Jung Seungyoun, Allen Naomi, Arslan Alan A, Baglietto Laura, Barricarte Aurelio, Brinton Louise A, Egleston Brian L, Falk Roni T, Fortner Renée T, Helzlsouer Kathy J, Gao Yutang, Idahl Annika, Kaaks Rudolph, Krogh Vittorio, Merritt Melissa A, Lundin Eva, Onland-Moret N Charlotte, Rinaldi Sabina, Schock Helena, Shu Xiao-Ou, Sluss Patrick M, Staats Paul N, Sacerdote Carlotta, Travis Ruth C, Tjønneland Anne, Trichopoulou Antonia, Tworoger Shelley S, Visvanathan Kala, Weiderpass Elisabete, Zeleniuch-Jacquotte Anne, Dorgan Joanne F
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD.
Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
Int J Cancer. 2018 Jan 15;142(2):262-270. doi: 10.1002/ijc.31058. Epub 2017 Oct 4.
Animal and experimental data suggest that anti-Müllerian hormone (AMH) serves as a marker of ovarian reserve and inhibits the growth of ovarian tumors. However, few epidemiologic studies have examined the association between AMH and ovarian cancer risk. We conducted a nested case-control study of 302 ovarian cancer cases and 336 matched controls from nine cohorts. Prediagnostic blood samples of premenopausal women were assayed for AMH using a picoAMH enzyme-linked immunosorbent assay. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using multivariable-adjusted conditional logistic regression. AMH concentration was not associated with overall ovarian cancer risk. The multivariable-adjusted OR (95% CI), comparing the highest to the lowest quartile of AMH, was 0.99 (0.59-1.67) (P : 0.91). The association did not differ by age at blood draw or oral contraceptive use (all P : ≥0.26). There also was no evidence for heterogeneity of risk for tumors defined by histologic developmental pathway, stage, and grade, and by age at diagnosis and time between blood draw and diagnosis (all P : ≥0.39). In conclusion, this analysis of mostly late premenopausal women from nine cohorts does not support the hypothesized inverse association between prediagnostic circulating levels of AMH and risk of ovarian cancer.
动物和实验数据表明,抗苗勒管激素(AMH)是卵巢储备的标志物,并可抑制卵巢肿瘤的生长。然而,很少有流行病学研究探讨AMH与卵巢癌风险之间的关联。我们对来自9个队列的302例卵巢癌病例和336例匹配对照进行了一项巢式病例对照研究。使用picoAMH酶联免疫吸附测定法对绝经前女性的诊断前血样进行AMH检测。采用多变量调整的条件逻辑回归计算比值比(OR)和95%置信区间(CI)。AMH浓度与总体卵巢癌风险无关。将AMH最高四分位数与最低四分位数进行比较,多变量调整后的OR(95%CI)为0.99(0.59 - 1.67)(P = 0.91)。该关联在采血时的年龄或口服避孕药使用情况方面无差异(所有P≥0.26)。对于按组织学发育途径、分期、分级以及诊断时年龄和采血与诊断之间的时间定义的肿瘤,也没有证据表明存在风险异质性(所有P≥0.39)。总之,对来自9个队列的大多为接近绝经的女性进行的这项分析不支持AMH诊断前循环水平与卵巢癌风险之间存在假设的负相关。