of glioma and meningioma tumors are largely unknown. Although reproductive hormones are thought to influence the risk of these tumors, epidemiologic data are not supportive of this hypothesis; however, few cohort studies have published on this topic. We examined the relation between reproductive factors and the risk of glioma and meningioma among women in the European Prospective Investigation into Cancer and Nutrition (EPIC).
After a mean of 8.4 years of follow-up, 193 glioma and 194 meningioma cases were identified among 276,212 women. Information on reproductive factors and hormone use was collected at baseline. Cox proportional hazard regression was used to determine hazard ratios (HR) and 95% confidence intervals (95% CI).
No associations were observed between glioma or meningioma risk and reproductive factors, including age at menarche, parity, age at first birth, menopausal status, and age at menopause. A higher risk of meningioma was observed among postmenopausal women who were current users of hormone replacement therapy (HR, 1.79; 95% CI, 1.18-2.71) compared with never users. Similarly, current users of oral contraceptives were at higher risk of meningioma than never users (HR, 3.61; 95% CI, 1.75-7.46).
Our results do not support a role for estrogens and glioma risk. Use of exogenous hormones, especially current use, seems to increase meningioma risk. However, these findings could be due to diagnostic bias and require confirmation.
Elucidating the role of hormones in brain tumor development has important implications and needs to be further examined using biological measurements.
胶质细胞瘤和脑膜瘤的病因在很大程度上尚不清楚。虽然生殖激素被认为会影响这些肿瘤的风险，但流行病学数据并不支持这一假说；然而，关于这个主题的队列研究很少。我们在欧洲癌症与营养前瞻性调查（EPIC）中研究了女性生殖因素与胶质细胞瘤和脑膜瘤风险之间的关系。
在平均 8.4 年的随访后，在 276212 名女性中发现了 193 例胶质细胞瘤和 194 例脑膜瘤病例。在基线时收集了生殖因素和激素使用的信息。使用 Cox 比例风险回归来确定风险比（HR）和 95%置信区间（95%CI）。
未观察到生殖因素与胶质细胞瘤或脑膜瘤风险之间存在关联，包括初潮年龄、产次、初产年龄、绝经状态和绝经年龄。与从未使用者相比，绝经后正在使用激素替代疗法的女性脑膜瘤风险更高（HR，1.79；95%CI，1.18-2.71）。同样，正在使用口服避孕药的女性脑膜瘤风险高于从未使用者（HR，3.61；95%CI，1.75-7.46）。
我们的结果不支持雌激素与胶质细胞瘤风险之间的关系。外源性激素的使用，特别是当前的使用，似乎会增加脑膜瘤的风险。然而，这些发现可能是由于诊断偏差所致，需要进一步证实。
阐明激素在脑肿瘤发展中的作用具有重要意义，需要进一步使用生物学测量进行研究。
