Kleemann D, Kunkel S, Bellin T
Hals-Nasen-Ohren-Klinik und Poliklinik, Medizinische Fakultät, Universität Rostock.
Laryngorhinootologie. 1996 Feb;75(2):88-90. doi: 10.1055/s-2007-997541.
The high incidence ratio males to females is the reason for considering a hormonal dependency of these tumours for many years. The low incidence of laryngeal cancer in women has generally been suggested as being due to "oestrogen defense". Although we do have some circumstantial evidence in the meantime, no final evidence on this topic is available so far.
The oestrogen feedback effect could be another more objective parameter to bring more light to the research of this question. As one of the regulation mechanisms of the hypothalamic-pituitary-adrenal axis the oestrogen feedback mechanism represents the regulation of LH and FSH production in the pituitary gland by peripheral oestrogens. The mechanism is known to exist lifelong under normal conditions. Whereas the positive oestrogen feedback is typical for women, a negative response pattern is mostly found in men. The positive response pattern is characterised by increasing LH values, higher than the starting level, on the 3 th and 4 th day after intravenious application of oestrogens.
The results of the present investigation show some difference. 5 of 6 examined women with laryngeal cancer were found to have a clearly negative oestrogen feedback, whereas 4 of 5 healthy women had a positive oestrogen feedback effect. 5 healthy men showed the typical negative effect for men.
We may assume a narrow relationship between the male regulation type and the occurrence of laryngeal cancer in women, if further trials including more patients are able to reproduce these results.
多年来，男性与女性的高发病率之比一直是认为这些肿瘤存在激素依赖性的原因。女性喉癌发病率低通常被认为是由于“雌激素保护”。尽管在此期间我们有一些间接证据，但到目前为止，关于这个话题还没有最终证据。
雌激素反馈效应可能是另一个更客观的参数，能为这个问题的研究提供更多线索。作为下丘脑 - 垂体 - 肾上腺轴的调节机制之一，雌激素反馈机制代表外周雌激素对垂体中促黄体生成素（LH）和促卵泡生成素（FSH）产生的调节。已知在正常情况下该机制终生存在。虽然雌激素阳性反馈是女性的典型特征，但男性大多呈现阴性反应模式。阳性反应模式的特征是在静脉注射雌激素后的第3天和第4天，LH值升高，高于起始水平。
本研究结果显示出一些差异。6名接受检查的喉癌女性中有5名被发现有明显的雌激素阴性反馈，而5名健康女性中有4名有阳性雌激素反馈效应。5名健康男性表现出典型的男性阴性效应。
如果包括更多患者的进一步试验能够重现这些结果，我们可以假设男性调节类型与女性喉癌的发生之间存在密切关系。
