雌二醇和睾酮与乳腺癌风险的关系：一项荟萃分析。

Estradiol and testosterone associated with risk of breast cancer: A meta-analysis.

作者信息

Liu Yanqing, Kang Yujuan, Li Xiaofei, Qu Nina

机构信息

Yantai Yuhuangding Hospital, Breast Surgery Department, Shandong, China.

Yantai Yuhuangding Hospital, Ultrasound Department, Shandong, China.

出版信息

J Med Biochem. 2024 Nov 16;43(6):819-827. doi: 10.5937/jomb0-50871.

DOI:10.5937/jomb0-50871

PMID:39876910

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11771977/

Abstract

BACKGROUND

This paper aimed to investigate the correlation between estradiol and testosterone in patients with breast cancer.

METHODS

The research papers on the correlation between estradiol and testosterone on the risk of breast cancer were searched and collected. The time limit is that each database was established until December 2023. After screening, the modified Jadad scale was used to evaluate the quality of the research literature. NoteExpress 3.2 was used for literature management, and Excel 2003 was used for data collection and extraction. Statistical analysis was performed using RevMan 5.4.1 software to determine whether there was heterogeneity in the study according to the size of the Q test (P-value), and then the OR value of combined effects was calculated using fixed or random effects models, and forest maps were drawn. At the same time, papers with the greatest weight were excluded for sensitivity analysis, and the literature bias was evaluated by drawing a funnel plot.

RESULTS

A total of 628 pieces of research were retrieved, and 11 case-control trials met the criteria for inclusion. Meta-analysis results showed that the level of E2 in breast cancer patients was higher than that in the non-breast cancer control group, but the difference was not statistically significant (OR=121.56, 95%CI (-3.32-264.44), P=0.06). The level of E2 in premenopausal patients with breast cancer was higher than that in the non-breast cancer control group, but the difference was not statistically significant (OR=8.26, 95%CI (-2.83-19.34), P=0.14). The level of E2 in postmenopausal patients with breast cancer was higher than that in the non-breast cancer control group, and the difference was statistically significant (OR=20.36, 95%CI (7.04-33.68), P=0.003). Preoperative T level was higher in patients with breast cancer than in the non-breast cancer control group, but the difference was not statistically significant (OR=14.77, 95%CI (-14.11-43.65), P=0.32). The T level before and after surgery in breast cancer patients was higher than that in the non-breast cancer control group, and the difference was statistically significant (OR=12.91, 95%CI (4.43-21.39), P=0.003). Sensitivity analysis showed that the combined effect size results were stable and reliable OR (95%CI) was 24.41 (10.21~38.61), P=0.0007. Funnel plot results showed publication bias.

CONCLUSIONS

There is a positive correlation between the levels of estradiol and testosterone and the occurrence and development of breast cancer after menopause.

摘要

背景

本文旨在研究乳腺癌患者雌二醇与睾酮之间的相关性。

方法

检索并收集关于雌二醇与睾酮对乳腺癌风险影响的相关性研究论文。时间范围为各数据库建库至2023年12月。筛选后，采用改良Jadad量表评估研究文献质量。使用NoteExpress 3.2进行文献管理，Excel 2003进行数据收集与提取。运用RevMan 5.4.1软件进行统计分析，根据Q检验（P值）大小判断研究是否存在异质性，然后使用固定效应或随机效应模型计算合并效应的OR值，并绘制森林图。同时，排除权重最大的论文进行敏感性分析，通过绘制漏斗图评估文献偏倚。

结果

共检索到628篇研究，11项病例对照试验符合纳入标准。Meta分析结果显示，乳腺癌患者的E2水平高于非乳腺癌对照组，但差异无统计学意义（OR = 121.56，95%CI（-3.32 - 264.44），P = 0.06）。绝经前乳腺癌患者的E2水平高于非乳腺癌对照组，但差异无统计学意义（OR = 8.26，95%CI（-2.83 - 19.34），P = 0.14）。绝经后乳腺癌患者的E2水平高于非乳腺癌对照组，差异有统计学意义（OR = 20.36，95%CI（7.04 - 33.68），P = 0.003）。乳腺癌患者术前T水平高于非乳腺癌对照组，但差异无统计学意义（OR = 14.77，95%CI（-14.11 - 43.65），P = 0.32）。乳腺癌患者手术前后的T水平高于非乳腺癌对照组，差异有统计学意义（OR = 12.91，95%CI（4.43 - 21.39），P = 0.003）。敏感性分析显示合并效应量结果稳定可靠，OR（95%CI）为24.41（10.21~38.61），P = 0.0007。漏斗图结果显示存在发表偏倚。