Use of four biomarkers to evaluate the risk of breast cancer subtypes in the women's contraceptive and reproductive experiences study.
Use of four biomarkers to evaluate the risk of breast cancer subtypes in the women's contraceptive and reproductive experiences study.
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DOI：
10.1158/0008-5472.can-09-3460
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发表时间：
2010-01-15
期刊：
影响因子：
11.2
通讯作者：
Bernstein L
中科院分区：
文献类型：
--
作者：
Ma H;Wang Y;Sullivan-Halley J;Weiss L;Marchbanks PA;Spirtas R;Ursin G;Burkman RT;Simon MS;Malone KE;Strom BL;McDonald JA;Press MF;Bernstein L
流行病学研究表明，一些与乳腺癌相关的危险因素对乳腺癌亚型（由肿瘤组织中雌激素受体（ER）和孕激素受体（PR）表达状态定义）的风险有不同的影响。然而，目前尚不清楚肿瘤组织中人表皮生长因子受体2（HER 2）和p53蛋白（p53）的表达状态是否进一步区分这些肿瘤风险组的关联。我们评估了口服避孕药（OC）使用和生殖因素与女性避孕和生殖经验研究的洛杉矶县或底特律组成部分的1197例基于人群的病例和2015例对照中侵袭性乳腺癌亚型的相关性。我们采用多变量非条件Logistic回归方法，通过ER/PR/HER 2/p53状态进行病例对照比较。我们发现OC的使用与ER/PR/HER 2/p53定义的任何乳腺癌亚型无关，除了在18岁之前开始使用OC的老年女性（45-64岁）中三阴性（ER-/PR-/HER 2-）肿瘤的风险增加2.9倍。产次与管腔A（ER+或PR+，HER 2-）、管腔B（ER+或PR+，HER 2+）和ER-/PR-/HER 2+肿瘤的风险降低相关。首次足月妊娠的年龄与老年妇女中的管腔A型肿瘤呈正相关。这些生殖因素都与三阴性肿瘤无关。长期母乳喂养降低了三阴性和管腔A肿瘤的风险。当p53也被考虑时，没有进一步的差异风险模式。这些结果提供了证据支持三阴性和ER/PR/HER 2定义的其他乳腺癌亚型之间某些乳腺癌相关风险因素特征的差异。
Epidemiological studies have suggested that some hormone-related breast cancer risk factors differentially influence risk of breast cancer subtypes defined by estrogen receptor (ER) and progesterone receptor (PR) expression status in tumor tissue. However, it remains unclear whether human epidermal growth factor receptor-2 (HER2) and p53 protein (p53) expression status in tumor tissue further differentiate these exposure-risk-group associations. We evaluated the associations of oral contraceptive (OC) use and reproductive factors with incident invasive breast cancer subtypes among 1197 population-based cases and 2015 controls from the Los Angeles County or Detroit components of the Women’s Contraceptive and Reproductive Experiences Study. We used multivariable polychotomous unconditional logistic regression methods to conduct case-control comparisons by ER/PR/HER2/p53 status. We found that OC use was not associated with any breast cancer subtype defined by ER/PR/HER2/p53, except for a 2.9-fold increased risk for triple negative (ER−/PR−/HER2−) tumors among older women (ages 45–64 years) who started OC use before age 18. Parity was associated with decreased risk of luminal A (ER+ or PR+, HER2−), luminal B (ER+ or PR+, HER2+), and ER−/PR−/HER2+ tumors. Age at first full-term pregnancy was positively associated with luminal A tumors among older women. Neither of these reproductive factors was associated with triple negative tumors. Long duration of breastfeeding lowered risk of triple negative and luminal A tumors. No further differential risk patterns were noted when p53 was also considered. These results provide evidence supporting a difference in some hormone-related risk factor profiles between triple negative and other breast cancer subtypes defined by ER/PR/HER2.