Moysich K B, Ambrosone C B, Vena J E, Shields P G, Mendola P, Kostyniak P, Greizerstein H, Graham S, Marshall J R, Schisterman E F, Freudenheim J L
Department of Social and Preventive Medicine, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, 14214, USA.
Cancer Epidemiol Biomarkers Prev. 1998 Mar;7(3):181-8.
Environmental exposure to organochlorine compounds has been associated with a potential role in breast cancer etiology, but results from previous investigations yielded inconsistent results. In this case-control study, we examined the effect of 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (DDE), hexachlorobenzene (HCB), mirex, and several measures of polychlorinated biphenyls (PCBs) on postmenopausal breast cancer risk. The study sample included 154 primary, incident, histologically confirmed, postmenopausal breast cancer cases and 192 postmenopausal community controls. Usual diet, reproductive and medical histories, and other lifestyle information was obtained by an extensive in person interview. Serum levels (ng/g) of DDE, HCB, mirex, and 73 PCB congeners were determined by gas chromatography with electron capture. PCB exposure was examined as total measured PCB levels, total number of detected PCB peaks, and three PCB congener groups. In the total sample, there was no evidence of an adverse effect of serum levels of DDE [odds ratio (OR), 1.34; 95% confidence interval (CI) 0.71-2.55], HCB (OR, 0.81; 95% CI, 0.43-1.53), or mirex (OR, 1.37; 95% CI, 0.78-2.39). Further, higher serum levels of total PCBs (OR, 1.14; 95% CI, 0.61-2.15), moderately chlorinated PCBs (OR, 1.37; 95% CI, 0.73-2.59), more highly chlorinated PCBs (OR, 1.19; 95% CI, 0.60-2.36), or greater number of detected peaks (OR, 1.34; 95% CI, 0.72-2.47) were not associated with increased risk. There was some indication of a modest increase in risk for women with detectable levels of less chlorinated PCBs (OR, 1.66; 95% CI, 1.07-2.88). Among parous women who had never lactated, there was some evidence for increased risk, associated with having detectable levels of mirex (OR, 2.42; 95% CI, 0.98-4.32), higher serum concentrations of total PCBs (OR, 2.87; 95% CI, 1.01-7.29), moderately chlorinated PCBs (OR, 3.57; 95% CI, 1.10-8.60), and greater numbers of detected PCB congeners (OR, 3.31; 95% CI, 1.04-11.3). These results suggest that an increase in risk of postmenopausal breast cancer associated with environmental exposure to PCBs and mirex, if at all present, is restricted to parous women who had never breast-fed an infant. Future studies should consider lactation history of participants, as well as use similar epidemiological and laboratory methodologies, to ensure comparability of results across studies.
环境暴露于有机氯化合物与乳腺癌病因学中的潜在作用有关，但先前调查的结果并不一致。在这项病例对照研究中，我们研究了1,1 - 二氯 - 2,2 - 双（对氯苯基）乙烯（DDE）、六氯苯（HCB）、灭蚁灵以及几种多氯联苯（PCBs）测量指标对绝经后乳腺癌风险的影响。研究样本包括154例原发性、新发、经组织学确诊的绝经后乳腺癌病例和192例绝经后社区对照。通过广泛的面对面访谈获取了日常饮食、生殖和医疗史以及其他生活方式信息。采用带电子捕获的气相色谱法测定血清中DDE、HCB、灭蚁灵以及73种多氯联苯同系物的水平（ng/g）。多氯联苯暴露通过测量的多氯联苯总水平、检测到的多氯联苯峰总数以及三个多氯联苯同系物组进行评估。在整个样本中，没有证据表明血清DDE水平[比值比（OR），1.34；95%置信区间（CI）0.71 - 2.55]、HCB水平（OR，0.81；95% CI，0.43 - 1.53）或灭蚁灵水平（OR，1.37；95% CI, 0.78 - 2.39）有不良影响。此外，血清多氯联苯总水平较高（OR，1.14；95% CI，0.61 - 2.15）、中等氯化程度的多氯联苯（OR，1.37；95% CI，0.73 - 2.59）、高度氯化的多氯联苯（OR，1.19；95% CI，0.60 - 2.36）或检测到的峰数较多（OR，1.34；95% CI，0.72 - 2.47）与风险增加无关。有迹象表明，氯化程度较低的多氯联苯可检测水平的女性风险略有增加（OR，1.66；95% CI，1.07 - 2.88）。在从未哺乳的经产妇中，有证据表明风险增加，这与灭蚁灵可检测水平（OR，2.42；95% CI，0.98 - 4.32）、血清多氯联苯总浓度较高（OR，2.87；95% CI，1.01 - 7.29）、中等氯化程度的多氯联苯（OR，3.57；95% CI，1.10 - 8.60）以及检测到的多氯联苯同系物数量较多（OR，3.31；95% CI，1.04 - 11.3）有关。这些结果表明，如果存在与环境暴露于多氯联苯和灭蚁灵相关的绝经后乳腺癌风险增加，那么这种增加仅限于从未哺乳过婴儿的经产妇。未来的研究应考虑参与者的哺乳史，并采用类似的流行病学和实验室方法，以确保各研究结果的可比性。
