诊断前性类固醇激素与男性乳腺癌风险的关系
Prediagnostic Sex Steroid Hormones in Relation to Male Breast Cancer Risk.
作者信息
Brinton Louise A, Key Tim J, Kolonel Laurence N, Michels Karin B, Sesso Howard D, Ursin Giske, Van Den Eeden Stephen K, Wood Shannon N, Falk Roni T, Parisi Dominick, Guillemette Chantal, Caron Patrick, Turcotte Véronique, Habel Laurel A, Isaacs Claudine J, Riboli Elio, Weiderpass Elisabete, Cook Michael B
机构信息
Louise A. Brinton, Shannon N. Wood, Roni T. Falk, and Michael B. Cook, National Cancer Institute, Bethesda; Dominick Parisi, Information Management Services, Rockville, MD; Tim J. Key, University of Oxford, Oxford; Elio Riboli, Imperial College School of Public Health, London, United Kingdom; Laurence N. Kolonel, University of Hawaii, Honolulu, HI; Karin B. Michels, Harvard Medical School and Harvard School of Public Health; Karin B. Michels and Howard D. Sesso, Brigham and Women's Hospital, Boston, MA; Giske Ursin, University of Oslo; Giske Ursin and Elisabete Weiderpass, Cancer Registry of Norway, Oslo; University of Tromsø-Arctic University of Norway, Tromsø, Norway; Karolinska Institutet, Stockholm, Sweden; and Samfundet Folkhalsan, Helsinki, Finland; Giske Ursin, University of Southern California, Los Angeles; Stephen K. Van Den Eeden and Laurel A. Habel, Kaiser Permanente Northern California, Oakland, CA; Chantal Guillemette, Patrick Caron, and Véronique Turcotte, Centre Hospitalier Universitaire de Québec and Laval University, Québec City, Québec, Canada; and Claudine J. Isaacs, Georgetown University, Washington, DC.
出版信息
J Clin Oncol. 2015 Jun 20;33(18):2041-50. doi: 10.1200/JCO.2014.59.1602. Epub 2015 May 11.
PURPOSE
Although previous studies have implicated a variety of hormone-related risk factors in the etiology of male breast cancers, no previous studies have examined the effects of endogenous hormones.
PATIENTS AND METHODS
Within the Male Breast Cancer Pooling Project, an international consortium comprising 21 case-control and cohort investigations, a subset of seven prospective cohort studies were able to contribute prediagnostic serum or plasma samples for hormone quantitation. Using a nested case-control design, multivariable unconditional logistic regression analyses estimated odds ratios and 95% CIs for associations between male breast cancer risk and 11 individual estrogens and androgens, as well as selected ratios of these analytes.
RESULTS
Data from 101 cases and 217 matched controls were analyzed. After adjustment for age and date of blood draw, race, and body mass index, androgens were found to be largely unrelated to risk, but circulating estradiol levels showed a significant association. Men in the highest quartile had an odds ratio of 2.47 (95% CI, 1.10 to 5.58) compared with those in the lowest quartile (trend P = .06). Assessment of estradiol as a ratio to various individual androgens or sum of androgens showed no further enhancement of risk. These relations were not significantly modified by either age or body mass index, although estradiol was slightly more strongly related to breast cancers occurring among younger (age < 67 years) than older men.
CONCLUSION
Our results support the notion of an important role for estradiol in the etiology of male breast cancers, similar to female breast cancers.
目的
尽管先前的研究已将多种激素相关风险因素牵连到男性乳腺癌的病因中，但此前尚无研究考察内源性激素的影响。
患者与方法
在男性乳腺癌合并项目中，该项目是一个由21项病例对照研究和队列研究组成的国际联合体，其中七项前瞻性队列研究的子集能够提供用于激素定量的诊断前血清或血浆样本。采用巢式病例对照设计，多变量无条件逻辑回归分析估计了男性乳腺癌风险与11种个体雌激素和雄激素以及这些分析物的选定比值之间关联的比值比和95%置信区间。
结果
分析了101例病例和217例匹配对照的数据。在调整年龄、采血日期、种族和体重指数后，发现雄激素与风险基本无关，但循环雌二醇水平显示出显著关联。最高四分位数的男性与最低四分位数的男性相比，比值比为2.47（95%置信区间，1.10至5.58）（趋势P = 0.06）。将雌二醇作为与各种个体雄激素或雄激素总和的比值进行评估，未显示风险有进一步增加。这些关系在年龄或体重指数方面均未得到显著改变，尽管雌二醇与较年轻男性（年龄<67岁）发生的乳腺癌的相关性略强于老年男性。
结论
我们的结果支持雌二醇在男性乳腺癌病因中起重要作用这一观点，这与女性乳腺癌相似。
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