Janerich D T, Mineau G P, Kerber R A
University of Utah School of Medicine, Salt Lake City.
Cancer Causes Control. 1994 Jan;5(1):26-30. doi: 10.1007/BF01830723.
We examined the relationship between the survival of women with breast cancer and the gender of their first children using a genealogy-based survival analysis. The study group consisted of 2,155 parous women diagnosed in Utah (United States) with first primary breast cancers (excluding in situ tumors). We calculated hazard rate ratios (HRR) which were adjusted for stage, median survival times, and proportions surviving for three-, five-, and 10-year intervals stratified by age at diagnosis. Median survival among women diagnosed under the age of 45 was 171 months if the first child was female, but only 66 months if the first child was male (HRR = 1.66, 95 percent confidence interval = 1.07-2.57, for male children). For women diagnosed at age 45 or older, all survival times were similar, although women whose first child was male had slightly longer median survival time. These findings suggest that the gender of the first child has a strong influence on survival among women diagnosed under 45 years of age, but not among those diagnosed later in life. Gender of the first offspring may be a useful clinical indicator of prognosis and survival and may provide insights into etiologic and promotional factors for breast cancer.
我们采用基于系谱的生存分析方法,研究了乳腺癌女性患者的生存情况与其头胎子女的性别之间的关系。研究组由2155名在犹他州(美国)被诊断为原发性乳腺癌(不包括原位肿瘤)的经产妇女组成。我们计算了风险率比(HRR),并根据诊断时的年龄进行分层,对分期、中位生存时间以及3年、5年和10年间隔的生存比例进行了调整。如果头胎是女性,45岁以下被诊断出乳腺癌的女性的中位生存期为171个月,但如果头胎是男性,则仅为66个月(头胎为男性时,HRR = 1.66,95%置信区间 = 1.07 - 2.57)。对于45岁及以上被诊断出乳腺癌的女性,所有生存时间相似,尽管头胎是男性的女性中位生存时间略长。这些发现表明,头胎子女的性别对45岁以下被诊断出乳腺癌的女性的生存有很大影响,但对那些在晚年被诊断出乳腺癌的女性则没有影响。头胎子女的性别可能是一个有用的临床预后和生存指标,并且可能为乳腺癌的病因和促发因素提供见解。