高危HPV检测在宫颈癌筛查防治及判断预后中的意义

宫颈癌在女性肿瘤中发病率仅次于乳腺癌，位居第二位，是全球最主要的癌症之一。目前大量的流行病学和分子生物学研究已经证明人乳头瘤病毒（Human Papillomavirus，HPV）感染是宫颈癌发生的最主要危险因素。迄今已发现100多型HPV病毒，其中HPV16、18、31、33、35、39、45等型持续感染可引起宫颈上皮内瘤变（cervical intraepithelial neoplasm，CIN）与宫颈癌，     

雌激素受体基因多态性与女性雌激素相关肿瘤发病风险的关系

  雌激素受体（ER）存在两种亚型雌激素受体α（ERα）与雌激素受体β（ERβ），是一种能与雌激素（E）特异性结合的糖蛋白，广泛分布于体内多个器官与组织中，其中女性生殖系统与乳腺被认为是E作用的经典靶组织。研究发现，ER基因多态性与女性生殖系统肿瘤及乳腺癌的发生有关。文章从ER的分子结构、功能、作用方式、基因多态性以及与女性生殖系统肿瘤及乳腺癌的关系进行综述。     

雌激素受体β与乳腺癌

乳腺癌是一种激素依赖性肿瘤。雌激素受体α（ERα）在雌激素介导的乳腺癌发生、发展中起重要作用。然而,最近研究发现乳腺癌细胞的雌激素受体存在另一亚型——雌激素受体β（ERβ）,也可能在乳腺癌的发生、发展中起重要作用。与ERd的作用不同,ERβ在细胞实验和动物模型研究中表现出对乳腺癌细胞增殖抑制作用。文章从ERβ与ERd及孕激素受体（PR）的关系、乳腺癌浸润与转移及对内分泌治疗的影响等方面阐述其与乳腺癌的关系。     

PTEN及其在乳腺癌预后中的意义

PTEN是1997年发现的具有磷酸酶活性的肿瘤抑制基因（PTEN），其缺失和多种肿瘤相关，包括脑、前列腺和乳腺肿瘤等。乳腺癌是女性常见的恶性肿瘤，欧美的发病率达到1／7～1／8，我国女性的发病率也在逐年升高，研究发现PTEN缺失的乳腺癌预后较差。本文将PTEN基因研究进展及其对乳腺癌的预后意义作简要综述。     

乳腺癌患者手术前后血清S-CD105 的表达及相关因素分析

 目的 探讨乳腺癌患者手术前、后血清S-CD105的表达情况及其影响因素。方法 用酶联免疫吸附实验（ELISA）检测37例乳腺癌，10例乳腺良性肿瘤患者及10位健康成年女性血清SICD105的浓度。结果 乳腺癌患者血清S-CD105浓度明显高于乳腺良性肿瘤患者及健康女性（P=0．021）；手术前组血清S-CD105浓度明显高于术后30天组（P=0．000）；术后3（）天组血清SICD105浓度与乳腺良性肿瘤患者及健康女性之间无差异（P=0．311）；进一步研究发现：肿瘤最大直径〉5cm、淋巴结转移≥4枚、临床TNM分期Ⅱ期以上以及肿瘤组织血管内皮生长因子（VEGF）表达强阳性的患者，血清S-CD105浓度均明显升高（P〈0．05）；1例骨转移患者血清S-CD105浓度明显升高。结论 手术前乳腺癌患者血清S-CD105表达明显升高，且与肿瘤大小、淋巴结转移、临床分期以及肿瘤组织中VEGF表达水平明显相关，表明其具有评价预后的临床价值。1例术后骨转移患者血清S-CD105浓度显著升高，表明其可能具有监测复发和转移的临床价值，有待于进一步研究。     

血脂水平与乳腺恶性肿瘤的关系

在世界范围内,乳腺癌是女性中最常见的癌症,每年有超过130万例患者被诊断为乳腺癌［1］。一些流行病学研究表明肥胖、体重增加、饱和脂肪的饮食与癌症发展的风险增加之间存在联系［2］。乳腺癌患者往往表现出较低水平的总胆固醇,被称为癌症的临床前效应［3］。本文作者比较了正常女性和乳腺导管浸润癌患者血胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL）及低密度脂蛋白（LDL）水平,以探讨血脂水平与肿瘤的关系。     

