Reproductive factors, exogenous hormone use and risk of hepatocellular carcinoma among US women: results from the Liver Cancer Pooling Project.
Reproductive factors, exogenous hormone use and risk of hepatocellular carcinoma among US women: results from the Liver Cancer Pooling Project.
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DOI：
10.1038/bjc.2015.58
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发表时间：
2015-03-31
影响因子：
8.8
通讯作者：
Zeleniuch-Jacquotte, A.
中科院分区：
文献类型：
--
作者：
McGlynn, K. A.;Sahasrabuddhe, V. V.;Campbell, P. T.;Graubard, B. I.;Chen, J.;Schwartz, L. M.;Petrick, J. L.;Alavanja, M. C.;Andreotti, G.;Boggs, D. A.;Buring, J. E.;Chan, A. T.;Freedman, N. D.;Gapstur, S. M.;Hollenbeck, A. R.;Hou, L.;King, L. Y.;Koshiol, J.;Linet, M.;Palmer, J. R.;Poynter, J. N.;Purdue, M.;Robien, K.;Schairer, C.;Sesso, H. D.;Sigurdson, A.;Wactawski-Wende, J.;Zeleniuch-Jacquotte, A.
在世界上几乎所有地区，肝细胞癌（HCC）在女性中的发生率都低于男性。风险的差异在绝经前特别明显，这表明生殖期间的激素暴露可能具有保护作用。然而，据报道，外源性雌激素暴露如口服避孕药（OC）会增加风险，这表明雌激素可能是肝癌。为了研究生殖因素和外源性激素对风险的影响，我们对一大群美国妇女进行了前瞻性分析。在肝癌汇集项目中，一个基于美国的队列研究联盟，来自11个队列的799500名女性的数据被汇集和协调。考克斯比例风险回归模型用于生成生殖因素和外源性激素与HCC相关性的风险比（HR）和95%置信区间（CI）（n=248）。双侧卵巢切除术与HCC风险显著增加相关（HR=2.67，95%CI =1.22-5.85），这似乎与内源性激素暴露时间较短或绝经期激素治疗使用无关。OC使用与HCC之间无相关性（HR=1.12，95%CI =0.82-1.55）。也没有与产次，首次生育年龄，自然绝经年龄或生育期的相关性。目前的研究表明，双侧卵巢切除术增加了肝癌的风险，但这种关联的解释尚不清楚。OC使用与HCC风险之间没有关联。检查与HCC相关的内源性激素水平可能有助于澄清当前研究的结果。
Hepatocellular carcinoma (HCC) occurs less commonly among women than men in almost all regions of the world. The disparity in risk is particularly notable prior to menopause suggesting that hormonal exposures during reproductive life may be protective. Exogenous oestrogenic exposures such as oral contraceptives (OCs), however, have been reported to increase risk, suggesting that estrogens may be hepatocarcinogenic. To examine the effects of reproductive factors and exogenous hormones on risk, we conducted a prospective analysis among a large group of US women. In the Liver Cancer Pooling Project, a consortium of US-based cohort studies, data from 799 500 women in 11 cohorts were pooled and harmonised. Cox proportional hazards regression models were used to generate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations of reproductive factors and exogenous hormones with HCC (n=248). Bilateral oophorectomy was associated with a significantly increased risk of HCC (HR=2.67, 95% CI=1.22–5.85), which did not appear to be related to a shorter duration of exposure to endogenous hormones or to menopausal hormone therapy use. There was no association between OC use and HCC (HR=1.12, 95% CI=0.82–1.55). Nor were there associations with parity, age at first birth, age at natural menopause, or duration of fertility. The current study suggests that bilateral oophorectomy increases the risk of HCC but the explanation for the association is unclear. There was no association between OC use and HCC risk. Examination of endogenous hormone levels in relation to HCC may help to clarify the findings of the current study.
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影响因子：
7.7
作者：
KVALE, G;HEUCH, I;NILSSEN, S
通讯作者：
NILSSEN, S
影响因子：
2.3
作者：
HSING, AW;HOOVER, RN;FRAUMENI, JF
通讯作者：
FRAUMENI, JF
影响因子：
6.4
作者：
LAMBE, M;TRICHOPOULOS, D;PAVIA, M
通讯作者：
PAVIA, M
影响因子：
6.4
作者：
PLESKO, I;PRESTONMARTIN, S;SOMOGYI, J
通讯作者：
SOMOGYI, J
影响因子：
3.2
作者：
McKenzie, Joyce;Fisher, B. Miles;Sattar, Naveed
通讯作者：
Sattar, Naveed