A case-control study of reproductive factors associated with subtypes of breast cancer in Northeast China
A case-control study of reproductive factors associated with subtypes of breast cancer in Northeast China
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DOI：
10.1007/s12032-009-9308-7
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发表时间：
2010-09-01
期刊：
影响因子：
3.4
通讯作者：
Jin, Feng
中科院分区：
文献类型：
--
作者：
Xing, Peng;Li, Jiguang;Jin, Feng
根据雌激素受体(ER)、孕激素受体(PR)和HER2/neu(HER2)的表达，乳腺癌分为几种亚型：腔A(ER+和/或PR+，HER2-)，腔B(ER+和/或PR+，HER2+)，HER2过表达(ER-，PR-，HER2+)和三阴性(ER-，PR-，HER2-)。本病例对照研究的目的是确定与中国女性乳腺癌亚型相关的生殖因素。研究对象为2001年至2009年在沈阳中国医科大学附属第一医院中国医院就诊的1,417名乳腺癌患者和1,587名无乳腺癌病史的对照组。进行个人访谈，以获得有关生殖特征和临床病史的信息。用Logistic回归分析各因素与乳腺癌亚型之间的关系，计算优势比(OR)和95%可信区间(CI)。值得注意的是，腔A(50.0%)是最常见的亚型，其次是腔B(15.10%)、HER2过表达(10.87%)和三阴性(23.08%)。月经初潮早与腔性A的风险降低相关(OR，2.35；95%CI，1.45-3.81)。母乳喂养可以保护产妇免受任何亚型乳腺癌的侵袭。绝经后和自然流产与子宫腔肿瘤的风险呈负相关。相比之下，多胎、乳腺癌家族史和人工流产会增加患乳腺癌的风险。总体而言，我们的发现表明，初潮年龄、产次、母乳喂养、绝经状况和流产史等生殖因素对中国女性乳腺癌亚型有不同的影响。
Based on the expression of estrogen receptor (ER), progesterone receptor (PR) and HER2/neu (HER2), breast cancer is classified into several subtypes: luminal A (ER+ and/or PR+, HER2-), luminal B (ER+ and/or PR+, HER2+), HER2-overexpressing (ER-, PR-, and HER2+) and triple-negative (ER-, PR-, and HER2-). The aim of this case-control study is to determine reproductive factors associated with breast cancer subtypes in Chinese women. A total of 1,417 patients diagnosed with breast cancer in the First Affiliated Hospital, China Medical University, Shenyang, China between 2001 and 2009 and 1,587 matched controls without a prior breast cancer were enrolled. Personal interviews were conducted to obtain information on reproductive characteristics and clinical history. Relationships between the factors and the subtypes of breast cancer were examined using logistic regression to compute odds ratios (OR) and 95% confidence intervals (Cl). Notably, luminal A (50.0%) was the most prevalent subtype relative to luminal B (15.10%), HER2-overexpressing (10.87%) and triple-negative (23.08%). Menarche at an early age was associated with a reduced risk of luminal A (OR, 2.35; 95% CI, 1.45-3.81). Breastfeeding protected parous women from any subtype of breast cancer. Postmenopause and spontaneous abortion were inversely associated with the risk of luminal tumors. By contrast, multiparity, family history of breast cancer and induced abortion increased the risk of breast cancer. Collectively, our findings suggest that reproductive factors such as age at menarche, parity, breastfeeding, menopausal status and abortion history have different effects on the subtypes of breast cancer in Chinese women.