Alcohol intake and risk of breast cancer defined by estrogen and progesterone receptor status - A meta-analysis of epidemiological studies
Alcohol intake and risk of breast cancer defined by estrogen and progesterone receptor status - A meta-analysis of epidemiological studies
复制标题
DOI：
10.1002/ijc.23184
复制
发表时间：
2008-04-15
影响因子：
6.4
通讯作者：
Wolk, Alicja
中科院分区：
文献类型：
--
作者：
Suzuki, Reiko;Orsini, Nicola;Wolk, Alicja
饮酒与乳腺癌风险增加之间的联系已经确立。然而，目前尚不清楚这种关系是否在雌激素受体(ER)和孕激素受体(PR)肿瘤亚型中有所不同。为了定量评估酒精摄入与ER/PR定义的乳腺癌风险之间的关系，我们对队列和病例对照研究进行了荟萃分析。通过检索PubMed至2007年4月20日的文献和检索相关文章的参考文献列表来确定这些研究。使用随机效应模型计算具有95%可信区间(CI)的汇总风险估计(RES)。荟萃分析的总结结果显示，比较最高和最低消耗类别的结果显示，发生全部ER+(27%)、ALL ER-(14%)、ER+PR+(22%)和ER+PR-(28%)的风险在统计学上显著更高，但没有ER-PR-肿瘤。剂量-反应荟萃分析显示，每天酒精摄入量增加10g与ER+(12%)、ALL ER(7%)、ER+PR+(11%)和ER+PR-(15%)的风险显著增加相关，但与ER-PR-无关。在所有ER+和ER-PR-中观察到RE具有统计学意义的异质性(P-异质性=0.02)。在调整了绝经后激素使用、体重指数和乳腺癌家族史后，研究的总结结果高于没有绝经后激素使用、体重指数和乳腺癌家族史的研究，在统计学上有显著差异。观察到的酒精与ER+PR+和ER+PR-肿瘤之间的正相关关系不能仅用雌激素依赖途径来解释。需要进一步的研究来阐明其生物学机制。
The association between alcohol consumption and an increased risk of breast cancer has been established. It is still unclear however, whether this relationship differs across the estrogen receptor (ER) and progesterone receptor (PR) tumors subtypes. To provide a quantitative assessment of the association between alcohol intake and the risk of ER-/PR-defined breast cancer, we conducted a meta-analysis of cohort and case-control studies. Studies were identified by a literature search of PubMed through April 20, 2007 and by searching the reference lists of relevant articles. Summarized risk estimates (REs) with 95% confidence intervals (CIs) were calculated using random-effects models. The summarized results of the meta-analysis comparing the highest versus the lowest consumption categories showed statistically significant higher risks of developing all ER+ (27%), all ER- (14%), ER+PR+ (22%) and ER+PR- (28%), but not ER-PR- tumors. The dose-response meta-analysis showed that an increase in alcohol consumption of 10 g of ethanol per day was associated with statistically significant increased risks for all ER+ (12%), all ER(7%), ER+PR+ (11%) and ER+PR- (15%), but not ER-PR-. A statistically significant heterogeneity of the REs across all ER+ versus ER-PR- was observed (P-heterogeneity = 0.02). The summarized results from studies with adjustment for postmenopausal hormone use, body mass index and family history of breast cancer were higher and statistically significantly different from those without. The observed positive associations with alcohol for ER+PR+ and ER+PR- tumors cannot be explained by estrogen-dependent pathway only. Further studies need to clarify the biological mechanisms.