Sex hormones and risk of breast cancer in premenopausal women: a collaborative reanalysis of individual participant data from seven prospective studies.
Sex hormones and risk of breast cancer in premenopausal women: a collaborative reanalysis of individual participant data from seven prospective studies.
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DOI：
10.1016/s1470-2045(13)70301-2
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发表时间：
2013-09
期刊：
影响因子：
--
通讯作者：
Vineis P
中科院分区：
文献类型：
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作者：
Endogenous Hormones and Breast Cancer Collaborative Group;Key TJ;Appleby PN;Reeves GK;Travis RC;Alberg AJ;Barricarte A;Berrino F;Krogh V;Sieri S;Brinton LA;Dorgan JF;Dossus L;Dowsett M;Eliassen AH;Fortner RT;Hankinson SE;Helzlsouer KJ;Hoff man-Bolton J;Comstock GW;Kaaks R;Kahle LL;Muti P;Overvad K;Peeters PH;Riboli E;Rinaldi S;Rollison DE;Stanczyk FZ;Trichopoulos D;Tworoger SS;Vineis P
雌激素、孕激素和雄激素的循环浓度与绝经前妇女乳腺癌及相关危险因素的关系尚不清楚。7项前瞻性研究提供了诊断前性激素和性激素结合球蛋白（SHBG）浓度的个体数据。分析仅限于绝经前和采血时年龄在50岁以下的妇女，以及50岁之前诊断出的乳腺癌病例。通过条件Logistic回归分析，在年龄、采血日期和周期天数匹配的767例病例和1699例对照中，评估了乳腺癌与激素浓度相关的比值比（OR）及其95%置信区间（95%CI），并按研究分层，进一步调整周期分期。通过比较这些危险因素类别中激素浓度的几何平均值，并根据研究、年龄、月经周期阶段和体重指数（BMI）进行调整，研究了激素与对照组女性乳腺癌危险因素的相关性。所有统计学检验均为双侧检验。与激素浓度加倍相关的乳腺癌OR为1.19（95% CI 1.06-1.35）雌二醇，1.17（1.03-1.33）对于计算的游离雌二醇，1.27（1.05-1.54）雌酮，1.30（1.10-1.55）雄烯二酮，1.17（1.04-1.32），睾酮1.18（1.03-1.35），游离睾酮1.08（0.97-1.21）。乳腺癌风险与黄体期孕酮无关（浓度加倍OR=1.00（0.92-1.09）），调整其他因素对这些OR的影响很小。对照组妇女的横断面分析显示了性激素与乳腺癌危险因素的几种联系。循环雌激素和雄激素与绝经前妇女患乳腺癌的风险呈正相关。
The relationships of circulating concentrations of oestrogens, progesterone and androgens with breast cancer and related risk factors in premenopausal women are not well understood. Individual data on prediagnostic sex hormone and sex hormone binding globulin (SHBG) concentrations were contributed by 7 prospective studies. Analyses were restricted to women who were premenopausal and under age 50 at blood collection, and to breast cancer cases diagnosed before age 50. The odds ratios (ORs) with 95% confidence intervals (95% CIs) for breast cancer associated with hormone concentrations were estimated by conditional logistic regression in up to 767 cases and 1699 controls matched for age, date of blood collection, and day of cycle, with stratification by study and further adjustment for cycle phase. The associations of hormones with risk factors for breast cancer in control women were examined by comparing geometric mean hormone concentrations in categories of these risk factors, adjusted for study, age, phase of menstrual cycle and body mass index (BMI). All statistical tests were two-sided. ORs for breast cancer associated with a doubling in hormone concentration were 1.19 (95% CI 1.06–1.35) for oestradiol, 1.17 (1.03–1.33) for calculated free oestradiol, 1.27 (1.05–1.54) for oestrone, 1.30 (1.10–1.55) for androstenedione, 1.17 (1.04–1.32) for dehydroepiandrosterone sulphate, 1.18 (1.03–1.35) for testosterone and 1.08 (0.97–1.21) for calculated free testosterone. Breast cancer risk was not associated with luteal phase progesterone (for a doubling in concentration OR=1.00 (0.92–1.09)), and adjustment for other factors had little effect on any of these ORs. The cross-sectional analyses in control women showed several associations of sex hormones with breast cancer risk factors. Circulating oestrogens and androgens are positively associated with the risk for breast cancer in premenopausal women.