Department of Cancer Epidemiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Cancer Prev Res (Phila). 2021 Jun;14(6):659-666. doi: 10.1158/1940-6207.CAPR-20-0497. Epub 2021 Mar 25.
Gastric cancer shows a strong male predominance, and sex steroid hormones have been hypothesized to explain this sex disparity. Previous studies examining the associations between sex hormones and sex hormone binding globulin (SHBG) and risk of gastric cancer come primarily from western populations and additional studies in diverse populations will help us better understand the association. We performed a nested case-control study in Linxian Nutrition Intervention Trials cohorts to evaluate the associations among Chinese men, where we had sufficient cases to perform a well-powered study. Using radioimmunoassays and immunoassays, we quantitated androgens, estrogens, and SHBG in baseline serum from 328 men that developed noncardia gastric cancer and matched controls. We used multivariable unconditional logistic regression to calculate ORs and 95% confidence intervals (CI) and explored interactions with body mass index (BMI), age, alcohol drinking, smoking, and follow-up time. Subjects with SHBG in the highest quartile, as compared with those in the lowest quartile, had a significantly increased risk of gastric cancer (OR = 1.87; 95% CI, 1.01-3.44). We found some evidence for associations of sex steroid hormones in men with lower BMI. Our study found a novel association suggesting that higher serum concentrations of SHBG may be associated with risk of gastric cancer in men. We found no overall associations with sex hormones themselves, but future studies should expand the scope of these studies to include women and further explore whether BMI modifies a potential association. PREVENTION RELEVANCE: It was the first study to investigate the association of gastric cancer with prediagnostic sex steroid hormones and SHBG in an Asian male population. Although there were no overall associations for sex steroid hormone concentrations, higher concentrations of SHBG was associated with increased risk of noncardia gastric cancer.
胃癌表现出强烈的男性优势，性激素被认为可以解释这种性别差异。之前研究性激素和性激素结合球蛋白（SHBG）与胃癌风险之间的关系的研究主要来自西方人群，在不同人群中进行更多的研究将有助于我们更好地理解这种关联。我们在林县营养干预试验队列中进行了一项巢式病例对照研究，以评估中国男性中这些因素之间的关系，我们有足够的病例来进行一项有力的研究。我们使用放射免疫分析和免疫分析方法，在 328 名患有非贲门胃癌的男性和匹配的对照者的基线血清中定量检测雄激素、雌激素和 SHBG。我们使用多变量非条件逻辑回归计算比值比（OR）和 95%置信区间（CI），并探索与体重指数（BMI）、年龄、饮酒、吸烟和随访时间的交互作用。与 SHBG 最低四分位组相比，SHBG 最高四分位组的男性患胃癌的风险显著增加（OR=1.87；95%CI，1.01-3.44）。我们发现一些证据表明，较低 BMI 的男性的性激素与胃癌之间存在关联。我们的研究发现了一种新的关联，提示男性血清中 SHBG 浓度升高可能与胃癌风险相关。我们没有发现性激素本身与胃癌之间存在总体关联，但未来的研究应该扩大这些研究的范围，包括女性，并进一步探索 BMI 是否会改变潜在的关联。预防相关性：这是第一项在亚洲男性人群中研究胃癌与术前性激素和 SHBG 之间关联的研究。尽管性激素浓度没有总体关联，但 SHBG 浓度升高与非贲门胃癌风险增加相关。
