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母亲的生育模式与女儿患乳腺癌的风险:来自犹他州人口数据库的结果

Maternal pattern of reproduction and risk of breast cancer in daughters: results from the Utah Population Database.

作者信息

Janerich D T, Thompson W D, Mineau G P

机构信息

Department of Medicine, School of Medicine, University of Utah, Salt Lake City.

出版信息

J Natl Cancer Inst. 1994 Nov 2;86(21):1634-9. doi: 10.1093/jnci/86.21.1634.

Abstract

BACKGROUND

Several studies have found that daughters born to older mothers have an elevated risk of breast cancer, and an endocrine hypothesis, among others, has been developed to explain these findings. Three recent studies have failed to find a consistent maternal age effect, indicating a need for further exploration of this issue.

PURPOSE

We used Utah breast cancer records linked to genealogical records to investigate maternal and paternal age and other maternal reproductive factors in relationship to the daughter's risk of breast cancer.

METHODS

The study group consisted of 2414 breast cancer case patients and 9138 individually matched control subjects. Breast cancer diagnoses were ascertained through the National Cancer Institute's Surveillance, Epidemiology, and End Results Program. The case patients and control subjects were born between 1875 and the end of 1947, and the mean age at diagnosis of the case patients was 65.9 years.

RESULTS

No consistent effect for maternal or paternal age was found, except possibly among women who were firstborn children (odds ratio [OR] = 1.42 for a 10-year differential in maternal age; 95% confidence interval [CI] = 1.00-2.00). Further examination of the data indicated that mothers of case patients experienced long intervals between marriage and their first birth but not between subsequent births, and they went on to have fewer children. For each year of delay between the mother's marriage and first birth, the odds of breast cancer in the daughter increased 1.05-fold (95% CI = 1.01-1.10).

CONCLUSIONS

We found no evidence of a consistent maternal age effect with regard to breast cancer risk in the daughter, but we did find evidence that the mothers of women who go on to get breast cancer have a reproductive pattern that could suggest some form of underlying infertility.

IMPLICATIONS

These findings widen the epidemiologic support for the fetal antigen hypothesis, which is an immunogenetic explanation for the relationships between reproductive factors and breast cancer risk. That hypothesis provides strategies for the identification of breast cancer genes and the eventual development of a breast cancer vaccine.

摘要

背景

多项研究发现,高龄母亲所生女儿患乳腺癌的风险升高,人们提出了一种内分泌假说等理论来解释这些发现。最近的三项研究未能发现一致的母亲年龄效应,这表明有必要进一步探讨这一问题。

目的

我们利用与家谱记录相关联的犹他州乳腺癌记录,调查母亲和父亲的年龄以及其他母亲生殖因素与女儿患乳腺癌风险之间的关系。

方法

研究组由2414例乳腺癌病例患者和9138例个体匹配的对照对象组成。乳腺癌诊断通过美国国立癌症研究所的监测、流行病学和最终结果计划确定。病例患者和对照对象出生于1875年至1947年底之间,病例患者的诊断平均年龄为65.9岁。

结果

未发现母亲或父亲年龄的一致效应,可能除了头胎出生的女性之外(母亲年龄相差10岁时的优势比[OR]=1.42;95%置信区间[CI]=1.00 - 2.00)。对数据的进一步检查表明,病例患者的母亲在初婚和首次生育之间间隔时间长,但后续生育之间的间隔不长,而且她们生育的子女较少。母亲初婚和首次生育之间每延迟一年,女儿患乳腺癌的几率增加1.05倍(95% CI = 1.01 - 1.10)。

结论

我们没有发现母亲年龄对女儿患乳腺癌风险有一致效应的证据,但我们确实发现有证据表明,患乳腺癌女性的母亲有一种生殖模式,这可能暗示某种形式的潜在不孕。

启示

这些发现拓宽了对胎儿抗原假说的流行病学支持,该假说是对生殖因素与乳腺癌风险之间关系的一种免疫遗传学解释。该假说为乳腺癌基因的识别以及最终开发乳腺癌疫苗提供了策略。

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