Russo I H, Russo J
League of Women Against Cancer, LOWAC, Corp., Rydal, PA 19046, USA.
Environ Health Perspect. 1996 Sep;104(9):938-67. doi: 10.1289/ehp.96104938.
Breast cancer, the most frequent spontaneous malignancy diagnosed in women in the western world, is continuously increasing in incidence in industrialized nations. Although breast cancer develops in women as the result of a combination of external and endogenous factors such as exposure to ionizing radiation, diet, socioeconomic status, and endocrinologic, familial, or genetic factors, no specific etiologic agent(s) or the mechanisms responsible of the disease has been identified as yet. Thus, experimental models that exhibit the same complex interactions are needed for testing various mechanisms and for assessing the carcinogenic potential of given chemicals. Rodent mammary carcinomas represent such a model to a great extent because, in these species, mammary cancer is a multistep complex process that can be induced by either chemicals, radiation, viruses, or genetic factors. Long-term studies in rodent models have been particularly useful for dissecting the initiation, promotion, and progression steps of carcinogenesis. The susceptibility of the rodent mammary gland to develop neoplasms has made this organ a unique target for testing the carcinogenic potential of specific genotoxic chemicals and environmental agents. Mammary tumors induced by indirect- or direct-acting carcinogens such as 7, 12-dimethlbenz(a)anthracene or N-methyl-N-nitrosourea are, in general, hormone dependent adenocarcinomas whose incidence, number of tumors per animal, tumor latency, and tumor type are influenced by the age, reproductive history, and endocarinologic milieu of the host at the time of carcinogen exposure. Rodent models are informative in the absence of human data. They have provided valuable information on the dose and route of administration to be used and optimal host conditions for eliciting maximal tumorigenic response. Studies of the influence of normal gland development on the pathogenesis of chemically induced mammary carcinomas have clarified the role of differentiation in cancer initiation. Comparative studies with the development of the human breast and the pathogenesis of breast cancer have contributed to validate rodent-to-human extrapolations. However, it has not been definitively established what type of information is necessary for human risk assessment, whether currently toxicity testing methodologies are sufficient for fulfilling those needs, or whether treatment-induced tumorigenic responses in rodents are predictive of potential human risk. An alternative to the traditional bioassays are mechanism-based toxicology and molecular and cellular approaches, combined with comparative in vitro systems. These approaches might allow the rapid screen of chemicals for setting priorities for further studies to determine the dose-response relationship for chemical effects at low doses, to assess effects other than mutagenesis and/or tumorigenesis, or to establish qualitative and quantitative relationships of biomarkers to toxic effects. Until there is enough information on the predictive value of mechanism-based toxicology for risk assessment, this approach should be used in conjunction with and validated by the traditional in vivo long-term bioassays.
乳腺癌是西方世界女性中最常见的自发性恶性肿瘤,在工业化国家其发病率持续上升。尽管乳腺癌在女性中的发生是外部和内源性因素共同作用的结果,如接触电离辐射、饮食、社会经济地位以及内分泌、家族或遗传因素,但尚未确定该疾病的具体病因或致病机制。因此,需要能够展现相同复杂相互作用的实验模型来测试各种机制,并评估特定化学物质的致癌潜力。啮齿动物乳腺癌在很大程度上代表了这样一种模型,因为在这些物种中,乳腺癌是一个多步骤的复杂过程,可由化学物质、辐射、病毒或遗传因素诱发。在啮齿动物模型中进行的长期研究对于剖析致癌作用的起始、促进和进展步骤特别有用。啮齿动物乳腺发生肿瘤的易感性使该器官成为测试特定遗传毒性化学物质和环境因子致癌潜力的独特靶点。由间接或直接作用的致癌物如7,12 - 二甲基苯并(a)蒽或N - 甲基 - N - 亚硝基脲诱导的乳腺肿瘤通常是激素依赖性腺癌,其发病率、每只动物的肿瘤数量、肿瘤潜伏期和肿瘤类型受宿主在接触致癌物时的年龄、生殖史和内分泌环境影响。在缺乏人类数据的情况下,啮齿动物模型具有参考价值。它们提供了关于所用给药剂量和途径以及引发最大致瘤反应的最佳宿主条件的有价值信息。对正常腺体发育对化学诱导的乳腺癌发病机制影响的研究阐明了分化在癌症起始中的作用。对人类乳腺发育和乳腺癌发病机制的比较研究有助于验证从啮齿动物到人类的外推。然而,尚未明确确定人类风险评估需要何种类型的信息,当前的毒性测试方法是否足以满足这些需求,或者啮齿动物中治疗诱导的致瘤反应是否可预测潜在的人类风险。传统生物测定的替代方法是基于机制的毒理学以及分子和细胞方法,结合比较体外系统。这些方法可能允许快速筛选化学物质,以便为进一步研究确定优先级,以确定低剂量化学效应的剂量 - 反应关系,评估除诱变和/或致瘤作用以外的效应,或建立生物标志物与毒性效应的定性和定量关系。在获得足够关于基于机制的毒理学对风险评估预测价值的信息之前,这种方法应与传统的体内长期生物测定结合使用并通过其验证。