Mastrangelo Giuseppe, Pavanello Sofia, Fadda Emanuela, Buja Alessandra, Fedeli Ugo
Departments of Cardiac, Thoracic and Vascular Sciences.
Molecular Medicine, University of Padova.
Eur J Cancer Prev. 2018 Jul;27(4):303-309. doi: 10.1097/CEJ.0000000000000333.
Transcripts of human endogenous retrovirus K are expressed in most breast cancers (BCs). Yellow fever vaccine 17D (YFV) expresses a protein with a closely homologous epitope. Cross-reactive immunity could hypothetically inhibit BC growth at least in women aged around 50 years at diagnosis, in whom the prognosis of BC was found to be better than that in women younger or older. A cohort of 12 804 women who received YFV in the Veneto Region, Italy, was divided into two subcohorts according to age at vaccination and followed up through the Veneto Tumor Registry. The time since vaccination until cancer incidence was categorized (≤1.9; 2-3.9; 4-5.9; 6-7.9; 8-10.9; ≥11 years) and, using the lowest class as a reference, the incidence rate ratio for BC with a 95% confidence interval and P-value was estimated by Poisson regression in each time since vaccination class, adjusting for age and calendar period. In 3140 women vaccinated at 40-54 years of age, YFV administration resulted in a protective effect of long duration slowly fading over time with a U-shaped pattern of response. Overall, BC risk was reduced by about 50% (incidence rate ratio=0.46; 95% confidence interval=0.26-0.83; P=0.009) 2 years after vaccination. Cross-reactive antigens could not be the mechanism because no protection was observed in women vaccinated before 40 or after 54 years of age. BC cells in a microscopic stage of disease can be destroyed or severely damaged by YFV if BC is not very aggressive. To prove that treatment is truly effective, a placebo-controlled double-blind trial should be conducted.
人类内源性逆转录病毒K的转录本在大多数乳腺癌中表达。黄热病疫苗17D(YFV)表达一种具有紧密同源表位的蛋白质。假设交叉反应性免疫至少在诊断时年龄约为50岁的女性中可抑制乳腺癌生长,在这些女性中发现乳腺癌的预后优于年轻或年长女性。意大利威尼托地区12804名接种YFV的女性队列,根据接种疫苗时的年龄分为两个亚组,并通过威尼托肿瘤登记处进行随访。将接种疫苗至癌症发病的时间分类(≤1.9年;2 - 3.9年;4 - 5.9年;6 - 7.9年;8 - 10.9年;≥11年),并以最低类别为参照,通过泊松回归在每个接种疫苗后的时间类别中估计乳腺癌的发病率比及95%置信区间和P值,同时对年龄和日历时间进行校正。在3140名40 - 54岁接种疫苗的女性中,YFV接种产生了长期的保护作用,随着时间推移保护作用缓慢减弱,呈现U形反应模式。总体而言,接种疫苗2年后乳腺癌风险降低了约50%(发病率比 = 0.46;95%置信区间 = 0.26 - 0.83;P = 0.009)。交叉反应性抗原不可能是其机制,因为在40岁之前或54岁之后接种疫苗的女性中未观察到保护作用。如果乳腺癌侵袭性不强,处于疾病微观阶段的乳腺癌细胞可被YFV破坏或严重损伤。为证明该治疗确实有效,应进行安慰剂对照双盲试验。