Endogenous estrogen, androgen, and progesterone concentrations and breast cancer risk among postmenopausal women
Endogenous estrogen, androgen, and progesterone concentrations and breast cancer risk among postmenopausal women
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DOI：
10.1093/jnci/djh336
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发表时间：
2004-12-15
影响因子：
10.3
通讯作者：
Hankinson, SE
中科院分区：
文献类型：
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作者：
Missmer, SA;Eliassen, AH;Hankinson, SE
背景：内源激素水平与绝经后妇女患乳腺癌的风险相关。然而，很少有研究调查激素水平与肿瘤受体状态或侵袭性与原位肿瘤状态之间的关联。乳腺癌风险与绝经后黄体酮水平之间的关系也尚未得到研究。我们在护士健康研究中的一项病例对照研究中前瞻性地调查了这些关系。方法：前瞻性收集 1989 年和 1990 年期间的血液样本。截至 6 月 30 日，在符合条件的绝经后妇女中，报告了 322 例乳腺癌（264 例为浸润性乳腺癌，41 例为原位癌，153 例为雌激素受体 [ER] 阳性和孕激素受体 [PR] 阳性 [ER+/PR+]，39 例为 ER 阴性和 PR 阴性 [ER-/PR-] 疾病）。 1998. 对于每个病例受试者，两名对照受试者（n = 643）在年龄和血液采集（按月份和一天中的时间）上进行匹配。测量血浆中的内源激素水平。我们使用条件和非条件逻辑回归分析来评估关联并控制已确定的乳腺癌危险因素。结果：我们观察到乳腺癌风险与雌激素和雄激素水平之间存在统计学上显着的直接关联，但我们没有发现该风险与黄体酮或性激素结合球蛋白水平之间存在任何（按年份）统计学上显着的关联。当我们将分析限制在患有 ER+/PR+ 肿瘤的病例受试者并比较最高和最低四分之一的血浆激素浓度时，我们观察到与雌二醇（相对风险 [RR] = 3.3，95% 置信区间 [CI] = 2.0 至 5.4）、睾酮（RR = 2.0，95% CI = 1.2 至 3.4）、雄烯二酮（RR = 2.5，95% CI = 1.4 至 4.3）和硫酸脱氢表雄酮（RR = 2.3，95% CI = 1.3 至 4.1）。此外，所有激素往往与原位疾病的相关性最强。结论：性类固醇激素的循环水平可能与 ER+/PR+ 乳腺肿瘤的风险密切相关。
Background: Levels of endogenous hormones have been associated with the risk of breast cancer among postmenopausal women. Little research, however, has investigated the association between hormone levels and tumor receptor status or invasive versus in situ tumor status. Nor has the relation between breast cancer risk and postmenopausal progesterone levels been investigated. We prospectively investigated these relations in a case-control study nested within the Nurses' Health Study. Methods: Blood samples were prospectively collected during 1989 and 1990. Among eligible postmenopausal women, 322 cases of breast cancer (264 invasive, 41 in situ, 153 estrogen receptor [ER]-positive and progesterone receptor [PR]-positive [ER+/PR+], and 39 ER-negative and PR-negative [ER-/PR-] disease) were reported through June 30, 1998. For each case subject, two control subjects (n = 643) were matched on age and blood collection (by month and time of day). Endogenous hormone levels were measured in blood plasma. We used conditional and unconditional logistic regression analyses to assess associations and to control for established breast cancer risk factors. Results: We observed a statistically significant direct association between breast cancer risk and the level of both estrogens and androgens, but we did not find any (by year) statistically significant associations between this risk and the level of progesterone or sex hormone binding globulin. When we restricted the analysis to case subjects with ER+/PR+ tumors and compared the highest with the lowest fourths of plasma hormone concentration, we observed an increased risk of breast cancer associated with estradiol (relative risk [RR] = 3.3, 95% confidence interval [CI] = 2.0 to 5.4), testosterone (RR = 2.0, 95% CI = 1.2 to 3.4), androstenedione (RR = 2.5, 95% CI = 1.4 to 4.3), and dehydroepiandrosterone sulfate (RR = 2.3, 95% CI = 1.3 to 4.1). In addition, all hormones tended to be associated most strongly with in situ disease. Conclusion: Circulating levels of sex steroid hormones may be most strongly associated with risk of ER+/PR+ breast tumors.