Lipophilic statin use and risk of breast cancer subtypes.
Lipophilic statin use and risk of breast cancer subtypes.
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DOI：
10.1158/1055-9965.epi-10-0524
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发表时间：
2010-10
期刊：
影响因子：
--
通讯作者：
Sieh W
中科院分区：
文献类型：
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作者：
Woditschka S;Habel LA;Udaltsova N;Friedman GD;Sieh W
他汀类药物作为潜在的癌症化学预防剂被广泛使用并引起高度关注。临床前研究表明，亲脂性他汀类药物具有针对激素受体（HR）阴性乳腺癌的抗癌特性。很少有流行病学研究调查了亲脂性他汀类药物使用与乳腺癌风险之间的关系，按HR状态分层。我们在北方加州的Kaiser Permanente（KPNC）进行了一项大型病例对照研究，以确定长期使用亲脂性他汀类药物是否与HR阴性乳腺癌或其他乳腺癌亚型的风险降低相关。我们确定了1997年至2007年期间诊断的22，488例乳腺癌病例，以及224，860例对照，这些对照与基于出生年份和KPNC药房覆盖时间的病例相匹配。使用KPNC的综合电子药房记录确定亲脂性他汀类药物的使用。我们在校正口服避孕药和激素治疗使用的条件Logistic回归模型中发现，亲脂性他汀类药物使用（≥2年vs从未使用）与总体乳腺癌风险（ORadj=1.02; 95%CI=0.97-1.08）之间无相关性。使用亲脂性他汀类药物的女性患HR阴性乳腺癌的风险没有降低（ORadj=0.98; 95%CI=0.84-1.14），也没有改变HR阳性疾病的风险（ORadj=1.03; 95%CI=0.97-1.10）。此外，使用亲脂性他汀类药物与任何内在亚型（管腔A型、管腔B型、HER 2 +/ER-或三阴性）的风险无关。我们的研究结果并不支持亲脂性他汀类药物的使用与乳腺癌风险的一般或HR阴性或其他乳腺癌亚型的风险之间的关联。这些发现并不能证实以前的报告可能的预防协会。
Statins are widely used and of high interest as potential chemopreventive agents for cancer. Preclinical studies suggest that lipophilic statins have anti-cancer properties targeting hormone receptor (HR)-negative breast cancer. Few epidemiologic studies have investigated the relationship between lipophilic statin use and risk of breast cancer, stratified by HR status. We conducted a large case-control study within the Kaiser Permanente of Northern California (KPNC) to determine whether chronic use of lipophilic statins is associated with decreased risk of HR-negative breast cancer, or other breast cancer subtypes. We identified 22,488 breast cancer cases diagnosed during 1997-2007, and 224,860 controls matched to cases based upon birth year and duration of KPNC pharmacy coverage. Use of lipophilic statins was ascertained using KPNC's comprehensive electronic pharmacy records. We found no association between lipophilic statin use (≥2 years vs. never) and overall breast cancer risk (ORadj=1.02; 95%CI=0.97-1.08) in conditional logistic regression models adjusted for oral contraceptive and hormone therapy use. Women who used lipophilic statins did not have a decreased risk of HR-negative breast cancer (ORadj=0.98; 95%CI=0.84-1.14), nor altered risk of HR-positive disease (ORadj=1.03; 95%CI=0.97-1.10). Furthermore, lipophilic statin use was not associated with risk of any of the intrinsic subtypes, luminal A, luminal B, HER2+/ER- or triple negative. Our results do not support an association of lipophilic statin use with the risk of breast cancer in general or with risks of HR-negative or other breast cancer subtypes specifically. These findings do not confirm previous reports of a possible preventive association.