Inserm U 1018, Center for research in Epidemiology and Population Health (CESP), University Paris-Sud, Paris-Saclay, 94807 Villejuif, France.
Department of Environmental and Occupational Health, School of Public Health, IRSPUM, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, QC H3C 3J7, Canada.
Int J Environ Res Public Health. 2019 Jan 18;16(2):271. doi: 10.3390/ijerph16020271.
Exposure to environmental chemicals with hormonal effects, such as organochlorine compounds (OCs), during developmental periods of breast cells may have an impact on the incidence of breast cancer later in life. However, the assessment of exposure to these chemicals that occurred in early life at the time of breast cancer development in adult women is a difficult challenge in epidemiological studies. Plasma levels of the OCs p,p'-dichlorodiphenyl dichloroethene (DDE) and polychlorinated biphenyl congener 153 (PCB153) were measured in 695 cases and 1055 controls of a population-based case-control study conducted in France (CECILE study). Based on these values, we used a physiologically-based pharmacokinetic (PBPK) model to estimate PCB153 levels at age 11⁻20 years when the women were adolescents. Overall, there was no clear association between breast cancer risk and measured levels of DDE and PCB153 at the time of diagnosis, but there was a trend of decreasing odds ratios of breast cancer with increasing DDE and PCB153 levels in women aged 50 years and over. The PBPK model revealed that PCB153 concentrations estimated during adolescence were highest in the youngest women born after 1960 who reached adolescence at a time when environmental contamination was maximum, and very low in the oldest women who attained adolescence before the contamination peak. Negative associations between breast cancer and PCB153 estimates during adolescence were also found. The negative associations between DDE and PCB153 levels measured at the time of diagnosis or estimated during adolescence in our study were unexplained. Further investigations are needed to clarify whether this finding is real or related to study artifacts. However, this study suggests that using PBPK models in epidemiological studies to back-estimate OC exposures during early life stages may be useful to address critical questions on cancer development.
暴露于具有激素作用的环境化学物质,如有机氯化合物(OCs),在乳腺细胞的发育时期,可能会对以后生活中的乳腺癌发病率产生影响。然而,在成年女性乳腺癌发展时评估早期生活中接触这些化学物质,是流行病学研究中的一个难题。在法国进行的一项基于人群的病例对照研究(CECILE 研究)中,测量了 695 例病例和 1055 例对照的血浆有机氯化合物 p,p'-二氯二苯二氯乙烯(DDE)和多氯联苯同系物 153(PCB153)水平。基于这些值,我们使用基于生理学的药代动力学(PBPK)模型来估计女性处于青少年时期(11⁻20 岁)时的 PCB153 水平。总体而言,在诊断时,DDE 和 PCB153 的测量水平与乳腺癌风险之间没有明显关联,但在 50 岁及以上的女性中,DDE 和 PCB153 水平升高与乳腺癌比值比降低呈趋势。PBPK 模型表明,在出生于 1960 年后的最年轻女性中,青少年时期估计的 PCB153 浓度最高,这些女性在环境污染最严重的时候进入青春期,而在污染高峰期之前进入青春期的最年长女性的浓度则非常低。在青少年时期,乳腺癌与 PCB153 估计值之间也存在负相关。我们的研究中还发现,在诊断时或青少年时期估计的 DDE 和 PCB153 水平与乳腺癌之间呈负相关,但这一结果无法解释。需要进一步研究以阐明这一发现是真实的还是与研究 artifact 有关。然而,这项研究表明,在流行病学研究中使用 PBPK 模型回溯估计早期生命阶段的 OC 暴露,可能有助于解决癌症发展的关键问题。