IGF1 and risk of additional breast cancer in the WHEL study
IGF1 and risk of additional breast cancer in the WHEL study
复制标题
DOI：
10.1530/erc-10-0121
复制
发表时间：
2011-04-01
影响因子：
3.9
通讯作者：
Pierce, John P.
中科院分区：
文献类型：
--
作者：
Al-Delaimy, Wael K.;Flatt, Shirley W.;Pierce, John P.
IGF 1、IGF结合蛋白-3（IGFBP-3）、IGFBP-1、胰岛素、瘦素和脂联素与乳腺癌发病率的相关性不一致。我们探讨这些因素如何与乳腺癌复发有关，以及在女性健康饮食和生活（WHEL）研究中，他莫昔芬治疗如何与乳腺癌幸存者的IGF 1水平有关。采用巢式病例对照设计将乳腺癌病例（有额外乳腺癌事件）与对照组相匹配。对510例匹配病例和对照组的基线血样进行了IGF-1水平分析;对188对样本进行了其他五种激素和结合蛋白的分析。中位随访时间为7.3年。匹配是在招募网站，癌症阶段，癌症诊断时的年龄，癌症诊断日期和随机化。考克斯比例风险回归模型，分层病例对照对，用于评估协会。胰岛素、IGFBP-1、IGFBP-3、瘦素和脂联素不能显著预测乳腺癌的复发。在未校正的分析中，IGF 1与复发呈正相关，但不显著（风险比（HR）：1.33（95%置信区间（CI）0.98-1.81））。调整绝经状态和他莫昔芬使用后，HR降至1.07（95% CI 0.76-1.40）。对他莫昔芬使用不一致的病例对照对的分析显示相反的HR：如果病例未接受他莫昔芬治疗，IGF 1预测复发风险较高。总之，在乳腺癌幸存者中，IGF 1水平或其他相关因素与其他乳腺癌风险之间没有显着关联。他莫昔芬可能混淆IGF 1和复发的分析。这支持重新评估IGF 1对乳腺癌复发的意义。内分泌相关癌症（2011）18 235-244
IGF1, IGF-binding protein-3 (IGFBP-3), IGFBP-1, insulin, leptin, and adiponectin have been inconsistently associated with breast cancer incidence. We explore how these factors are related to breast cancer recurrence and how tamoxifen treatment is related to IGF1 levels among breast cancer survivors in the Women's Healthy Eating and Living (WHEL) study. A nested case-control design was used to match breast cancer cases (who had an additional breast cancer event) to controls. Baseline blood samples from 510 matched cases and controls were analyzed for IGF-1 levels; a subset of 188 pairs were analyzed for five other hormones and binding proteins. Median follow-up was 7.3 years. Matching was on recruitment site, cancer stage, age at cancer diagnosis, dates of cancer diagnosis, and randomization. Cox proportional hazards regression models, stratified on case-control pair, were used to assess the associations. Insulin, IGFBP-1, IGFBP-3, leptin, and adiponectin did not significantly predict recurrence of breast cancer. IGF1 was positively, but not significantly, associated with recurrence (hazard ratio (HR): 1.33 (95% confidence interval (CI) 0.98-1.81)) in the unadjusted analyses. Adjusting for menopausal status and tamoxifen use attenuated the HR to 1.07 (95% CI 0.76-1.40). Analyses of case-control pairs with discordant tamoxifen use show opposing HR: IGF1 predicts higher risk of recurrence if cases did not receive tamoxifen treatment. In conclusion, no significant association was found between IGF1 levels, or other related factors, and risk of additional breast cancer among breast cancer survivors. Tamoxifen can confound analysis of IGF1 and recurrence. This supports re-evaluating significance of IGF1 to breast cancer recurrence. Endocrine-Related Cancer (2011) 18 235-244