Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland.
International Agency for Research on Cancer, World Health Organization, Lyon, France.
Cancer Epidemiol Biomarkers Prev. 2020 Mar;29(3):636-642. doi: 10.1158/1055-9965.EPI-19-0675. Epub 2020 Jan 13.
Reproductive factors, including parity, breastfeeding, and contraceptive use, affect lifetime ovulatory cycles and cumulative exposure to gonadotropins and are associated with ovarian cancer. To understand the role of ovulation-regulating hormones in the etiology of ovarian cancer, we prospectively analyzed the association of anti-Mullerian hormone (AMH), follicle-stimulating hormone (FSH), and inhibin B with ovarian cancer risk.
Our study included 370 women from the Janus Serum Bank, including 54 type I and 82 type II invasive epithelial ovarian cancers, 49 borderline tumors, and 185 age-matched controls. We used conditional logistic regression to assess the relationship between hormones and risk of ovarian cancer overall and by subtype (types I and II).
Inhibin B was associated with increased risk of ovarian cancer overall [OR, 1.97; 95% confidence interval (CI), 1.14-3.39; = 0.05] and with type I ovarian (OR, 3.10; 95% CI, 1.04-9.23; = 0.06). FSH was not associated with ovarian cancer risk overall, but higher FSH was associated with type II ovarian cancers (OR, 2.78; 95% CI, 1.05-7.38). AMH was not associated with ovarian cancer risk.
FSH and inhibin B may be associated with increased risk in different ovarian cancer subtypes, suggesting that gonadotropin exposure may influence risk of ovarian cancer differently across subtypes.
Associations between prospectively collected AMH, FSH, and inhibin B levels with risk of ovarian cancer provide novel insight on the influence of premenopausal markers of ovarian reserve and gonadotropin signaling. Heterogeneity of inhibin B and FSH effects in different tumor types may be informative of tumor etiology.
生殖因素,包括生育次数、哺乳和避孕措施,会影响一生中的排卵周期和促性腺激素的累积暴露,与卵巢癌相关。为了了解排卵调节激素在卵巢癌病因学中的作用,我们前瞻性地分析了抗苗勒管激素(AMH)、卵泡刺激素(FSH)和抑制素 B 与卵巢癌风险的关系。
我们的研究包括来自扬努斯血清库的 370 名女性,包括 54 例 I 型和 82 例 II 型侵袭性上皮性卵巢癌、49 例交界性肿瘤和 185 名年龄匹配的对照者。我们使用条件 logistic 回归来评估激素与卵巢癌总体风险以及各亚型(I 型和 II 型)风险之间的关系。
抑制素 B 与卵巢癌总体风险增加相关(OR,1.97;95%置信区间(CI),1.14-3.39;P=0.05),与 I 型卵巢癌(OR,3.10;95%CI,1.04-9.23;P=0.06)也相关。FSH 与卵巢癌总体风险无关,但较高的 FSH 与 II 型卵巢癌相关(OR,2.78;95%CI,1.05-7.38)。AMH 与卵巢癌风险无关。
FSH 和抑制素 B 可能与不同的卵巢癌亚型的风险增加有关,这表明促性腺激素暴露可能会以不同的方式影响不同亚型的卵巢癌风险。
前瞻性收集的 AMH、FSH 和抑制素 B 水平与卵巢癌风险之间的关联为卵巢储备和促性腺激素信号的绝经前标志物对卵巢癌的影响提供了新的见解。不同肿瘤类型中抑制素 B 和 FSH 作用的异质性可能为肿瘤病因学提供信息。