Department of Epidemiology, School of Public Health, University of Washington, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA.
Cancer Prev Res (Phila). 2011 Jun;4(6):840-50. doi: 10.1158/1940-6207.CAPR-10-0389. Epub 2011 Apr 19.
The incidences of esophageal adenocarcinoma and squamous cell carcinoma (SCC) are higher in males than in females. We investigated whether female-related hormonal factors are associated with risks of these two types of esophageal cancer. We examined the association between use of hormone therapy (HT) and the risks of esophageal adenocarcinoma and SCC in postmenopausal women enrolled in the Women's Health Initiative (WHI) clinical trials and observational studies. Twenty-three esophageal adenocarcinoma and 34 esophageal SCC cases were confirmed among the 161,080 participants, after a median of 11.82 years of follow-up. Risk of esophageal SCC was lower among HT users (past users: HR = 0.25, 95% CI: 0.06-1.10 in 2 cases; current users: HR = 0.41, 95% CI: 0.18-0.94 in 9 cases). A decreased esophageal SCC risk was observed for current users of estrogen plus progestin (E+P) therapy (HR = 0.25, 95% CI: 0.07-0.86 in 3 cases) but not for current users of estrogen-only therapy (HR = 0.96, 95% CI: 0.28-3.29 in 6 cases). No association was observed between the use of HT and the risk of esophageal adenocarcinoma. No other reproductive or hormonal factors were significantly associated with the risk of either SCC or adenocarcinoma. Current use of E+P therapy was found to be associated with a decreased risk of esophageal SCC, but no association was observed with esophageal adenocarcinoma. To provide more definitive evidence, a pooled analysis of all available studies or a much larger study would be needed.
食管腺癌和鳞状细胞癌（SCC）的发病率在男性中高于女性。我们研究了女性相关的激素因素是否与这两种类型的食管癌风险相关。我们检查了激素治疗（HT）的使用与参加妇女健康倡议（WHI）临床试验和观察性研究的绝经后妇女的食管腺癌和 SCC 风险之间的关联。在中位随访 11.82 年后，在 161080 名参与者中确认了 23 例食管腺癌和 34 例食管 SCC 病例。HT 使用者的食管 SCC 风险较低（既往使用者：2 例 HR=0.25，95%CI：0.06-1.10；当前使用者：9 例 HR=0.41，95%CI：0.18-0.94）。观察到当前使用雌孕激素联合治疗（E+P）的患者食管 SCC 风险降低（3 例 HR=0.25，95%CI：0.07-0.86），但当前使用单纯雌激素治疗的患者则不然（6 例 HR=0.96，95%CI：0.28-3.29）。HT 的使用与食管腺癌风险之间没有关联。其他生殖或激素因素与 SCC 或腺癌的风险均无显著关联。目前使用 E+P 治疗与食管 SCC 风险降低相关，但与食管腺癌无关。为了提供更明确的证据，可能需要对所有可用研究进行汇总分析或进行更大规模的研究。
