西班牙一项基于人群的多病例对照研究中血清样本中的总有效外源性雌激素负荷与乳腺癌风险
Total Effective Xenoestrogen Burden in Serum Samples and Risk for Breast Cancer in a Population-Based Multicase-Control Study in Spain.
作者信息
Pastor-Barriuso Roberto, Fernández Mariana F, Castaño-Vinyals Gemma, Whelan Denis, Pérez-Gómez Beatriz, Llorca Javier, Villanueva Cristina M, Guevara Marcela, Molina-Molina José-Manuel, Artacho-Cordón Francisco, Barriuso-Lapresa Laura, Tusquets Ignasi, Dierssen-Sotos Trinidad, Aragonés Nuria, Olea Nicolás, Kogevinas Manolis, Pollán Marina
机构信息
Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.
出版信息
Environ Health Perspect. 2016 Oct;124(10):1575-1582. doi: 10.1289/EHP157. Epub 2016 May 20.
BACKGROUND
Most studies on endocrine-disrupting chemicals and breast cancer have focused on single compounds and have produced inconclusive findings.
OBJECTIVES
We assessed the combined estrogenic effects of mixtures of xenoestrogens in serum and their relationship to breast cancer risk.
METHODS
A total of 186 incident pretreatment breast cancer cases and 196 frequency-matched controls were randomly sampled from a large population-based multicase-control study in Spain. The total effective xenoestrogen burden attributable to organohalogenated xenoestrogens (TEXB-α) and endogenous hormones and more polar xenoestrogens (TEXB-β) was determined in serum samples using high-performance liquid chromatography and E-Screen bioassay. Odds ratios for breast cancer comparing tertiles of serum TEXB-α and TEXB-β were estimated using logistic models, and smooth risk trends were obtained using spline models.
RESULTS
Cases had higher geometric mean TEXB-α and TEXB-β levels (8.32 and 9.94 Eeq pM/mL, respectively) than controls (2.99 and 5.96 Eeq pM/mL, respectively). The fully adjusted odds ratios for breast cancer (95% confidence intervals) comparing the second and third tertiles of TEXB-α with the first tertile were 1.77 (0.76, 4.10) and 3.45 (1.50, 7.97), respectively, and those for TEXB-β were 2.35 (1.10, 5.03) and 4.01 (1.88, 8.56), respectively. A steady increase in risk was evident across all detected TEXB-α levels and a sigmoidal trend was observed for TEXB-β. Individual xenoestrogens showed weak and opposing associations with breast cancer risk.
CONCLUSIONS
This is the first study to show a strong positive association between serum total xenoestrogen burden and breast cancer risk, highlighting the importance of evaluating xenoestrogen mixtures, rather than single compounds, when studying hormone-related cancers.
CITATION
Pastor-Barriuso R, Fernández MF, Castaño-Vinyals G, Whelan D, Pérez-Gómez B, Llorca J, Villanueva CM, Guevara M, Molina-Molina JM, Artacho-Cordón F, Barriuso-Lapresa L, Tusquets I, Dierssen-Sotos T, Aragonés N, Olea N, Kogevinas M, Pollán M. 2016. Total effective xenoestrogen burden in serum samples and risk for breast cancer in a population-based multicase-control study in Spain. Environ Health Perspect 124:1575-1582; http://dx.doi.org/10.1289/EHP157.
背景
大多数关于内分泌干扰化学物与乳腺癌的研究都聚焦于单一化合物，结果尚无定论。
目的
我们评估了血清中异雌激素混合物的联合雌激素效应及其与乳腺癌风险的关系。
方法
从西班牙一项基于人群的大型多病例对照研究中随机抽取了186例初发乳腺癌病例和196例频率匹配的对照。使用高效液相色谱法和E-Screen生物测定法测定血清样本中有机卤化异雌激素（TEXB-α）、内源性激素和极性更强的异雌激素（TEXB-β）所致的总有效异雌激素负荷。使用逻辑模型估计比较血清TEXB-α和TEXB-β三分位数的乳腺癌比值比，并使用样条模型获得平滑的风险趋势。
结果
病例组的TEXB-α和TEXB-β几何平均水平（分别为8.32和9.94 Eeq pM/mL）高于对照组（分别为2.99和5.96 Eeq pM/mL）。将TEXB-α的第二和第三三分位数与第一三分位数比较，乳腺癌的完全调整比值比（95%置信区间）分别为1.77（0.76，4.10）和3.45（1.50，7.97），TEXB-β的分别为2.35（1.10，5.03）和4.01（1.88，8.56）。在所有检测到的TEXB-α水平上，风险均呈稳步上升，而TEXB-β呈S形趋势。个体异雌激素与乳腺癌风险的关联较弱且方向相反。
结论
这是第一项显示血清总异雌激素负荷与乳腺癌风险之间存在强正相关的研究，突出了在研究激素相关癌症时评估异雌激素混合物而非单一化合物的重要性。
引用文献
Pastor-Barriuso R, Fernández MF, Castaño-Vinyals G, Whelan D, Pérez-Gómez B, Llorca J, Villanueva CM, Guevara M, Molina-Molina JM, Artacho-Cordón F, Barriuso-Lapresa L, Tusquets I, Dierssen-Sotos T, Aragonés N, Olea N, Kogevinas M, Pollán M. 2016. Total effective xenoestrogen burden in serum samples and risk for breast cancer in a population-based multicase-control study in Spain. Environ Health Perspect 124:1575-1582; http://dx.doi.org/10.1289/EHP157.
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