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女性乳腺癌中的宿主异质性:对病理生理学、治疗和预防的潜在意义。

Host heterogeneity in female breast cancer: possible significance for pathophysiology, therapy, and prevention.

作者信息

Cohen P

出版信息

Breast Cancer Res Treat. 1990 May;15(3):205-12. doi: 10.1007/BF01806357.

Abstract

Longitudinal studies on human growth have revealed seasonal patterns in the gain of height in 1/3 of the population. Seasonal sensitivity of growth velocity is apparently linked with a lean body structure. This being so, a subgroup with specific biological features could be isolated, including specific endocrine mechanisms (e.g. shorter interval between menarche and menopause, higher incidence of irregular early postmenstrual cycles, and higher concentration of growth hormone secretion) and specific metabolic pathways (more frequent drinking, smoking, and use of the contraceptive pill). This biological specificity may be responsible for behavioral heterogeneity in cancer in general and in breast malignancies in particular. One third of the breast cancer patient population is hormone responsive. The response to all the methods of cancer adjuvant therapy (including ablation of hormone producing organs, chemotherapy, and immunologic manipulation) used up till now does not surpass 33% in the long run. Breast cancer risk reduction by 1/3 due to full-term teenage pregnancies suggests that this may be a consequence of the interruption of a premalignant process initiated in women of the aforementioned subgroup. Simulation of early pregnancy might therefore lead to prevention of breast cancer in women who had seasonal growth patterns as children.

摘要

对人类生长的纵向研究表明,三分之一的人口在身高增长方面存在季节性模式。生长速度的季节性敏感性显然与瘦体型结构有关。既然如此,就可以分离出一个具有特定生物学特征的亚组,包括特定的内分泌机制(例如初潮与绝经之间的间隔较短、月经周期不规则的早期发生率较高以及生长激素分泌浓度较高)和特定的代谢途径(饮酒、吸烟和使用避孕药更为频繁)。这种生物学特异性可能是导致一般癌症尤其是乳腺恶性肿瘤行为异质性的原因。三分之一的乳腺癌患者群体对激素有反应。到目前为止,所有癌症辅助治疗方法(包括切除产生激素的器官、化疗和免疫操作)的长期有效率都不超过33%。由于青少年足月妊娠使乳腺癌风险降低三分之一,这表明这可能是上述亚组女性中启动的癌前过程中断的结果。因此,模拟早孕可能会预防儿童时期有季节性生长模式的女性患乳腺癌。

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