摘要
目的 :评价绝经前后血浆类固醇性激素水平与汉族女性乳腺癌危险性的关系。方法 :采用放射免疫法检测原发性乳腺癌病例 90例和 116例匹配对照组血浆雌二醇 (E2 )、睾酮 (T)及孕酮 (P)水平 ,并应用条件Logistic回归等方法分析绝经前后血浆E2 、T、P水平 ,以及体质指数 (BMI)和腰臀围比 (WHR)对乳腺癌的危险度 (OR)及 95 %可信限(CI)。结果 :①绝经前 ,病例组血浆P水平显著低于对照组 ;绝经后血浆T、E2 水平、BMI和WHR ,病例组均显著高于对照组 ;②以下四分位 (P2 5)为非暴露参考 ,绝经前 ,血浆P上四分位 (P75)水平调整OR(95 %CI)为 0 .2 1(0 .11～0 .6 0 ) ,趋势P =0 .19;绝经后 ,血浆E2 P75水平OR为 3.74 (1.17～ 11.96 ) ,调整OR为 2 .98(0 .84～ 7.96 ) ,趋势P =0 .0 3;③BMI和WHR与绝经后乳腺癌有正性联系 ,OR分别为 4 .97(2 .0 9～ 11.79)和 2 .80 (1.2 7～ 6 .17)。结论 :血浆性激素水平与乳腺癌的危险性相关。血浆P水平对绝经前乳腺癌有保护作用 ;血浆E2 为绝经后乳腺癌的危险因素 ,且存在剂量反应暴露效应 ;BMI和WHR与血浆E2 呈正相关且为绝经后乳腺癌的危险因素。
Objective: To evaluated the relationships between steroid sex hormone levels in plasma and risk of breast cancer in both pre- and post-menopausal Hans of Chinese women. Methods:By use of case-control study, plasma estradiol(E 2), testosterone(T) and progesterone(P) concentrations were measured in 90 breast cancer patients and 116 matched control subjects by radio-immunoassay. Odds ratio (OR) and 95% confidence interval(CI) of plasma E 2, T, P, body mass index(BMI) and waist-hip ratio(WHR) were estimated by conditional logistic regression analysis. Results:① In premenopausal women, the levels of plasma P in case group was significant lower than those in control group(P=0.05). And the levels of plasma T and E 2 , BMI and those in WHR in postmenopausal women were significant higher in case group than those in control group. ② From comparisons of the highest and lowest (reference)quartiles, in premenopausal status, there were significant negative associations between the risk of breast can cer and the plasma levels of P, the adjusted OR was 0.21, (95%CI=0.11～0.60, P value for trend=0.19). In postmenopausal status, plasma E 2 was positively associated with risk of breast cancer (OR= 3.74, 95%CI=1.17～11.96, adjusted OR=2.98, 95%CI=0.84～7.96, P value for trend= 0.03); ③ Significant positive associations were observed between risk of breast cancer and BMI (OR=4.97, 95%CI=2.09～11.79) and WHR(OR=2.80, 95%CI=1.27～6.17) in postmenopausal status. Conclusion:There exist associations between plasma concentration of steroid sex hormones and breast cancer risk. The levels of plasma P exerts a protective effect on breast cancer in premenopausal women, but E 2 is a risk factor in postmenopausal women and E 2 has a dose-response of exposure effect. BMI and WHR are positively associated with the levels of plasma E 2 , and they are risk factors for breast cancer in postmenopausal women.
出处
《武汉大学学报（医学版）》
CAS
2004年第6期694-697,共4页
Medical Journal of Wuhan University
基金
湖北省教育厅攻关项目 ( 2 0 0 2B0 3 0 12 )
