Department of Public Health, College of Health Science, Kaohsiung Medical University, No.100, Shin-Chuan 1st Road, Sanmin Dist., Kaohsiung, 80708, Taiwan, ROC.
Division of Breast Oncology and Surgery, Department of Surgery, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, 80756, Taiwan, ROC.
Sci Rep. 2022 Feb 21;12(1):2858. doi: 10.1038/s41598-022-06709-3.
The association between phthalate exposure and breast cancer remains controversial. We performed a prospective patient cohort design to explore the interaction between creatinine-corrected urinary phthalate metabolites and hormone receptors as well as body mass index (BMI) on recurrent breast cancer. In this follow-up study, 636 female breast cancer patients and 45 new recurrent cases diagnosed for a total of 1576.68 person-years of follow-up were recruited. Mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP) was negatively associated with breast cancer recurrence, with adjusted hazard ratio (aHR) 3rd vs. 1st quartile of 0.15 (95% CI 0.04-0.51). The MEOHP presented as a non-monotonic dose-response (NMDR) curve, being U-shaped. In the stratification of hormone receptors, MEOHP still exhibited a U-shaped dose-response curve. The third quartile of MEOHP showed significant lowest recurrent risk in the status of ER-positive (aHR 0.18, 95% CI 0.05-0.66), PR-negative (aHR 0.14, 95% CI 0.03-0.63), and HER2-negative (aHR 0.24, 95% CI 0.08-0.76). Whether in BMI < 25 or in BMI ≥ 25, the third quartile of MEOHP was negatively associated with recurrent breast cancer, and there was a negative interaction on an additive scale between MEOHP and BMI (p = 0.042). The association between MEOHP and recurrent breast cancer was modified by hormone receptors and BMI.
邻苯二甲酸酯暴露与乳腺癌的相关性仍存在争议。我们采用前瞻性患者队列设计，探讨了肌酐校正的尿邻苯二甲酸代谢物与激素受体以及体重指数（BMI）之间的相互作用，以研究其对乳腺癌复发的影响。在这项随访研究中，共招募了 636 名女性乳腺癌患者和 45 例新确诊的复发病例，随访总时间为 1576.68 人年。单-（2-乙基-5-氧代己基）邻苯二甲酸酯（MEOHP）与乳腺癌复发呈负相关，调整后的危险比（aHR）第 3 四分位与第 1 四分位相比为 0.15（95%CI 0.04-0.51）。MEOHP 呈现非单调剂量反应（NMDR）曲线，呈 U 型。在激素受体的分层中，MEOHP 仍表现出 U 型剂量反应曲线。MEOHP 的第三四分位数在 ER 阳性（aHR 0.18，95%CI 0.05-0.66）、PR 阴性（aHR 0.14，95%CI 0.03-0.63）和 HER2 阴性（aHR 0.24，95%CI 0.08-0.76）状态下显示出最低的复发风险。无论 BMI 是否<25 或 BMI≥25，MEOHP 的第三四分位数与乳腺癌复发呈负相关，并且 MEOHP 与 BMI 之间存在负的相加尺度交互作用（p=0.042）。MEOHP 与乳腺癌复发的关联受激素受体和 BMI 的影响。
