Adiposity, hormone replacement therapy use and breast cancer risk by age and hormone receptor status: a large prospective cohort study.
Adiposity, hormone replacement therapy use and breast cancer risk by age and hormone receptor status: a large prospective cohort study.
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DOI：
10.1186/bcr3186
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发表时间：
2012-05-14
期刊：
影响因子：
--
通讯作者：
Kaaks R
中科院分区：
文献类型：
--
作者：
Ritte R;Lukanova A;Berrino F;Dossus L;Tjønneland A;Olsen A;Overvad TF;Overvad K;Clavel-Chapelon F;Fournier A;Fagherazzi G;Rohrmann S;Teucher B;Boeing H;Aleksandrova K;Trichopoulou A;Lagiou P;Trichopoulos D;Palli D;Sieri S;Panico S;Tumino R;Vineis P;Quirós JR;Buckland G;Sánchez MJ;Amiano P;Chirlaque MD;Ardanaz E;Sund M;Lenner P;Bueno-de-Mesquita B;van Gils CH;Peeters PH;Krum-Hansen S;Gram IT;Lund E;Khaw KT;Wareham N;Allen NE;Key TJ;Romieu I;Rinaldi S;Siddiq A;Cox D;Riboli E;Kaaks R
激素受体阳性的乳腺癌与过度肥胖之间的关系已被很好地描述；然而，关于体重指数(BMI)与激素受体阴性的恶性肿瘤之间的联系，以及激素替代疗法(HRT)的使用可能产生的相互作用，仍存在不确定性。在欧洲EPIC队列中，使用COX比例风险模型描述BMI、腰围和臀围与5岁年龄段内雌激素受体(ER)阴性、孕激素受体(PR)阴性(n=1021)和ER+PR+(n=3586)乳腺癌风险的关系。在绝经后妇女中，分析了BMI和HRT使用的联合影响。对于ER-PR-肿瘤的风险，不同年龄段的BMI没有相关性。然而，当分析仅限于绝经后从未使用激素替代疗法的人时，观察到与BMI呈正相关(第三与第一三分位数HR=1.47(1.01至2.15))。在≤年龄49岁的女性中，体重指数与ER+PR+肿瘤呈负相关(每增加5 kg/m2，HR=0.79(95%CI 0.68~0.91))，而在≥65岁的女性中，体重指数与风险呈正相关(HR=1.25(1.16~1.34))。调整BMI、腰围和臀围与乳腺癌亚型的风险没有进一步的关联。目前使用激素替代疗法与受体阴性(激素替代疗法与激素替代疗法相比从不使用激素替代疗法)和阳性肿瘤(HR：1.74(1.56至1.95))的风险增加显著相关，尽管ER-PR疾病的风险增加较弱(PHET=0.035)。对于ER-PR-(HR：1.74(1.15~2.63))和ER+PR+(HR：2.33(1.84~2.92))乳腺癌，较瘦的女性(BMI≤22.5 kg/m2)明显强于超重女性(BMI≥25.9 kg/m2)，并且不受任何特定的HRT方案的限制。在从未使用激素替代疗法的绝经后妇女中，BMI升高可能与ER-PR肿瘤的风险呈正相关。此外，绝经后HRT使用者患ER-PR-以及ER+PR+肿瘤的风险增加，尤其是在较瘦的女性中。对于激素受体阳性的肿瘤，而不是激素受体阴性的肿瘤，我们的研究证实，在绝经前的年轻女性中，风险与BMI呈负相关。我们的数据为性激素在激素受体阴性肿瘤的病因学中可能的作用提供了证据。
Associations of hormone-receptor positive breast cancer with excess adiposity are reasonably well characterized; however, uncertainty remains regarding the association of body mass index (BMI) with hormone-receptor negative malignancies, and possible interactions by hormone replacement therapy (HRT) use. Within the European EPIC cohort, Cox proportional hazards models were used to describe the relationship of BMI, waist and hip circumferences with risk of estrogen-receptor (ER) negative and progesterone-receptor (PR) negative (n = 1,021) and ER+PR+ (n = 3,586) breast tumors within five-year age bands. Among postmenopausal women, the joint effects of BMI and HRT use were analyzed. For risk of ER-PR- tumors, there was no association of BMI across the age bands. However, when analyses were restricted to postmenopausal HRT never users, a positive risk association with BMI (third versus first tertile HR = 1.47 (1.01 to 2.15)) was observed. BMI was inversely associated with ER+PR+ tumors among women aged ≤49 years (per 5 kg/m2 increase, HR = 0.79 (95%CI 0.68 to 0.91)), and positively associated with risk among women ≥65 years (HR = 1.25 (1.16 to 1.34)). Adjusting for BMI, waist and hip circumferences showed no further associations with risks of breast cancer subtypes. Current use of HRT was significantly associated with an increased risk of receptor-negative (HRT current use compared to HRT never use HR: 1.30 (1.05 to 1.62)) and positive tumors (HR: 1.74 (1.56 to 1.95)), although this risk increase was weaker for ER-PR- disease (Phet = 0.035). The association of HRT was significantly stronger in the leaner women (BMI ≤22.5 kg/m2) than for more overweight women (BMI ≥25.9 kg/m2) for, both, ER-PR- (HR: 1.74 (1.15 to 2.63)) and ER+PR+ (HR: 2.33 (1.84 to 2.92)) breast cancer and was not restricted to any particular HRT regime. An elevated BMI may be positively associated with risk of ER-PR- tumors among postmenopausal women who never used HRT. Furthermore, postmenopausal HRT users were at an increased risk of ER-PR- as well as ER+PR+ tumors, especially among leaner women. For hormone-receptor positive tumors, but not for hormone-receptor negative tumors, our study confirms an inverse association of risk with BMI among young women of premenopausal age. Our data provide evidence for a possible role of sex hormones in the etiology of hormone-receptor negative tumors.
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影响因子：
3.8
作者：
Feigelson, HS;Jonas, CR;Calle, EE
通讯作者：
Calle, EE
激素受体状态，肿瘤特征和预后：乳腺癌患者的前瞻性队列。
DOI：
10.1186/bcr1639
发表时间：
2007
期刊：
Breast cancer research : BCR
影响因子：
--
作者：
Dunnwald LK;Rossing MA;Li CI
通讯作者：
Li CI
影响因子：
7.4
作者：
Allred, DC;Brown, P;Medina, D
通讯作者：
Medina, D
影响因子：
64.8
作者：
Asselin-Labat, Marie-Liesse;Vaillant, Francois;Visvader, Jane E.
通讯作者：
Visvader, Jane E.
影响因子：
6.2
作者：
Chen, WY;Hankinson, SE;Colditz, GA
通讯作者：
Colditz, GA