Adami H O, Lipworth L, Titus-Ernstoff L, Hsieh C C, Hanberg A, Ahlborg U, Baron J, Trichopoulos D
Department of Cancer Epidemiology, Uppsala University, Sweden.
Cancer Causes Control. 1995 Nov;6(6):551-66. doi: 10.1007/BF00054165.
The organochlorines, a diverse group of some 15,000 compounds, have been implicated increasingly as being harmful to humans. Some congeners of DDT and PCB elicit very weak estrogenic responses in animals, while the dioxin TCDD and related compounds have antiestrogenic properties. This review summarizes the evidence regarding whether certain organochlorine compounds, usually as persistent food-chain contaminants, increase the risk of breast and endometrial cancers through their estrogenic potential. In humans, neither ecologic data nor occupational studies provide clear support for an association between organochlorine exposure and the occurrence of these cancers. In our summary analysis of occupational exposure, the rate ratio of breast cancer for exposed cf unexposed women was 0.84 (95 percent confidence interval [CI] = 0.50-1.33) for PCBs and 1.08 (CI = 0.68-1.58) for TCDD. Similarly, effect estimates close to unity were found in summary analysis of breast cancer case-control studies regarding levels of DDE and PCB in adipose tissue or serum. In two recent nested case-control studies using stored specimens, the odds ratio per standard deviation increase in serum p,p'-DDE was 1.27 (CI = 0.95-1.69). Although estrogenic effects of certain organochlorine compounds should be easier to detect on the endometrium, we know of no analytic epidemiologic studies of endometrial cancer published to data. We conclude that available data do not indicate that organochlorines will affect the risk of these two cancers in any but the most unusual situation.
有机氯化合物是一组约15000种不同的化合物,越来越多地被认为对人类有害。滴滴涕和多氯联苯的一些同系物在动物体内会引发非常微弱的雌激素反应,而二恶英TCDD及相关化合物具有抗雌激素特性。本综述总结了有关某些有机氯化合物(通常作为持久性食物链污染物)是否通过其雌激素潜力增加乳腺癌和子宫内膜癌风险的证据。在人类中,生态学数据和职业研究均未明确支持有机氯暴露与这些癌症发生之间的关联。在我们对职业暴露的汇总分析中,接触多氯联苯的女性与未接触女性相比,患乳腺癌的率比为0.84(95%置信区间[CI]=0.50-1.33),接触TCDD的率比为1.08(CI=0.68-1.58)。同样,在关于脂肪组织或血清中DDE和多氯联苯水平的乳腺癌病例对照研究的汇总分析中,发现效应估计值接近1。在两项最近使用储存标本的巢式病例对照研究中,血清中p,p'-DDE每增加一个标准差,比值比为1.27(CI=0.95-1.69)。尽管某些有机氯化合物的雌激素作用在子宫内膜上应该更容易检测到,但我们目前还没有看到已发表的关于子宫内膜癌的分析性流行病学研究。我们得出结论,现有数据并未表明在任何情况下,除了最特殊的情况外,有机氯会影响这两种癌症的风险。