Gordon G B, Helzlsouer K J, Alberg A J, Comstock G W
Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205.
Cancer Epidemiol Biomarkers Prev. 1993 Jan-Feb;2(1):33-5.
Although the incidence of gastric cancer varies widely between countries it is nonetheless a leading cause of cancer deaths worldwide. Migration studies indicate that dietary choices are an important exogenous factor. The United States has a very low incidence of gastric cancer, suggesting that exogenous etiological agents are at a minimum and providing a favorable setting for detecting important endogenous etiological factors. Dehydroepiandrosterone and dehydroepiandrosterone sulfate are endogenous steroids produced in the adrenal gland. Epidemiological studies show that the risk of developing specific cancers is related to the serum or urinary levels of these steroids. In addition, dehydroepiandrosterone prevents a variety of spontaneous and chemically induced tumors when administered to laboratory animals. To examine the association between circulating levels of dehydroepiandrosterone and dehydroepiandrosterone sulfate and the development of gastric cancer, we measured the serum levels of these steroids in 13 individuals who donated serum to the Washington County Maryland serum bank in 1974 and who subsequently developed gastric cancer and in 52 matched controls. Prediagnostic serum levels of dehydroepiandrosterone were 38% lower in cases as compared to controls (P = 0.09). The risk of developing gastric cancer increased with decreasing levels of both steroids. Adjustment for confounding factors such as smoking or the interval between blood donation and time to diagnosis did not alter the findings. These results suggest that there may be a role for this steroid in the prevention of gastric cancer.
尽管各国胃癌发病率差异很大，但它仍是全球癌症死亡的主要原因。移民研究表明，饮食选择是一个重要的外部因素。美国胃癌发病率极低，这表明外部致病因素最少，为检测重要的内源性致病因素提供了有利环境。脱氢表雄酮和硫酸脱氢表雄酮是肾上腺产生的内源性类固醇。流行病学研究表明，患特定癌症的风险与这些类固醇的血清或尿液水平有关。此外，给实验动物注射脱氢表雄酮可预防多种自发和化学诱导的肿瘤。为了研究脱氢表雄酮和硫酸脱氢表雄酮的循环水平与胃癌发生之间的关联，我们测量了1974年向马里兰州华盛顿县血清库捐献血清且随后患胃癌的13名个体以及52名匹配对照者的这些类固醇的血清水平。病例组诊断前的脱氢表雄酮血清水平比对照组低38%（P = 0.09）。两种类固醇水平降低，患胃癌的风险都会增加。对吸烟或献血与诊断时间间隔等混杂因素进行调整后，结果并未改变。这些结果表明，这种类固醇可能在预防胃癌中发挥作用。
