Gapstur S M, Dupuis J, Gann P, Collila S, Winchester D P
Department of Preventive Medicine, Northwestern University Medical School, Chicago, Illinois 60611-4402, USA.
Cancer. 1996 Apr 15;77(8):1465-71. doi: 10.1002/(SICI)1097-0142(19960415)77:8<1465::AID-CNCR7>3.0.CO;2-B.
It has been postulated that different biologic characteristics of a tumor might account for at least a portion of the disparity in breast cancer survival for patients across racial and ethnic groups. The hormone receptor status of breast tumors is one characteristic with prognostic significance. Results of several studies indicate a higher proportion of estrogen receptor negative (ER-) breast tumors among black or Hispanic women compared with non-Hispanic whites. We investigated whether the association between race and ethnicity and the joint combination of ER and progesterone receptor (PR) status was independent of age and other tumor characteristics at diagnosis.
Relevant data were obtained from 13,239 breast cancer cases identified as part of the 1990 Patient Care Evaluation Study of Breast Cancer.
In univariate analysis, the proportions of ER+PR+, ER+PR-, ER-PR+, and ER-PR- tumors among non-Hispanics whites were 59%, 15%, 6%, and 20%, respectively; among Hispanics the proportions were 58%, 12%, 8%, and 22%, respectively; and among blacks the proportions were 44%, 14%, 7%, and 35%, respectively. After controlling for age, tumor size, and histology, using polychotomous logistic regression, these was no difference in hormone-receptor status between Hispanic and non-Hispanic white women. However, ER-PR- tumors were more likely to occur in blacks than in non-Hispanic whites (odds ratio = 1.8, 95% confidence interval = 1.6, 2.1)
The results of this study corroborate differences in hormone-receptor status between non-Hispanic white and black women, but not between Hispanics. Future studies of breast cancer should examine differences in epidemiologic risk factors between blacks and whites stratified on ER/PR status.
据推测，肿瘤的不同生物学特性可能至少部分解释了不同种族和族裔乳腺癌患者生存差异的原因。乳腺肿瘤的激素受体状态是一个具有预后意义的特征。多项研究结果表明，与非西班牙裔白人相比，黑人或西班牙裔女性中雌激素受体阴性（ER-）乳腺肿瘤的比例更高。我们调查了种族和族裔与雌激素受体（ER）和孕激素受体（PR）状态的联合组合之间的关联是否独立于诊断时的年龄和其他肿瘤特征。
相关数据来自13239例乳腺癌病例，这些病例是1990年乳腺癌患者护理评估研究的一部分。
在单因素分析中，非西班牙裔白人中ER+PR+、ER+PR-、ER-PR+和ER-PR-肿瘤的比例分别为59%、15%、6%和20%；西班牙裔中的比例分别为58%、12%、8%和22%；黑人中的比例分别为44%、14%、7%和35%。在控制年龄、肿瘤大小和组织学后，使用多分类逻辑回归分析，西班牙裔和非西班牙裔白人女性之间的激素受体状态没有差异。然而，ER-PR-肿瘤在黑人中比在非西班牙裔白人中更易发生（优势比=1.8，95%置信区间=1.6，2.1）
本研究结果证实了非西班牙裔白人和黑人女性在激素受体状态上的差异，但西班牙裔女性之间没有差异。未来的乳腺癌研究应检查按ER/PR状态分层的黑人和白人在流行病学危险因素方面的差异。
