Ingram D M, Nottage E M, Willcox D L, Roberts A
University Department of Surgery, Queen Elizabeth II Medical Centre, Nedlands, Western Australia.
Br J Cancer. 1990 Feb;61(2):303-7. doi: 10.1038/bjc.1990.57.
Although women with breast cancer tend to have a greater proportion of their circulating oestradiol non-protein bound and albumin bound, and less SHBG-bound, than controls, it remains uncertain whether this has an aetiological role or is an effect of the tumour. Oestradiol and its binding to serum proteins was investigated: (a) in relation to risk factors for breast cancer in a normal population; (b) in women with proliferative benign breast disease as a risk group for breast cancer, and women with non-proliferative benign breast disease as a low risk group, as well as breast cancer patients. The strongest associations were with body mass index; the greater the body mass the greater the bioavailability of oestradiol. Changes in relation to age at menarche and menopause could have been a function of body mass. An interesting change with age was noted with a fall in bioavailability over the menopausal years. There was no relationship apparent for parity, age at first full term pregnancy, family history or country of birth. Similar differences in oestradiol binding between cases and controls were seen for patients with breast cancer, benign epithelial hyperplasia and fibrocystic disease without proliferative changes, but these were not significant. This study provides limited support for the concept that oestradiol binding has an aetiological role in the development of breast cancer.
尽管与对照组相比，乳腺癌女性循环中的雌二醇与非蛋白质结合及与白蛋白结合的比例更高，而与性激素结合球蛋白结合的比例更低，但目前仍不确定这是具有病因学作用还是肿瘤的一种效应。对雌二醇及其与血清蛋白的结合情况进行了研究：(a) 在正常人群中与乳腺癌风险因素的关系；(b) 在作为乳腺癌风险组的患有增生性良性乳腺疾病的女性、作为低风险组的患有非增生性良性乳腺疾病的女性以及乳腺癌患者中。最强的关联与体重指数有关；体重越大，雌二醇的生物利用度越高。初潮年龄和绝经年龄的变化可能是体重的作用。随着年龄增长，在绝经后的几年里生物利用度下降，出现了一个有趣的变化。产次、首次足月妊娠年龄、家族史或出生国家之间没有明显关系。在乳腺癌患者、良性上皮增生患者以及无增生性改变的纤维囊性疾病患者中，病例组和对照组之间在雌二醇结合方面也存在类似差异，但这些差异并不显著。本研究为雌二醇结合在乳腺癌发生中具有病因学作用这一概念提供了有限的支持。
