Reproductive variables, soy intake, and lung cancer risk among nonsmoking women in the Singapore Chinese Health Study.
Reproductive variables, soy intake, and lung cancer risk among nonsmoking women in the Singapore Chinese Health Study.
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DOI：
10.1158/1055-9965.epi-08-0892
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发表时间：
2009-03
期刊：
影响因子：
--
通讯作者：
Yu MC
中科院分区：
文献类型：
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作者：
Seow A;Koh WP;Wang R;Lee HP;Yu MC
非吸烟者中的肺癌已成为一种独特的临床病理实体，其病因尚不清楚，但在女性肺癌中占很大比例。虽然雌激素已被证明在肺细胞中具有有丝分裂作用，并在肿瘤发生中与生长因子途径相互作用，但生殖激素与肺癌之间存在联系的流行病学证据很少，而且不一致。在新加坡的一组中老年华人女性中，91%是终生非吸烟者，我们研究了产次、月经初潮/绝经年龄、周期长度和外源性激素的使用，以及饮食大豆和大豆异黄酮类摄入量对肺癌风险的影响。在35298名女性(平均随访时间9.6年)中，有298例肺癌发生，其中189例(63.4%)发生在非吸烟者中。与未分娩的妇女相比，有1到2个、3到4个和5个以上活产的妇女患所有肺癌的相对风险在0.49到0.59P之间(趋势和0.001)，腺癌的相对风险在0.32到0.42之间(趋势和lt；0.01)。在吸烟者和不吸烟者中都观察到了这种关系。初潮年龄和绝经似乎并不影响患病风险。仅在非吸烟者中，饮食中大豆异黄酮类化合物的摄入量与统计上显著的相反趋势相关(相对风险，最高四分位数与较低四分位数的相对风险为0.59%；趋势的P为0.021)。这些发现增加了荷尔蒙因素在非吸烟女性肺癌病因中的作用，并与这方面的新实验证据再次一致。
Lung cancer among nonsmokers has emerged as a distinct clinicopathologic entity for which the etiology is still poorly understood, but which accounts for a significant proportion of the lung cancers among women. Although estrogens have been shown to have mitogenic effects in lung cells and interact with growth factor pathways in tumorigenesis, epidemiologic evidence for a link between reproductive hormones and lung cancer is sparse and inconsistent. We examined the effect of parity, age at menarche/menopause, cycle length and use of exogenous hormones, and dietary soy and soy isoflavonoid intake on lung cancer risk in a prospective cohort of middle-aged and elderly Chinese women in Singapore among whom 91% were lifetime nonsmokers. Among 35,298 women (mean follow-up time, 9.6 years), 298 cases of incident lung cancer were recorded, of which 189 (63.4%) occurred in nonsmokers. Compared with nulliparous women, those with one to two, three to four, and more than five livebirths had relative risks of between 0.49 and 0.59 P (for trend < 0.01) for all lung cancers, and between 0.32 and 0.42 (P for trend < 0.001) for adenocarcinomas. This relationship was observed in both smokers and nonsmokers. Age at menarche and menopause did not seem to influence risk. Dietary soy isoflavonoid intake was associated with a statistically significant inverse trend among nonsmokers only (relative risks, 0.59 for highest versus lower quartile; P for trend, 0.021). These findings add support for the role of hormonal factors in the etiology of lung cancer among nonsmoking women, and a re consistent with emerging experimental evidence in this regard.