人绒毛膜促性腺激素与乳腺癌发生发展的关系

乳腺癌是女性最常见的恶性肿瘤之一。每年全世界约有130万人被诊断为乳腺癌,约有40万人死于该病。在流行病学因素中,妊娠,特别是较早孕龄（24岁以前）的妊娠被认为可显著降低发生乳腺癌的风险．而实验发现妊娠期间由胎盘分泌的人绒毛膜促性腺激素（human chorionic gonadotropin,hCG）同样可以抑制乳腺癌的发生、发展。故学者们提出：可应用hCG模拟妊娠。从而抑制乳腺癌的发生、发展。     

pS2基因的研究进展

雄基因（也叫BCEI，pNRZ，MdZ）是三叶草因子家族（TFF）中的第一个成员，首先是在人乳腺癌细胞系MCF7中借助雌激素调节而发现的，此后在其它肿瘤及正常组织中也被发现尸］。已知的入三叶草因子家族有pSZ，解痉多肽hSP和人肠三叶因子1lljr，均定位于对号染色体上L」，最近将其分别命名为1？T？fLI、TFFZ和TFF3ta］。pSZ在胃肠道粘膜修复中起作用，但临床研究发现乳腺癌pSZ阳性患者其无病生存期（IIFS）和总生存期（OS）较革2阴性患者明显高，持续pSZ表达的乳腺癌患者预后好，可作为乳腺癌抗雌激素治疗反应的预测指标，许2…     

EB病毒与乳腺癌

乳腺癌的发病是一个多因素长期作用、逐步发展的过程,已知的高危因素,如雌激素和生长激素过高,女性初潮过早、绝经过晚、绝经后肥胖、不恰当的激素治疗及个体的基因易感性等都在乳腺癌的发病中起重要作用。近年的研究发现主要有三种病毒：EB病毒（EBV）、人类乳头瘤状病毒（HPV）、小鼠乳腺肿瘤病毒（MMTV）可能在乳腺癌的发病过程中也起重要作用。     

Intake of dairy products,calcium, and vitamin d and risk of breast cancer

BACKGROUND: Laboratory data suggest that calcium and vitamin D, found at high levels in dairy products, might reduce breast carcinogenesis. However, epidemiologic studies regarding dairy products and breast cancer have yielded inconsistent results. We examined data from a large, long-term cohort study to evaluate whether high intake of dairy products, calcium, or vitamin D is associated with reduced risk of breast cancer. METHODS: We followed 88 691 women in the Nurses' Health Study cohort from the date of return of their food-frequency questionnaire in 1980 until May 31, 1996. Dietary information was collected in 1980 and updated in 1984, 1986, 1990, and 1994. We identified 3482 women (premenopausal = 827, postmenopausal = 2345, and uncertain menopausal status = 310) with incident invasive breast cancer. We used pooled logistic regression to estimate multivariable relative risks (RRs) using 2-year time increments. The RRs and 95% confidence intervals (CIs) were calculated for each category of intake compared with the lowest intake group. All statistical tests were two-sided. RESULTS: Intakes of dairy products, calcium, or vitamin D were not statistically significantly associated with breast cancer risk in postmenopausal women. In premenopausal women, however, consumption of dairy products, especially of low-fat dairy foods and skim/low-fat milk, was inversely associated with risk of breast cancer. The multivariable RRs comparing highest (>1 serving/day) and lowest (800 mg/day versus 500 IU/day versus 相似文献   

Intake of dairy products and the risk of breast cancer.

