King R J
School of Biological Sciences, University of Surrey, Guildford, United Kingdom.
Breast Cancer Res Treat. 1993;27(1-2):3-15. doi: 10.1007/BF00683189.
The influences of estrogen and progestin on human mammary neoplasia are reviewed with a view to identifying what is known about their effects. Estrogens promote growth of established cancer and pharmacological levels of progestins induce remission. In vivo, highest proliferation of histologically normal mammary epithelium occurs in the progestogenic phase of the menstrual cycle or under the progestogenic influence of oral contraceptives. Little additional hard data exist to indicate whether progestins promote or inhibit human mammary carcinogenesis. Effects on proliferation, steroid receptor content and development are discussed together with interpretation of epidemiological data on risk factors that have hormonal components. Progestins may not be the benign or beneficial agents previously supposed, and there are virtually no data to suggest that they are antiestrogenic. It is hypothesized that carcinogenesis may be accompanied by increased sensitivity to estrogen, which provides a growth advantage to the tumor by maximizing use of the low estrogen concentrations encountered in the postmenopausal state.
本文综述了雌激素和孕激素对人类乳腺肿瘤形成的影响，旨在明确关于它们作用的已知信息。雌激素促进已形成癌症的生长，而药理水平的孕激素可诱导缓解。在体内，组织学上正常的乳腺上皮细胞在月经周期的孕激素期或口服避孕药的孕激素影响下增殖最为旺盛。几乎没有更多确凿的数据表明孕激素是促进还是抑制人类乳腺癌的发生。本文讨论了孕激素对增殖、类固醇受体含量和发育的影响，并对具有激素成分的风险因素的流行病学数据进行了解读。孕激素可能并非如之前所认为的那样是良性或有益的药物，而且几乎没有数据表明它们具有抗雌激素作用。据推测，致癌过程可能伴随着对雌激素敏感性的增加，这通过最大限度地利用绝经后状态下遇到的低雌激素浓度为肿瘤提供了生长优势。
