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中国女性脂肪组织中多溴联苯醚水平与乳腺癌风险的病例对照研究。

Adipose tissue levels of polybrominated diphenyl ethers and breast cancer risk in Chinese women: A case-control study.

机构信息

Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, Guangdong, China.

Clinical Laboratory, Cancer Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China.

出版信息

Environ Res. 2018 Nov;167:160-168. doi: 10.1016/j.envres.2018.07.009. Epub 2018 Jul 5.

Abstract

Polybrominated diphenyl ethers (PBDEs) are suspected to be associated with breast cancer risk because of their estrogenic potencies. Epidemiological studies of PBDEs and breast cancer are scarce. Our study aimed to estimate the association between adipose-tissue PBDE concentrations and breast cancer risk. A total of 209 breast cancer cases and 165 controls were recruited from hospitals between January 2014 and May 2016 in Shantou, Chaoshan area, China. Concentrations of 14 PBDE congeners were measured in adipose tissues obtained from the breast for cases and the abdomen/breast for controls during surgery. Demographic and clinicopathologic characteristics were obtained from medical records. Breast cancer risk as well as clinicopathologic characteristics were evaluated by adipose-tissue PBDE level. Odds ratios (ORs) and 95% confidence intervals (95% CIs) for breast cancer risk associated with levels of PBDE congeners were estimated from logistic regression models for all cases and stratified by estrogen receptor (ER) status. Level of total PBDEs (∑PBDE) and most individual PBDE congeners were higher in breast cancer cases than controls (median ∑PBDE, 94.99 vs 73.72 ng/g lipid). In the adjusted univariate model for all cases, breast cancer risk was increased with both 2nd and 3rd tertiles versus the 1st tertile of BDE-47 level (OR 2.05 [95% CI 1.08-3.92]; 5.47 [2.96-10.11]) and BDE-209 level (2.48 [1.30-4.73]; 4.72 [2.52-8.83]) with trend (both P < 0.001) and with the 3rd tertile of BDE-28 level (2.83 [1.63-4.92]), BDE-99 (3.22 [1.85-5.60]), BDE-100 (5.45 [2.90-10.23]), BDE-138 (2.40 [1.37-4.20]), BDE-153 (1.74 [1.02-2.97]), BDE-154 (1.84 [1.05-3.22]), and ∑PBDE levels (1.83 [1.07-3.14]) but decreased with the 3rd tertile of BDE-71 level (0.38 [0.22-0.65]) with trend (all P < 0.01). After stratifying by ER-positive or -negative status, the adjusted results were similar for ER-positive patients except for BDE-153 and BDE-154, with no statistical significance. In the multivariate model for all cases, age, menarche age, BDE-47, 71, 99, 100, 183 and 209 were independent factors associated with breast-cancer risk. ∑PBDE and most individual PBDE congeners investigated were positively associated with breast cancer risk in women from the Chaoshan area, China. PBDE may play a role in the occurrence and development of breast cancer.

摘要

多溴联苯醚(PBDEs)因其类雌激素活性而被怀疑与乳腺癌风险有关。关于 PBDEs 和乳腺癌的流行病学研究很少。我们的研究旨在评估脂肪组织中 PBDE 浓度与乳腺癌风险之间的关联。2014 年 1 月至 2016 年 5 月期间,我们从中国潮汕地区的医院招募了 209 名乳腺癌病例和 165 名对照。在手术期间,从乳房获得病例的脂肪组织和腹部/乳房获得对照的脂肪组织中测量了 14 种 PBDE 同系物的浓度。从病历中获得了人口统计学和临床病理特征。通过脂肪组织 PBDE 水平评估乳腺癌风险和临床病理特征。使用逻辑回归模型估计所有病例和按雌激素受体(ER)状态分层的与 PBDE 同系物水平相关的乳腺癌风险的比值比(OR)和 95%置信区间(95%CI)。在所有病例的调整单变量模型中,与第 1 tert 相比,第 2 和第 3 tert 的 BDE-47 水平(OR 2.05 [95%CI 1.08-3.92];5.47 [2.96-10.11])和 BDE-209 水平(2.48 [1.30-4.73];4.72 [2.52-8.83])与趋势相关(均 P<0.001),并且与 BDE-28 水平的第 3 tert (2.83 [1.63-4.92])、BDE-99(3.22 [1.85-5.60])、BDE-100(5.45 [2.90-10.23])、BDE-138(2.40 [1.37-4.20])、BDE-153(1.74 [1.02-2.97])、BDE-154(1.84 [1.05-3.22])和∑PBDE 水平(1.83 [1.07-3.14])增加,但与 BDE-71 水平的第 3 tert 呈下降趋势(0.38 [0.22-0.65])(均 P<0.01)。按 ER 阳性或阴性状态分层后,除 BDE-153 和 BDE-154 外,ER 阳性患者的调整结果相似,无统计学意义。在所有病例的多变量模型中,年龄、初潮年龄、BDE-47、71、99、100、183 和 209 是与乳腺癌风险相关的独立因素。在中国潮汕地区的女性中,∑PBDE 和大多数研究的个体 PBDE 同系物与乳腺癌风险呈正相关。PBDE 可能在乳腺癌的发生和发展中起作用。

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