Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece; Department of Epidemiology, Harvard School of Public Health, Boston, USA; Bureau of Epidemiologic Research, Academy of Athens, Athens.
Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece.
Ann Oncol. 2013 Oct;24(10):2527-2533. doi: 10.1093/annonc/mdt207. Epub 2013 May 30.
Benign breast disease (BBD), particularly proliferative BBD, is an established breast cancer risk factor. However, there has been no systematic attempt to compare the hormonal profiles of the two conditions. In a case-control investigation in Athens, Greece, we compared levels of estrogens, testosterone and insulin-like growth factor-1 (IGF-1), as well as their principal binding proteins, between breast cancer patients, women with BBD by histological type (proliferative and nonproliferative) and women with no breast pathology.
We studied 466 women with incident breast cancer, 704 women with BBD and 244 healthy women. We used multiple regression to compare log-transformed serum hormone levels of breast cancer patients with those of healthy women and women with BBD by histological type (proliferative and nonproliferative BBD).
The hormonal profile of breast cancer in our study was in line with the generally accepted hormonal profile of this disease, as reported from large cohort studies. Compared with healthy women, breast cancer patients tended to have higher levels of steroid hormones. The evidence was strong for estrone (difference 21.5%, P < 0.001), weaker for testosterone (difference 15.8%, P = 0.07) and weaker still for estradiol (difference 12.0%, P = 0.18). Also compared with healthy women, breast cancer patients had barely higher levels of IGF-1 (difference 2.0%, P = 0.51), but had significantly lower levels of IGF binding protein 3 (IGFBP-3) (difference -6.7%, P = 0.001). Compared with women with BBD, breast cancer patients had nonstatistically significantly lower levels of steroid hormones, but they had higher levels of IGF-1 [difference 5.5%, 95% confidence interval (CI) 0.7% to 10.6%] and lower levels of IGFBP-3 (difference -3.7%, 95% CI -6.7% to -0.7%). Differences were more pronounced when breast cancer patients were contrasted to women with proliferative BBD.
Our findings suggest that high levels of IGF-1 may be an important factor toward the evolution of BBD to breast cancer.
良性乳腺疾病（BBD），特别是增生性 BBD，是公认的乳腺癌危险因素。然而，目前尚无系统的方法来比较这两种情况的激素谱。在希腊雅典进行的一项病例对照研究中，我们比较了乳腺癌患者、组织学类型为 BBD（增生性和非增生性）的女性以及无乳腺病变的女性之间雌激素、睾丸激素和胰岛素样生长因子-1（IGF-1）以及它们的主要结合蛋白的水平。
我们研究了 466 名新发乳腺癌患者、704 名 BBD 患者和 244 名健康女性。我们使用多元回归比较了乳腺癌患者与健康女性和组织学类型为 BBD（增生性和非增生性 BBD）的女性之间血清激素水平的对数值。
我们研究中的乳腺癌激素谱与从大型队列研究中报道的一般公认的这种疾病的激素谱一致。与健康女性相比，乳腺癌患者的甾体激素水平往往较高。雌酮水平差异明显（21.5%，P<0.001），睾丸激素水平差异较弱（15.8%，P=0.07），雌二醇水平差异更弱（12.0%，P=0.18）。与健康女性相比，乳腺癌患者的 IGF-1 水平也略高（2.0%，P=0.51），但 IGF 结合蛋白 3（IGFBP-3）水平明显较低（-6.7%，P=0.001）。与 BBD 患者相比，乳腺癌患者的甾体激素水平非统计学上显著降低，但 IGF-1 水平较高[差异 5.5%，95%置信区间（CI）0.7%至 10.6%]，IGFBP-3 水平较低[差异-3.7%，95% CI -6.7%至-0.7%]。当将乳腺癌患者与增生性 BBD 患者进行对比时，差异更为明显。
我们的发现表明，IGF-1 水平升高可能是 BBD 向乳腺癌发展的一个重要因素。
