Baanders-van Halewyn E A, Blankenstein M A, Thijssen J H, de Ridder C M, de Waard F
Department of Epidemiology, University of Utrecht, The Netherlands.
Eur J Cancer Prev. 1996 Apr;5(2):105-12. doi: 10.1097/00008469-199604000-00004.
A cohort study has been carried out to investigate risk factors for cancer as well as hyperplasia of the endometrium. Over the 13 years for which we followed 25,000 women aged 40-65 (who took part in a population-based screening programme for breast cancer), 111 cases of endometrial cancer and 109 cases of endometrial hyperplasia were diagnosed. A comparison of the outcome between the two disease entities revealed that large body weight among postmenopausal women and the use of oestrogenic drugs at all ages were risk factors for both cancer and hyperplasia of the endometrium. However, reproductive histories and premenopausal steroid profiles differed. Steroid excretion determinations in urine samples collected years before diagnosis provided further evidence in favour of the hypothesis of unopposed action of oestrogens in the aetiology of endometrial cancer. In women who were to develop endometrial hyperplasia or cancer the obesity-oestrogen relationship was stronger than in those who remained free of endometrial disease during the period of follow-up. The possible significance of differences in aromatase activity among the obese is considered.
一项队列研究已经开展，旨在调查癌症以及子宫内膜增生的风险因素。在我们对25000名年龄在40 - 65岁的女性（她们参加了一项基于人群的乳腺癌筛查项目）进行随访的13年中，诊断出111例子宫内膜癌和109例子宫内膜增生。对这两种疾病实体的结果进行比较发现，绝经后女性体重超标以及各年龄段使用雌激素药物都是子宫内膜癌和增生的风险因素。然而，生殖史和绝经前的类固醇谱有所不同。在诊断前数年收集的尿液样本中的类固醇排泄测定为雌激素在子宫内膜癌病因中无对抗作用的假说提供了进一步证据。在即将发生子宫内膜增生或癌症的女性中，肥胖与雌激素的关系比在随访期间未患子宫内膜疾病的女性中更强。文中考虑了肥胖者中芳香化酶活性差异的可能意义。
