Anderson T J, Battersby S, King R J, McPherson K, Going J J
Department of Pathology, University of Edinburgh, Scotland.
Hum Pathol. 1989 Dec;20(12):1139-44. doi: 10.1016/s0046-8177(89)80003-6.
The controversy that surrounds oral contraceptive use and breast cancer risk has arisen from epidemiologic studies, yet the direct effect of such use on breast tissue remains undefined. Breast epithelial proliferation was assessed by 3H-thymidine labeling of normal lobular units dissected from benign biopsies of 347 females aged 14 to 48 years. Factors shown to influence this response included cycle phase, time since menarche (breast age), and parity status. Multivariate analysis allowing for these influences was used to compare activity of natural cycles and those artificially regulated by oral contraceptives (OC). The increased activity in nulliparous OC users was highly significant (P less than .005). Comparing the effect of differences in OC type, whether combined, triphasic, progestin only, or according to estrogen or progestin content, showed a heterogeneity in response that was significant (P less than .01). Examined specifically, the formulation of OC according to progestin content did not have a significant influence, although progestin-only OC was most active, while the influence of increasing estrogen content was significant (P less than .05). However, emphasis is given to acknowledging the multiple factors and interactive processes responsible for breast epithelial stimulation when considering strategies of intervention.
围绕口服避孕药使用与乳腺癌风险的争议源于流行病学研究，但这种使用对乳腺组织的直接影响仍不明确。通过对从347名年龄在14至48岁女性的良性活检标本中分离出的正常小叶单位进行³H-胸腺嘧啶核苷标记，评估乳腺上皮细胞增殖情况。已显示影响这种反应的因素包括月经周期阶段、初潮以来的时间（乳腺年龄）和生育状况。采用考虑了这些影响因素的多变量分析方法，比较自然周期和口服避孕药（OC）人工调节周期的活性。未生育的OC使用者中活性增加非常显著（P<0.005）。比较不同类型OC（无论是复方、三相、仅含孕激素还是根据雌激素或孕激素含量）的差异影响，结果显示反应存在显著异质性（P<0.01）。具体检查发现，根据孕激素含量制定的OC配方没有显著影响，尽管仅含孕激素的OC活性最高，而雌激素含量增加的影响则是显著的（P<0.05）。然而，在考虑干预策略时，需要着重认识到导致乳腺上皮细胞刺激的多种因素和相互作用过程。
