Circulating estrogens and postmenopausal ovarian and endometrial cancer risk among current hormone users in the Women's Health Initiative Observational Study.
Circulating estrogens and postmenopausal ovarian and endometrial cancer risk among current hormone users in the Women's Health Initiative Observational Study.
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妇女健康倡议观察研究中当前激素使用者的循环雌激素与绝经后卵巢癌和子宫内膜癌的风险。
DOI：
10.1007/s10552-019-01233-8
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Xu,Xia
中科院分区：
文献类型：
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作者：
Trabert,Britton;Coburn,SallyB;Falk,RoniT;Manson,JoAnnE;Brinton,LouiseA;Gass,MargeryL;Kuller,LewisH;Rohan,ThomasE;Pfeiffer,RuthM;Qi,Lihong;Stefanick,MarciaL;Wentzensen,Nicolas;Anderson,GarnetL;Xu,Xia
月经激素治疗（MHT）的使用引起循环雌激素/雌激素代谢物的改变，这可能有助于改变目前使用者生殖道癌的风险。因此，当前的研究评估了MHT使用者中循环雌激素/雌激素代谢物与卵巢癌和子宫内膜癌风险之间的关联。方法我们在妇女健康倡议观察性研究中对基线使用MHT的绝经后妇女进行了一项巢式病例对照研究（179例卵巢癌，396例对照; 230例子宫内膜癌，253例对照）。多变量Logistic回归估计比值比和95%的置信区间整体和subtype.ResultsEstrogen/雌激素代谢产物水平与整体或浆液性卵巢癌的风险，分别检查。然而，未结合雌二醇与非浆液性卵巢癌风险呈正相关[五分位数5与五分位数1：3.01（1.17-7.73）;p-trend = 0.03;p-het < 0.01]。子宫内膜癌的风险是不相关的雌激素/雌激素代谢物水平的妇女谁采取联合雌激素/孕激素治疗（EPT）。结论这些研究结果提供了新的证据，可能支持异质性激素病因卵巢癌亚型。循环雌激素对EPT诱导的高雌激素水平妇女的子宫内膜癌风险没有影响。需要更大规模的研究来描述卵巢/子宫内膜癌亚型与MHT使用背景下雌激素水平之间的关系。
PurposeMenopausal hormone therapy (MHT) use induces alterations in circulating estrogens/estrogen metabolites, which may contribute to the altered risk of reproductive tract cancers among current users. Thus, the current study assessed associations between circulating estrogens/estrogen metabolites and ovarian and endometrial cancer risk among MHT users.MethodsWe conducted a nested case–control study among postmenopausal women using MHT at baseline in the Women’s Health Initiative Observational Study (179 ovarian cancers, 396 controls; 230 endometrial cancers, 253 controls). Multivariable logistic regression was utilized to estimate odds ratios and 95% confidence intervals overall and by subtype.ResultsEstrogen/estrogen metabolite levels were not associated with overall or serous ovarian cancer risk, examined separately. However, unconjugated estradiol was positively associated with non-serous ovarian cancer risk [quintile 5 vs. quintile 1: 3.01 (1.17–7.73);p-trend = 0.03;p-het < 0.01]. Endometrial cancer risk was unrelated to estrogen/estrogen metabolite levels among women who took combined estrogen/progestin therapy (EPT).ConclusionsThese findings provide novel evidence that may support a heterogeneous hormonal etiology across ovarian cancer subtypes. Circulating estrogens did not influence endometrial cancer risk among women with EPT-induced high-estrogen levels. Larger studies are needed to delineate the relationship between ovarian/endometrial cancer subtypes and estrogen levels in the context of MHT use.