Ethnic differences in breast cancer risk: A possible role for pregnancy levels of alpha-fetoprotein?
Ethnic differences in breast cancer risk: A possible role for pregnancy levels of alpha-fetoprotein?
复制标题
DOI：
10.1097/00001648-200301000-00020
复制
发表时间：
2003-01-01
期刊：
影响因子：
5.4
通讯作者：
Wide, L
中科院分区：
文献类型：
--
作者：
Lambe, M;Trichopoulos, D;Wide, L
背景美国白色女性的乳腺癌发病率比中国和日本的亚洲女性高出5倍。寻找改变雌激素生物学效应的因素在不同种族群体之间的差异可能会增加对乳腺癌风险国际差异的理解。最近的证据表明，甲胎蛋白，一种由胎儿肝脏产生的糖蛋白，具有重要的抗雌激素特性。在妊娠期间，甲胎蛋白在妊娠晚期达到母体血清的峰值浓度。我们比较了1994年3月至1995年10月在波士顿和中国上海两个乳腺癌高危人群中妊娠期甲胎蛋白水平。可用于甲胎蛋白分析的标本数量为1，033。在两个时间点，上海孕妇的甲胎蛋白水平（根据妊娠时间调整）均显著高于波士顿孕妇。当对孕前体重、产次、后代性别和母亲年龄进行调整后，上海地区孕妇在妊娠16周时的甲胎蛋白水平仍高出13%，而在妊娠27周时则没有。这些发现可能至少部分解释了中国和美国女性之间乳腺癌风险的差异。在人群水平上，甲胎蛋白可能通过改变母体和子宫内雌性后代中生物活性雌激素的作用来影响风险。
Background. Breast cancer incidence rates are up to five times higher in white women in the United States compared with Asian women in China and Japan. A search for factors that modify estrogen's biological effect differentially between ethnic groups may add to the understanding of international variations in breast cancer risk. Recent evidence indicates that alpha-fetoprotein, a glycoprotein produced by the fetal liver, has important antiestrogenic properties. During pregnancy, alpha,fetoprotein reaches peak concentrations in maternal serum during the third trimester.Methods. We compared pregnancy levels of alpha-fetoprotein in a population with high risk of breast cancer (Boston, MA) and low risk (Shanghai, China), Blood samples were collected around the 16th week and around the 27th week of gestation among women enrolled from March 1994 to October 1995. The number of specimens available for alpha-fetoprotein analysis was 1,033.Results. Alpha-fetoprotein levels, adjusted for gestational length, were substantially higher in Shanghai compared with Boston women at both time points. When adjustments were made for prepregnancy weight, parity, offspring's sex and maternal age, alpha,fetoprotein levels remained 13% higher in Shanghai at 16 weeks of pregnancy but not at 27 weeks.Conclusions. These findings may explain, at least in part, the difference in breast cancer risk between Chinese and American women. On the population level, alpha-fetoprotein may influence risk by modifying the effect of biologically active estrogens both in the mother and in female offspring in utero.