Antunes C M, Strolley P D, Rosenshein N B, Davies J L, Tonascia J A, Brown C, Burnett L, Rutledge A, Pokempner M, Garcia R
N Engl J Med. 1979 Jan 4;300(1):9-13. doi: 10.1056/NEJM197901043000103.
Our case-control study of the relation between estrogen use and endometrial cancer involved 451 cases and 888 controls. The overall risk of endometrial carcinoma was sixfold for estrogen users as compared with nonusers; long-term users (greater than five years) had a 15-fold risk. Excess risk was present for both diethylstilberstrol and conjugated estrogens. The risk associated with cyclic use was as great as that for continuous use. Increased risk was associated with estrogen use for all histologic grades of the tumor. The risk of advanced-stage carcinoma was fourfold for estrogen users, but rhe confidence interval was wide, and this question requires further study. Finally, this investigation contradicts the speculation that the association between this cancer and estrogen use can be explained by swifter diagnosis for estrogen users, misclassification of estrogen-related hyperplasia or treatment of early symptoms of the tumor with estrogen.
我们关于雌激素使用与子宫内膜癌关系的病例对照研究涉及451例病例和888名对照。与未使用者相比，雌激素使用者患子宫内膜癌的总体风险高出六倍；长期使用者（超过五年）的风险则高出15倍。己烯雌酚和结合雌激素使用者均存在额外风险。周期性使用与持续性使用的风险相当。对于所有组织学分级的肿瘤，雌激素使用均与风险增加相关。雌激素使用者患晚期癌的风险为四倍，但置信区间较宽，这个问题需要进一步研究。最后，本调查反驳了这样一种推测，即该癌症与雌激素使用之间的关联可通过雌激素使用者诊断更快、雌激素相关增生的错误分类或用雌激素治疗肿瘤早期症状来解释。
