Li Xiaomin, Fang Ling, Li Hongjiang, Yang Xiaoqin
Department of Breast Surgery, West China Hospital, Sichuan University, Chengdu, China.
Department of Breast Surgery, Cheng Du Shang Jin Nan Fu Hospital, West China Hospital, Sichuan University, Chengdu, China.
Endocr Connect. 2021 Dec 14;10(12):1615-1622. doi: 10.1530/EC-21-0226.
In China, the association between estrogen metabolism and breast cancer risk and the differences in metabolic pattern between breast cancer patients and controls are poorly understood.
A total of 84 patients with invasive breast cancer and 47 controls with benign breast diseases were included in this study. Estrogen metabolites from their morning urine were determined by HPLC-MS/MS and evaluated in both groups, and the predictive value of each estrogen metabolite in the malignant group according to their menstrual status was analyzed.
Urinary concentration of estrogen metabolites 2-hydroxyestrone (2-OHE1), 2-hydroxyestradiol (2-OHE2), 4-hydroxyestradiol (4-OHE2), 4-methoxyestrone (4-MeOE1), and 16α-hydroxyestrone were lower in postmenopausal patients with breast cancer, compared with benign controls. In logistic regression model, breast cancer risk increased with the decline in the levels of 4-OHE2 and 4-MeOE1. In premenopausal patients, a difference in the level of 2-OHE2 was observed between both groups, and 2-OHE2 was found to have predictive value for breast cancer. Additionally, urinary 2-OHE2 level in premenopausal hormone receptor positive (HR+) patients was considerably higher compared with hormone receptor negative patients.
We found that lower urinary levels of 4-OHE2 and 4-MeOE1 had predictive value for breast cancer, and higher 2-OHE1 were associated with HR+ breast cancer in premenopausal women.
在中国,雌激素代谢与乳腺癌风险之间的关系以及乳腺癌患者与对照组之间代谢模式的差异尚不清楚。
本研究共纳入84例浸润性乳腺癌患者和47例患有良性乳腺疾病的对照者。通过高效液相色谱-串联质谱法(HPLC-MS/MS)测定其晨尿中的雌激素代谢物,并在两组中进行评估,同时分析各雌激素代谢物在恶性组中根据月经状态的预测价值。
绝经后乳腺癌患者尿液中雌激素代谢物2-羟雌酮(2-OHE1)、2-羟雌二醇(2-OHE2)、4-羟雌二醇(4-OHE2)、4-甲氧基雌酮(4-MeOE1)和16α-羟雌酮的浓度低于良性对照组。在逻辑回归模型中,乳腺癌风险随着4-OHE2和4-MeOE1水平的下降而增加。在绝经前患者中,两组间观察到2-OHE2水平存在差异,且发现2-OHE2对乳腺癌具有预测价值。此外,绝经前激素受体阳性(HR+)患者的尿液2-OHE2水平显著高于激素受体阴性患者。
我们发现尿液中较低水平的4-OHE2和4-MeOE1对乳腺癌具有预测价值,而较高水平的2-OHE1与绝经前女性的HR+乳腺癌相关。