Stanford J L, Szklo M, Boring C C, Brinton L A, Diamond E A, Greenberg R S, Hoover R N
Am J Epidemiol. 1987 Feb;125(2):184-94. doi: 10.1093/oxfordjournals.aje.a114519.
A population-based case-control study was conducted to examine whether tumor estrogen receptor status differentiated risk factor patterns for breast cancer. From December 1980 to December 1982, 458 women with newly diagnosed breast cancer and 568 control women, aged 20-54 years, from the Atlanta, Georgia, metropolitan area were interviewed. On the basis of tumor estrogen receptor results, cases were classified as receptor-positive or receptor-negative. Intercase analysis showed that age was positively and significantly associated with estrogen receptor-positive breast cancer (p = 0.001); the relative risk for an estrogen receptor-positive as opposed to an estrogen receptor-negative tumor was elevated threefold among women aged 50-54 years compared with those aged less than 35 years. In the case-control analysis, race was the only individual factor that demonstrated a significant difference in the risk for estrogen receptor-positive versus estrogen receptor-negative cancer (p less than 0.05), with blacks being at a 25% excess risk for estrogen receptor-negative cancer compared with whites. Although a history of benign breast disease was a risk factor for both positive and negative tumors, the association was stronger for the estrogen receptor-positive tumors. Postmenopausal women were at a lower risk for both cancer subtypes compared with premenopausal women. Compared with non-users, women who had ever taken oral contraceptives had a 16% decrease in the risk for receptor-positive cancer and a 22% increase in the risk for receptor-negative cancer. These results are consistent with the notion that certain exposure variables may relate to hormonal status, possibly by augmentation or suppression of estrogen receptor activity.
开展了一项基于人群的病例对照研究，以检验肿瘤雌激素受体状态是否能区分乳腺癌的危险因素模式。1980年12月至1982年12月，对来自佐治亚州亚特兰大大都市地区的458名新诊断为乳腺癌的女性和568名年龄在20 - 54岁的对照女性进行了访谈。根据肿瘤雌激素受体检测结果，将病例分为受体阳性或受体阴性。病例间分析表明，年龄与雌激素受体阳性乳腺癌呈正相关且具有显著意义（p = 0.001）；与年龄小于35岁的女性相比，50 - 54岁女性中雌激素受体阳性肿瘤相对于雌激素受体阴性肿瘤的相对风险升高了两倍。在病例对照分析中，种族是唯一在雌激素受体阳性癌与雌激素受体阴性癌风险上显示出显著差异的个体因素（p < 0.05），与白人相比，黑人患雌激素受体阴性癌的风险高出25%。尽管良性乳腺疾病史是阳性和阴性肿瘤的危险因素，但与雌激素受体阳性肿瘤的关联更强。与绝经前女性相比，绝经后女性患这两种癌症亚型的风险较低。与未使用者相比，曾经服用口服避孕药的女性患受体阳性癌的风险降低了16%，患受体阴性癌的风险增加了22%。这些结果与某些暴露变量可能与激素状态有关的观点一致，可能是通过增强或抑制雌激素受体活性实现的。
