Fortner Renée T, Schock Helena, Jung Seungyoun, Allen Naomi E, Arslan Alan A, Brinton Louise A, Egleston Brian L, Falk Roni T, Gunter Marc J, Helzlsouer Kathy J, Idahl Annika, Johnson Theron S, Kaaks Rudolf, Krogh Vittorio, Lundin Eva, Merritt Melissa A, Navarro Carmen, Onland-Moret N Charlotte, Palli Domenico, Shu Xiao-Ou, Sluss Patrick M, Staats Paul N, Trichopoulou Antonia, Weiderpass Elisabete, Zeleniuch-Jacquotte Anne, Zheng Wei, Dorgan Joanne F
Division of Cancer Epidemiology, German Cancer Research Cancer, Heidelberg, Germany.
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA.
Br J Cancer. 2017 Oct 24;117(9):1412-1418. doi: 10.1038/bjc.2017.299. Epub 2017 Sep 5.
The Mullerian ducts are the embryological precursors of the female reproductive tract, including the uterus; anti-Mullerian hormone (AMH) has a key role in the regulation of foetal sexual differentiation. Anti-Mullerian hormone inhibits endometrial tumour growth in experimental models by stimulating apoptosis and cell cycle arrest. To date, there are no prospective epidemiologic data on circulating AMH and endometrial cancer risk.
We investigated this association among women premenopausal at blood collection in a multicohort study including participants from eight studies located in the United States, Europe, and China. We identified 329 endometrial cancer cases and 339 matched controls. Anti-Mullerian hormone concentrations in blood were quantified using an enzyme-linked immunosorbent assay. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CI) across tertiles and for a doubling of AMH concentrations (OR). Subgroup analyses were performed by ages at blood donation and diagnosis, oral contraceptive use, and tumour characteristics.
Anti-Mullerian hormone was not associated with the risk of endometrial cancer overall (OR: 1.07 (0.99-1.17)), or with any of the examined subgroups.
Although experimental models implicate AMH in endometrial cancer growth inhibition, our findings do not support a role for circulating AMH in the aetiology of endometrial cancer.
苗勒管是女性生殖道（包括子宫）的胚胎学前身；抗苗勒管激素（AMH）在胎儿性别分化调节中起关键作用。在实验模型中，抗苗勒管激素通过刺激细胞凋亡和细胞周期停滞来抑制子宫内膜肿瘤生长。迄今为止，尚无关于循环AMH与子宫内膜癌风险的前瞻性流行病学数据。
在一项多队列研究中，我们调查了采血时处于绝经前的女性中的这种关联，该研究纳入了来自美国、欧洲和中国的八项研究的参与者。我们确定了329例子宫内膜癌病例和339例匹配对照。使用酶联免疫吸附测定法定量血液中的抗苗勒管激素浓度。采用条件逻辑回归来估计三分位数以及AMH浓度加倍时的比值比（OR）和95%置信区间（CI）。按献血和诊断时的年龄、口服避孕药使用情况以及肿瘤特征进行亚组分析。
抗苗勒管激素总体上与子宫内膜癌风险无关（OR：1.07（0.99 - 1.17）），与任何所检查的亚组也均无关。
尽管实验模型表明AMH在抑制子宫内膜癌生长中起作用，但我们的研究结果不支持循环AMH在子宫内膜癌病因学中发挥作用。
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