BLOOD-LEVELS OF ORGANOCHLORINE RESIDUES AND RISK OF BREAST-CANCER
BLOOD-LEVELS OF ORGANOCHLORINE RESIDUES AND RISK OF BREAST-CANCER
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DOI：
10.1093/jnci/85.8.648
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发表时间：
1993-04-21
影响因子：
10.3
通讯作者：
DUBIN, N
中科院分区：
文献类型：
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作者：
WOLFF, MS;TONIOLO, PG;DUBIN, N
背景资料：DDT [2，2-双（对氯苯基）-1，1，1-三氯乙烷]和PCB（多氯联苯）等有机氯分别被广泛用作杀虫剂和电气元件的流体绝缘体，已知它们是持久性环境污染物和动物致癌物。这些药物由于其代谢效率低和在脂质中的溶解性而存在于人体组织中，导致其在脂肪组织中终身隔离。然而，它们与人类癌症发生的关系仅被少量探索，大多数研究只有20个或更少的病例。目的：这项盲法研究旨在确定接触多氯联苯和DDT的主要代谢物DDE（1，1-二氯-2，2-双（对氯苯基）乙烯）是否与妇女患乳腺癌的风险有关。研究方法：我们分析了14290名参加纽约大学妇女健康研究（一项关于激素、饮食和癌症的前瞻性队列研究）的1985年至1991年期间登记的受试者的血液样本。在我们的巢式病例对照研究中，发生乳腺癌的队列成员被纳入病例患者。DDE和PCBs测定气相色谱法在血清中的58名妇女诊断为乳腺癌1-6个月后，他们进入队列，并在171名匹配的对照受试者从同一研究人群谁没有发展成癌症。结果如下：乳腺癌病例患者的DDE和PCBs平均水平高于对照组，但仅DDE的配对差异具有统计学意义（P = 0.031）。在调整了乳腺癌一级家族史、终生哺乳和首次足月妊娠时的年龄后，条件Logistic回归分析显示，血清DDE浓度从2.0 ng/mL（第10百分位数）升高至19.1 ng/mL（第90百分位数），乳腺癌的相对风险增加4倍。对于多氯联苯，血清水平从3.9 ng/ml（第10百分位数）到10.6 ng/mL（第90百分位数）变化的相对风险小于两倍，在调整DDE后进一步降低的非显著相关性。结论：在这个纽约市的妇女群体中，乳腺癌与血清中的DDE密切相关，但与PCB无关。含义：这些研究结果表明，有机氯残留的环境化学污染可能是乳腺癌的一个重要致病因素。鉴于有机氯杀虫剂在环境和食物链中的广泛传播，其影响对全世界的公共卫生干预具有深远意义。
Background: Organochlorines such as DDT [2,2-bis(p-chlorophenyl)-1,1,1-trichloroethane] and PCBs (polychlorinated biphenyls), which have been used extensively as insecticides and as fluid insulators of electrical components, respectively, are known to be persistent environmental contaminants and animal carcinogens. These agents have been found in human tissue due to their inefficient metabolism and their solubility in lipids, which lead to lifelong sequestration in adipose tissue. Their association with human cancer occurrence, however, has been explored only marginally, with most studies having 20 or fewer cases. Purpose: This blinded study was designed to determine whether exposure to PCBs and to DDE [1,1-dichloro-2,2-bis(p-chlorophenyl) ethylene], the major metabolite of DDT, is associated with breast cancer risk in women. Methods: We analyzed sera from the stored blood specimens of 14290 participants enrolled between 1985 and 1991 in the New York University Women's Health Study, a prospective cohort study of hormones, diet, and cancer. Cohort members who developed breast cancer were included as case patients in our nested case-control study. DDE and PCBs were measured by gas chromatography in the sera of 58 women with a diagnosis of breast cancer 1-6 months after they entered the cohort and in 171 matched control subjects from the same study population who did not develop cancer. Results: Mean levels of DDE and PCBs were higher for breast cancer case patients than for control subjects, but paired differences were statistically significant only for DDE (P = .031). After adjustment for first-degree family history of breast cancer, lifetime lactation, and age at first full-term pregnancy, conditional logistic regression analysis showed a fourfold increase in relative risk of breast cancer for an elevation of serum DDE concentrations from 2.0 ng/mL (10th percentile) to 19.1 ng/mL (90th percentile). For PCBs, the relative risk for a change in serum levels from 3.9 ng/ml, (10th percentile) to 10.6 ng/mL (90th percentile) was less than twofold, a nonsignificant association that was further reduced after adjustment for DDE. Conclusion: In this population of New York City women, breast cancer was strongly associated with DDE in serum but not with PCBs. Implications: These findings suggest that environmental chemical contamination with organochlorine residues may be an important etiologic factor in breast cancer. Given the widespread dissemination of organochlorine insecticides in the environment and the food chain, the implications are far-reaching for public health intervention worldwide.