Nichols Hazel B, Baird Donna D, Stanczyk Frank Z, Steiner Anne Z, Troester Melissa A, Whitworth Kristina W, Sandler Dale P
Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina.
Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina.
Cancer Prev Res (Phila). 2015 Jun;8(6):528-34. doi: 10.1158/1940-6207.CAPR-14-0377. Epub 2015 Apr 14.
Laboratory models support an inverse association between anti-Müllerian hormone (AMH) and breast tumor development. Human studies are lacking; one study (N = 105 cases, 204 controls) with prospectively collected serum reported the opposite-an approximate 10-fold increase in breast cancer risk comparing fourth with first quartile AMH levels. We investigated the relation between serum AMH levels and breast cancer risk in a case-control (N = 452 cases, 902 controls) study nested within the prospective Sister Study cohort of 50,884 women. At enrollment, participants were ages 35 to 54, premenopausal, and completed questionnaires on medical and family history, lifestyle factors, and demographics. AMH (ng/mL) was measured by ultrasensitive ELISA in serum collected at enrollment and log-transformed for analysis. Multivariate conditional logistic regression was used to calculate ORs and 95% confidence intervals (CI) to account for matching on age and enrollment year. Mean age at enrollment was 46.8 years with an average 2.9 years from blood draw to breast cancer diagnosis (SD = 1.9). AMH concentrations were below the limit of detection (0.003 ng/mL) for approximately 25% of samples. Compared with samples below the LOD, women with AMH >2.84 ng/mL (90th percentile among controls) had a 2-fold increase in breast cancer odds (OR, 2.25; 95% CI, 1.26-4.02). For each 1-unit increase in lnAMH, overall breast cancer odds increased by 8% (OR, 1.08; 95% CI, 1.02-1.15) and odds of estrogen receptor-positive, invasive disease increased by 15% (OR, 1.15; 95% CI, 1.05-1.25). Our findings demonstrate an overall positive relation between AMH and breast cancer.
实验室模型支持抗苗勒管激素（AMH）与乳腺肿瘤发生之间存在负相关。人体研究尚缺；一项前瞻性收集血清的研究（105例病例，204例对照）却得出相反结果——与AMH水平第一四分位数相比，第四四分位数时乳腺癌风险增加约10倍。我们在一项巢式病例对照研究（452例病例，902例对照）中调查了血清AMH水平与乳腺癌风险之间的关系，该研究嵌套于一项有50,884名女性参与的前瞻性姐妹研究队列中。入组时，参与者年龄在35至54岁之间，处于绝经前，且完成了关于医疗和家族病史、生活方式因素及人口统计学的问卷调查。通过超敏酶联免疫吸附测定法（ELISA）对入组时采集的血清进行AMH（纳克/毫升）检测，并对其进行对数转换以用于分析。采用多变量条件逻辑回归计算比值比（OR）和95%置信区间（CI），以考虑年龄和入组年份的匹配情况。入组时的平均年龄为46.8岁，从采血到乳腺癌诊断的平均时间为2.9年（标准差=1.9）。约25%的样本AMH浓度低于检测限（0.003纳克/毫升）。与低于检测限的样本相比，AMH>2.84纳克/毫升（对照中第90百分位数）的女性患乳腺癌的几率增加了2倍（OR，2.25；95%CI，1.26 - 4.02）。lnAMH每增加1个单位，总体患乳腺癌的几率增加8%（OR，1.08；95%CI，1.02 - 1.15），雌激素受体阳性浸润性疾病的几率增加15%（OR，1.15；95%CI，1.05 - 1.25）。我们的研究结果表明AMH与乳腺癌之间总体呈正相关。
