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内源性激素与绝经前和绝经后妇女浸润性乳腺癌风险:来自英国生物银行的研究结果。

Endogenous hormones and risk of invasive breast cancer in pre- and post-menopausal women: findings from the UK Biobank.

机构信息

Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.

出版信息

Br J Cancer. 2021 Jul;125(1):126-134. doi: 10.1038/s41416-021-01392-z. Epub 2021 Apr 16.

Abstract

BACKGROUND

Some endogenous hormones have been associated with breast cancer risk, but the nature of these relationships is not fully understood.

METHODS

UK Biobank was used. Hormone concentrations were measured in serum collected in 2006-2010, and in a repeat subsample (N ~ 5000) in 2012-13. Incident cancers were identified through data linkage. Cox regression models were used, and hazard ratios (HRs) corrected for regression dilution bias.

RESULTS

Among 30,565 pre-menopausal and 133,294 post-menopausal women, 527 and 2,997, respectively, were diagnosed with invasive breast cancer during a median follow-up of 7.1 years. Cancer risk was positively associated with testosterone in post-menopausal women (HR per 0.5 nmol/L increment: 1.18; 95% CI: 1.14, 1.23) but not in pre-menopausal women (p = 0.03), and with IGF-1 (insulin-like growth factor-1) (HR per 5 nmol/L increment: 1.18; 1.02, 1.35 (pre-menopausal) and 1.07; 1.01, 1.12 (post-menopausal); p = 0.2), and inversely associated with SHBG (sex hormone-binding globulin) (HR per 30 nmol/L increment: 0.96; 0.79, 1.15 (pre-menopausal) and 0.89; 0.84, 0.94 (post-menopausal); p = 0.4). Oestradiol, assessed only in pre-menopausal women, was not associated with risk, but there were study limitations for this hormone.

CONCLUSIONS

This study confirms associations of testosterone, IGF-1 and SHBG with breast cancer risk, with heterogeneity by menopausal status for testosterone.

摘要

背景

一些内源性激素与乳腺癌风险相关,但这些关系的性质尚不完全清楚。

方法

本研究使用英国生物银行(UK Biobank)的数据。2006-2010 年采集血清样本测量激素浓度,2012-2013 年在重复样本(N~5000)中测量。通过数据链接确定癌症发病情况。采用 Cox 回归模型,校正回归稀释偏倚的危害比(HR)。

结果

在 30565 名绝经前和 133294 名绝经后女性中,分别有 527 名和 2997 名在中位随访 7.1 年后被诊断为浸润性乳腺癌。在绝经后女性中,癌症风险与睾酮呈正相关(每增加 0.5 nmol/L,HR:1.18;95%CI:1.14,1.23),但在绝经前女性中无相关性(p=0.03),与 IGF-1(胰岛素样生长因子-1)(每增加 5 nmol/L,HR:1.18;1.02,1.35(绝经前)和 1.07;1.01,1.12(绝经后);p=0.2)呈正相关,与 SHBG(性激素结合球蛋白)呈负相关(每增加 30 nmol/L,HR:0.96;0.79,1.15(绝经前)和 0.89;0.84,0.94(绝经后);p=0.4)。本研究仅在绝经前女性中评估了雌二醇,与风险无相关性,但这种激素的研究存在局限性。

结论

本研究证实了睾酮、IGF-1 和 SHBG 与乳腺癌风险相关,且与绝经状态有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b995/8257641/b353b4d527b1/41416_2021_1392_Fig1_HTML.jpg

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