Kabat Geoffrey C, Salazar Christian R, Zaslavsky Oleg, Lane Dorothy S, Rohan Thomas E
aDepartment of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx bDepartment of Preventive Medicine, University at Stony Brook, Stony Brook, New York, USA cDepartment of Nursing, University of Haifa, Haifa, Israel.
Eur J Cancer Prev. 2016 Sep;25(5):449-56. doi: 10.1097/CEJ.0000000000000193.
The aim of this study was to examine whether hemostatic factors associated with coagulation and inflammation pathways are associated with cancer risk in postmenopausal women. We used data from the Women's Health Initiative study to examine the association of plasma fibrinogen levels, factor VII antigen activity, and factor VII concentration measured at baseline and during follow-up with the risk for cancers of the breast, colorectum, and lung. Among 5287 women who were followed up for a median of 11.4 years, 275 cases of breast cancer, 102 cases of colorectal cancer, and 90 cases of lung cancer were identified. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals for the association of hemostatic factors with each cancer. Hemostatic factors were not associated with breast cancer in either baseline or longitudinal analyses. Baseline hemostatic factors showed weak associations with colorectal cancer; however, no association was seen in longitudinal analyses. Fibrinogen was positively associated with lung cancer in both baseline and longitudinal analyses; the association was seen only in never and former smokers, not in current smokers. We found no evidence of an association between hemostatic factors and breast or colorectal cancer in postmenopausal women. The positive association of fibrinogen levels with lung cancer requires confirmation in larger studies.
本研究的目的是检验与凝血和炎症途径相关的止血因子是否与绝经后女性的癌症风险相关。我们使用了妇女健康倡议研究的数据,来检验基线时及随访期间所测量的血浆纤维蛋白原水平、凝血因子VII抗原活性和凝血因子VII浓度与乳腺癌、结直肠癌和肺癌风险之间的关联。在中位随访时间为11.4年的5287名女性中,确诊了275例乳腺癌、102例结直肠癌和90例肺癌。采用Cox比例风险模型来估计止血因子与每种癌症关联的风险比及95%置信区间。在基线分析或纵向分析中,止血因子均与乳腺癌无关。基线止血因子与结直肠癌呈弱关联;然而,在纵向分析中未发现关联。在基线分析和纵向分析中,纤维蛋白原均与肺癌呈正相关;这种关联仅在从不吸烟和曾经吸烟的女性中可见,在当前吸烟者中未见。我们没有发现绝经后女性的止血因子与乳腺癌或结直肠癌之间存在关联的证据。纤维蛋白原水平与肺癌的正相关需要在更大规模的研究中得到证实。