DDE AND PCBS AS ENVIRONMENTAL FACTORS IN HUMAN CANCER

DDE和PCB是高持久性、亲脂性环境化学品。 已知它们具有雌激素特性， 动物为了验证这些化合物可能发挥作用的假设， 人类乳腺癌病因学作用的初步病例对照研究 进行了。结果显示， 乳腺癌患者与非癌症对照组的比较。（其中58 例，癌症在献血后6个月内被诊断出来。 现在，为了更广泛地研究有机氯在 人类致癌作用，一系列的三个“巢式”病例对照研究， 对于乳腺癌、结肠癌和子宫内膜癌， 一个参与了一项前瞻性研究的大量妇女， 1985-1992年间在纽约市进行的癌症治疗。对于乳腺癌， 有240个案例发生在至少12个月后， 入组;结肠癌，60-70例;子宫内膜（子宫） 癌症35-45例。对照品将单独匹配（3：1） 年龄、入组日期和绝经状态或绝经期 月经周期 多氯联苯和DDE的浓度将在血清样本中测量， 在入组时获得并冷冻储存。评价 DDE，PCBs和癌症之间的关联将控制潜在的 混杂因素和效应修饰因素，包括饮食和生殖史。 对于乳腺癌，在以后的几年中重复采集血液标本; 这些将被分析以记录可能发生的血清水平的任何变化， 在疾病发作期间。 使用该研究人群获得了几个优势。血清 已经获得了标本;高质量的基线历史 有关饮食和其他潜在风险因素的信息已掌握; 类固醇激素水平是已知的;人口后续机制 都是公认的。 这项研究的数据可能会阐明环境因素与 毒素、膳食脂肪和激素与癌症的发生， 更多地了解这些疾病， 干预

DDE and PCBs are highly persistent, lipophilic environmental chemicals. They are known to have estrogenic properties and to be carcinogenic in animals. To test the hypothesis that these compounds might play an etiologic role in human breast cancer, a preliminary case-control study was conducted. Elevated levels of DDE and PCBs were found in serum of women with breast cancer compared with non-cancer controls. (Among the 58 cases, cancer had been diagnosed within 6 months of blood donation.) Now, to investigate more broadly the possible role of organochlorines in human carcinogenesis, a series of three "nested" case-control studies is proposed--for breast cancer, colon cancer, and endometrial cancer--among a large population of women who participated in a prospective study of cancer undertaken in New York City during 1985-1992. For breast cancer, there are 240 cases available that occurred at least 12 months after enrollment; for colon cancer, 60-70 cases; for endometrial (uterine) cancer, 35-45 cases. Controls will be individually matched (3:1) on the basis of age, date of enrollment, and either menopausal status or phase of the menstrual cycle. Concentrations of PCBs and DDE will be measured in serum specimens that were obtained at the time of enrollment and stored frozen. The evaluation of associations between DDE, PCBs and cancer will control for potential confounders and effect modifiers, including diet and reproductive history. For breast cancer, repeated blood specimens were taken in later years; these will be analyzed to chart any changes in serum levels that may occur during onset of disease. Several advantages are gained from the use of this study population. Serum specimens have already been obtained; high-quality baseline historical information on dietary and other potential risk factors is in hand; steroid hormone levels are known; and mechanisms for population followup are well established. Data from this study may illuminate the association of environmental toxins, dietary fat and hormones with occurrence of cancer, providing greater understanding of these diseases and opportunities for intervention.