Janerich D T, Thompson W D
Department of Medicine, University of Utah School of Medicine, Salt Lake City 84132, USA.
Epidemiology. 1995 May;6(3):254-7. doi: 10.1097/00001648-199505000-00011.
Several reproductive factors have been found to be associated with breast cancer. Based on an immunologic rather than strictly hormonal interpretation of these observations, we hypothesized that, beyond the observed associations relating to pregnancy per se, multiple marriages would be found to protect women against breast cancer. We obtained cases and controls from linked records from the Utah Cancer Registry and genealogic records. A total of 2,414 women with newly diagnosed breast cancer and 9,138 individually matched controls were included. The unadjusted odds ratio for each marriage after the first was 0.81 [95% confidence interval (CI) = 0.68-0.97]. After adjustment for major reproductive factors, multiple marriages were still found to reduce the risk of breast cancer (odds ratio = 0.86; 95% CI = 0.72-1.03). The findings are consistent with the operation of an immunologic mechanism in the etiology of breast cancer and suggest that the gene/antigen responsible for this effect is quite common in males. Further empirical evaluation of the fetal antigen hypothesis seems warranted.
已发现多种生殖因素与乳腺癌有关。基于对这些观察结果的免疫学而非严格的激素学解释,我们推测,除了观察到的与妊娠本身相关的关联外,多次婚姻会被发现可保护女性预防乳腺癌。我们从犹他州癌症登记处的关联记录和家谱记录中获取了病例和对照。总共纳入了2414名新诊断为乳腺癌的女性和9138名个体匹配的对照。首次婚姻后的每次婚姻的未调整优势比为0.81[95%置信区间(CI)=0.68-0.97]。在对主要生殖因素进行调整后,仍发现多次婚姻可降低患乳腺癌的风险(优势比=0.86;95%CI=0.72-1.03)。这些发现与乳腺癌病因学中免疫机制的作用一致,并表明负责这种效应的基因/抗原在男性中相当常见。对胎儿抗原假说进行进一步的实证评估似乎是有必要的。