Association of hormone replacement therapy to estrogen and progesterone receptor status in invasive breast carcinoma
Association of hormone replacement therapy to estrogen and progesterone receptor status in invasive breast carcinoma
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DOI：
10.1002/cncr.20499
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发表时间：
2004-10-01
期刊：
影响因子：
6.2
通讯作者：
Colditz, GA
中科院分区：
文献类型：
--
作者：
Chen, WY;Hankinson, SE;Colditz, GA
背景。观察性研究和随机试验表明，激素替代疗法 (HRT) 会增加接受者患乳腺癌的风险。因为已知一些乳腺恶性肿瘤对激素有反应，而另一些则没有，因此推测 HRT 可能与雌激素受体 (ER) 阳性/孕激素受体 (PR) 阳性乳腺癌的发生相关，而不是与 ER 阴性/PR 阴性乳腺癌的发生相关。 方法。护士健康研究是一项前瞻性队列研究，于 1976 年招募了 121,700 名年龄在 30-55 岁的女性注册护士。在当前的研究中，作者分析了 1980 年至 2000 年间该队列中符合条件的绝经后妇女中发生的 2548 例恶性肿瘤，并且可获得有关 ER 和 PR 状态的数据。 结果。与从未使用过 HRT 的女性相比，目前长期使用 HRT 的女性更有可能患上 ER 阳性/PR 阳性乳腺癌（多变量风险比 [RR]，1.80；95% 置信区间 [CI]，1.52-2.12），但患 ER 阴性/PR 阴性乳腺癌的可能性并不高（多变量 RR，1.00；95% Cl， 0.72-1.39）。随着当前 HRT 使用时间的增加，这种效应变得更强，并且在体重指数 < 25 kg/m(2) 的女性中也更为明显。此外，在接受包含雌激素和孕激素的联合 HRT (CHRT) 方案的患者中，HRT 使用与 ER 阳性/PR 阳性疾病之间的关联比单独使用雌激素 (ERT) 的患者更强。此外，当前 CHRT 使用者的肿瘤发展速度往往比 ERT 使用者更快。结论。目前 HRT 使用者比 ER 阴性/PR 阴性肿瘤更有可能发生 ER 阳性/PR 阳性肿瘤，这一发现表明内源性和外源性激素因素都可能影响乳腺肿瘤特征。在分析激素因素对乳腺肿瘤发展的影响时，ER阳性/PR阳性肿瘤和ER阴性/PR阴性肿瘤应分别考虑。 (C) 2004 年美国癌症协会。
BACKGROUND. Observational studies and randomized trials have demonstrated that hormone replacement therapy (HRT) increases the recipient's risk of developing breast carcinoma. Because it is known that some breast malignancies are hormonally responsive and that others are not, it has been hypothesized that HRT may be associated with the development of estrogen receptor (ER)-positive/progesterone receptor (PR)-positive breast carcinoma more so than with the development of ER-negative/PR-negative breast carcinoma.METHODS. The Nurses' Health Study is a prospective cohort study that enrolled 121,700 female registered nurses ages 30-55 years in 1976. In the current study, the authors analyzed 2548 malignancies that developed among eligible postmenopausal women in that cohort between 1980 and 2000 and for which data on ER and PR status were available.RESULTS. Compared with women who had never used HRT, current long-term users of HRT were more likely to develop ER-positive/PR-positive breast carcinoma (multivariate risk ratio [RR], 1.80; 95% confidence interval [CI], 1.52-2.12) but were not any more likely to develop ER-negative/PR-negative disease (multivariate RR, 1.00; 95% Cl, 0.72-1.39). This effect grew stronger with increasing duration of current HRT use and was also more pronounced among women with body mass index < 25 kg/m(2). Furthermore, the association between HRT use and ER-positive/PR-positive disease was stronger among patients receiving combined HRT (CHRT) regimens, which included estrogen and progesterone, than among users of estrogen alone (ERT). In addition, tumors tended to develop more quickly in current users of CHRT than in ERT users.CONCLUSIONS. The finding that current users of HRT were more likely to develop ER-positive/PR-positive tumors than they were to develop ER-negative/PR-negative ones suggests that both endogenous and exogenous hormonal factors may influence breast tumor characteristics. In analyses of the effects of hormonal factors on breast tumor development, ER-positive/PR-positive tumors and ER-negative/PR-negative tumors should be considered separately from each other. (C) 2004 American Cancer Society.