上海和洛杉矶绝经前妇女血清性激素水平与乳腺癌危险性的关系

THE RELATIONSHIP BETWEEN RISK FOR BREAST CANCER AND SERUM HORMONE LEVELS IN PRE-MENOPAUSAL WOMEN IN SHANGHAI AND LOS ANGELES

为探索卵巢激素与乳腺癌的关系,作者在上海和洛杉矶同时进行年轻妇女乳腺癌的病例一对照研究。通过配对方法,对年龄、体重、身高、生育史和月经周期等因素作严格控制。本文包括上海的39例和洛杉矶的42例病灶局限的乳腺癌患者及其相同数量的健康妇女。用放免法定量测定月经周期第22天血清滩二醇(E_2)、性激素结合球蛋白(SHBG)和孕酮(Pg)的浓度。本文发现病例组E_2浓度高于对照组13％(P=0.038),E_2/SHBG比值上海高31.5％(P=0.020),洛杉矶的高24.8％(P=0.16)。洛杉矶对照的E_2浓度比上海对照高20.6％(P=0.036),E_2/SHBG比值高33.0％(P=0.018)。本文的结果说明绝经前乳腺癌患者血液E_2或游离E_2浓度显著高于健康对照。45岁以下美国白人妇女血液F_2或游离E_2浓度显著高上海妇女,这或许是解释两地妇女发病率差别的一种途径。

In order to investigate the relationship between the ovarian hormone productionand the risk for breast cancer, two concurrent case-control studies of breast cancer inyoung women were conducted in Shanghai and Los Angeles. Both studies were careful-Iy controlled for the possible confounding effects of age, weight, height, pregnancyhistory, and day of the menstrual cycle, by individually matching cases and controlson these factors. 39 patients with localized breast cancer in Shanghai and 42 in LosAngeles and the same number of health women as controls were included in this report.The concentrations of estradiol (E_2), sex-hormone binding globulin (SHBG) andprogesterone (Pg) on day 22 of her menstrual cycle were measured in serum by radio-immunoassays. Cases had 13.5% higher serum E_2 (P=0.038) overall and higher ratioof E_2 to SHBG (in Shanghai an excess of 31.5%,P=0.020;in Los Angeles 24. 8%,P=0.16) than those of controls. Los Angeles controls had higher E_2 concentrations(an excess of 20.6%,P=0.036)and ratio of E_2 to SHBG(an excess of 33.0%, P=0.018)than those of Shanghai controls. Our results indicate that serum E_2 or free E_2 concen-trations in pre-menopausal women with breast cancer are higher than those in healthwomen. The higher level of serum E_2 or free E_2 in white women might be one of thepossible explanations of the differences in breast cancer incidence rates of womenunder age 45 in Shanghai and Los Angeles.