The relationship between intake of dairy products and risk of breast cancer was studied in 4697 initially cancer-free women, aged 15 years or over. During a 25 year follow-up period after the collection of food consumption data, 88 breast cancers were diagnosed. Intakes of foods were calculated from dietary history interviews covering the habitual diet of examinees over the preceding year. There was a significant inverse gradient between milk intake and incidence of breast cancer, the age-adjusted relative risk of breast cancer being 0.42 (95% confidence interval=0.24-0.74) between the highest and lowest tertiles of milk consumption. The associations with respect to other dairy products were not significant. Adjustment for potential confounding factors, i.e. smoking, body mass index, number of childbirths, occupation and geographic area, resulted in only a minor change in the milk intake-breast cancer relation. Nor did adjustment for intake of other foodstuffs and nutrients, e.g. energy, carbohydrates, protein, fat, vitamins and trace elements, alter the results. No significant interactions between milk intake and demographic or dietary variables or time of cancer diagnosis were observed. Our data suggest that there is a protective effect, dietary or habitual, associated with consumption of milk that overwhelms the associations between different other factors and risk of breast cancer.     

Milk/dairy products consumption, galactose metabolism and ovarian cancer: meta-analysis of epidemiological studies.

Ovarian cancer is the fifth most common cause of cancer death among women and the leading cause of gynaecological cancer death in the United States. Milk/dairy products consumption was considered to be a risk factor for ovarian cancer mainly because milk carbohydrate-lactose and galactose metabolism is toxic to oocytes. However, recent evidence does not support this hypothesis completely. We collected epidemiological studies related to the association between milk/dairy products consumption or galactose metabolism (lactose, galactose, galactose-1-phosphate uridyltransferase, lactose/transferase) and ovarian cancer published between January 1966 and August 2003 and found 27 items from 22 independent studies. Twenty studies were case-control studies and the other two were cohort studies. A meta-analysis method was conducted to estimate relative risk combining all relative data. In general, we did not find any association between milk/dairy products or galactose metabolism and ovarian cancer risk in this meta-analysis. The consumption of whole milk and butter, which contain relatively high amounts of fat, was positively (relative risk > 1.2), but not significantly, associated with an increased risk.     

Dairy cattle serum and milk factors contributing to the risk of colon and breast cancers

The analysis of published epidemiological data on colon and breast cancer reveals a remarkable concordance for most regions of the world. A low incidence for both cancers has been recorded in Mongolia and Bolivia. Discrepant data, however, have been reported for India, Japan and Korea. In India, the incidence of breast cancer is significantly higher than for colon cancer, in Japan and Korea colon cancer exceeds by far the rate of breast cancer. Here, studies are summarized pointing to a species‐specific risk for colon cancer after consumption of beef originating from dairy cattle. Uptake of dairy products of Bos taurus‐derived milk cattle, particularly consumed at early age, is suggested to represent one of the main risk factors for the development of breast cancer. A recent demonstration of reduced breast cancer rates in individuals with lactose intolerance (Ji et al., Br J Cancer 2014; 112:149‐52) seems to be in line with this interpretation. Species‐specific risk factors for these cancers are compatible with the transmission of different infectious factors transferred via meat or dairy products. Countries with discordant rates of colon and breast cancer reveal a similar discordance between meat and milk product consumption of dairy cattle. The recent isolation of a larger number of novel presumably viral DNAs from serum, meat and dairy products of healthy dairy cows, at least part of them infectious for human cells, deserves further investigation. Systemic infections early in life, resulting in latency and prevention of subsequent infections with the same agent by neutralizing antibodies, would require reconsideration of ongoing prospective studies conducted in the adult population.     

Breast cancer mortality and diet in the United States

Internationally, breast cancer mortality is correlated with intestinal lactase sufficiency and dairy product consumption beyond childhood. Within the United States, age-adjusted breast cancer mortality is positively associated with consumption of milk, butter, and total milk fat in regional analyses, and it is associated with milk demand in state-based analyses. Breast cancer mortality is also positively associated with demand for total calories, protein, fat, beef, and table fats (butter and margarine), and it is negatively associated with egg demand. Only the associations with milk and egg demand, however, survive when the Southern states are eliminated from the analyses or when either age of first marriage or income is controlled. The associations with milk and egg demand persist despite multiple controls for other dietary and demographic variables, although the association with milk demand loses statistical significance in some second- and third-order partial correlations. The inverse correlation with egg demand is strong but in the opposite direction from what might have been expected from previous studies. The correlation between milk demand and breast cancer mortality, although weaker, is consistent with results from previous studies, and it suggests a possible special role for dairy products in the etiology of breast cancer.     

