A prospective study of plasma prolactin concentrations and risk of premenopausal and postmenopausal breast cancer
A prospective study of plasma prolactin concentrations and risk of premenopausal and postmenopausal breast cancer
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DOI：
10.1200/jco.2006.07.6356
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发表时间：
2007-04-20
影响因子：
45.3
通讯作者：
Hankinson, Susan E.
中科院分区：
文献类型：
--
作者：
Tworoger, Shelley S.;Eliassen, A. Heather;Hankinson, Susan E.
目的流行病学研究表明，催乳素与老年妇女患乳腺癌的风险有关。由于有限的前瞻性数据，特别是在年轻女性中，我们研究了催乳素浓度是否与42至55岁女性的乳腺癌风险相关（68%绝经前），然后对三项研究进行汇总分析。患者与方法分析包括377例2000年6月前抽血后确诊的乳腺癌患者;每个病例在年龄、抽血和诊断时的绝经状态、空腹状态以及采血的时间和月份方面匹配两个对照。这些数据与两个先前发表的NHS和NHSII队列的数据集（n = 1，539例，2，681例对照;年龄32 - 70岁）合并。结果催乳素与乳腺癌风险增加适度相关（相对风险[RR]，上/下四分位数= 1.3; 95%CI，0.9 - 1.9;趋势P = 0.12）。风险评估没有因绝经状态、肿瘤侵袭性或雌激素受体（ER）状态而变化。在汇总分析中，总体RR为1.3（95% CI，1.1至1.6;趋势P = 0.002），且不随绝经状态而变化（相互作用P = 0.95）。ER+肿瘤患者的风险最高（RR = 1.6; 95%CI，1.2 - 2.0; P <0.001）。校正人内变异，RR比较中位数的顶部与底部催乳素四分位数增加从1.3至1.7为所有妇女和1.5至2.1 ER+ cases.Conclusion这些数据，结合实验研究，表明催乳素可能是重要的乳腺癌病因，特别是ER+肿瘤，在广泛的年龄范围。
Purpose Epidemiologic studies suggest that prolactin is associated with breast cancer risk in older women. Because of limited prospective data, particularly in younger women, we examined whether prolactin concentrations were associated with breast cancer risk among women 42 to 55 years (68% premenopausal) from the Nurses' Health Study (NHS), and then conducted a pooled analysis of three studies.Patients and Methods The analysis included 377 cases of breast cancer diagnosed after blood draw and before June 2000; two controls were matched per case on age, menopausal status at blood draw and diagnosis, fasting status, and time of day and month of blood collection. These data were pooled with two previously published data sets from the NHS and NHSII cohorts (n = 1,539 cases, 2,681 controls; ages 32 to 70 years).Results Prolactin was modestly associated with an increased breast cancer risk (relative risk [RR], top v bottom quartile = 1.3; 95% CI, 0.9 to 1.9; P for trend = .12). Risk estimates did not vary by menopausal status, tumor invasiveness, or estrogen receptor (ER) status. In the pooled analysis, the overall RR was 1.3 (95% CI, 1.1 to 1.6; P for trend = .002), and did not vary by menopausal status (P for interaction = .95). The risk was strongest for women with ER+ tumors (RR = 1.6; 95% CI, 1.2 to 2.0; P for trend < .001). Correcting for within-person variability, the RR comparing the median of the top versus the bottom prolactin quartile increased from 1.3 to 1.7 for all women and from 1.5 to 2.1 for ER+ cases.Conclusion These data, in conjunction with experimental studies, indicate that prolactin likely is important in breast cancer etiology, particularly ER+ tumors, over a wide range of ages.