Plasma sex steroid hormone levels and risk of breast cancer in postmenopausal women
Plasma sex steroid hormone levels and risk of breast cancer in postmenopausal women
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DOI：
10.1093/jnci/90.17.1292
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发表时间：
1998-09-02
影响因子：
10.3
通讯作者：
Speizer, FE
中科院分区：
文献类型：
--
作者：
Hankinson, SE;Willett, WC;Speizer, FE
背景：绝经后妇女血浆雌激素水平与乳腺癌风险之间普遍存在正相关关系，但这些研究大多是小规模的，很少有研究评估特定的雌激素含量（如生物利用雌二醇百分比）。此外，很少有研究评估血浆雄激素水平与乳腺癌风险的关系，其结果也不一致。我们通过护士健康研究中的病例对照研究，前瞻性地评估了绝经后妇女血浆中性类固醇激素水平与乳腺癌风险之间的关系。方法：于1989 ~ 1990年采血。在采血时未使用激素替代疗法的绝经后妇女中（n = 1169名妇女），有156名妇女在采血后但在1994年6月1日之前被诊断为乳腺癌。每个病例受试者选择两名对照受试者，并在年龄、绝经状态、采血月份和时间以及采血时的禁食状态方面进行匹配。结果：通过最高和最低（参考）四分位数的比较，我们观察到循环中雌二醇（多变量相对危险度[RR] = 1.91； 95%可信区间[CI] = 1.06-3.46）、雌酮（多变量相对危险度[RR] = 1.96; 95% CI = 1.05-3.65）、硫酸雌酮（多变量相对危险度= 2.25;95% CI = 1.23- 4.12）和硫酸脱氢表雄酮（多变量相对危险度= 2.15;95% CI = 1.11-4.17）与乳腺癌风险有统计学意义的正相关。我们发现游离雌二醇、雄烯二酮、睾酮或脱氢表雄酮的百分比或生物利用度百分比没有实质性的关联。在没有接受过激素替代治疗的女性中，这种积极关系更为明显。结论：我们的数据，结合过去的流行病学和动物研究，为绝经后雌激素水平与乳腺癌风险之间的因果关系提供了强有力的证据。[J] contemporary medicine; 2009；90: 1292 - 9]
Background: A positive relationship has generally been observed between plasma estrogen levels and breast cancer risk in postmenopausal women, but most of these studies have been small and few have evaluated specific estrogen fractions (such as percent bioavailable estradiol). In addition, few studies have evaluated plasma androgen levels in relation to breast cancer risk, and their results have been inconsistent. We prospectively evaluated relationships between sex steroid hormone levels in plasma and risk of breast cancer in postmenopausal women by use of a case-control study nested within the Nurses' Health Study.Methods: Blood samples were collected during the period from 1989 through 1990. Among postmenopausal women not using hormone replacement therapy at blood collection (n = 11 169 women), 156 women were diagnosed with breast cancer after blood collection but before June 1, 1994. Two control subjects were selected per case subject and matched with respect to age, menopausal status, month and time of day of blood collection, and fasting status at the time of blood collection.Results: From comparisons of highest and lowest (reference) quartiles, we observed statistically significant positive associations with risk of breast cancer for circulating levels of estradiol (multivariate relative risk [RR] = 1.91; 95% confidence interval [CI] = 1.06-3.46), estrone (multivariate RR = 1.96; 95% CI = 1.05-3.65), estrone sulfate (multivariate RR = 2.25; 95% CI = 1.23- 4.12), and dehydroepiandrosterone sulfate (multivariate RR = 2.15; 95% CI = 1.11-4.17). We found no substantial associations with percent free or percent bioavailable estradiol, androstenedione, testosterone, or dehydroepiandrosterone. The positive relationships were substantially stronger among women with no previous hormone replacement therapy.Conclusion: Our data, in conjunction with past epidemiologic and animal studies, provide strong evidence for a causal relationship between postmenopausal estrogen levels and the risk of breast cancer. [J Natl Cancer Inst 1998;90: 1292-9]