Dairy product consumption and risk of colorectal cancer in an older mediterranean population at high cardiovascular risk

Prospective studies have reported an inverse association between the consumption of total dairy products and milk and the risk of colorectal cancer (CRC). Nonetheless, there is little and inconsistent evidence regarding subtypes of dairy product and CRC risk. We assessed the associations between the consumption of total dairy products, their different subtypes and CRC risk in older Mediterranean individuals at high cardiovascular risk. We analyzed data from 7,216 men and women (55–80 years) without CRC at baseline from the PREvención con DIeta MEDiterránea study. Individuals were recruited between 2003 and 2009 and followed up until December 2012. At baseline and yearly thereafter, consumption of total and specific dairy products was assessed using a validated 137‐item food‐frequency questionnaire. Cox proportional hazards ratios (HRs) of CRC incidence were estimated for tertiles of mean consumption of dairy products during the follow‐up. During a median [interquartile range] follow‐up of 6.0 [4.4–7.3] years, we documented 101 incident CRC cases. In the multivariable‐adjusted models, HRs and 95% confidence intervals (CIs) of CRC for the comparison of extreme tertiles of total dairy product and low‐fat milk consumption were 0.55 (95% CI: 0.31–0.99; p‐trend = 0.037) and 0.54 (95% CI: 0.32–0.92; p‐trend = 0.022), respectively. No significant associations with other dairy products (whole‐fat and low‐fat dairy products; total, low‐fat and whole‐fat yogurt; cheese; total, low‐fat and whole‐fat milk; concentrated full‐fat dairy products, sugar‐enriched dairy products and fermented dairy products) were found. A high consumption of total dairy products and low‐fat milk was significantly associated with a reduced CRC risk.     

Adolescent milk fat and galactose consumption and testicular germ cell cancer.

Recent case-control studies suggested that dairy product consumption is an important risk factor for testicular cancer. We examined the association between consumption of dairy products, especially milk, milk fat, and galactose, and testicular cancer in a population-based case-control study including 269 case and 797 controls (response proportions of 76% and 46%, respectively). Dietary history was assessed by food frequency questions for the index persons and through their mothers including diet 1 year before interview and diet at age 17 years. We used conditional logistic regression to calculate odds ratios as estimates of the relative risk (RR), 95% confidence intervals (95% CI), and to control for social status and height. The RR of testicular cancer was 1.37 (95% CI, 1.12-1.68) per additional 20 servings of milk per month (each 200 mL) in adolescence. This elevated overall risk was mainly due to an increased risk for seminoma (RR, 1.66; 95% CI, 1.30-2.12) per additional 20 milk servings per month. The RR for seminoma was 1.30 (95% CI, 1.15-1.48) for each additional 200 g milk fat per month and was 2.01 (95% CI, 1.41-2.86) for each additional 200 g galactose per month during adolescence. Our results suggest that milk fat and/or galactose may explain the association between milk and dairy product consumption and seminomatous testicular cancer.     

Dairy intake in relation to prostate cancer survival

Dairy intake has been associated with increased risk of advanced prostate cancer. Two US cohort studies reported increased prostate cancer‐specific mortality with increased high‐fat milk intake. We examined whether dairy and related nutrient intake were associated with prostate cancer progression in a Swedish patient population with high dairy consumption. We prospectively followed 525 men with newly diagnosed prostate cancer (diagnosed 1989–1994). We identified and confirmed deaths through February 2011 (n = 222 prostate cancer‐specific, n = 268 from other causes). Cox proportional hazards regression was used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for the associations between food or nutrient intake and prostate cancer‐specific death. On average, patients consumed 5.0 servings/day of total dairy products at diagnosis. In the whole population, high‐fat milk intake was not associated with prostate cancer‐specific death (95% CI: 0.78, 2.10; p‐trend = 0.32; multivariate‐adjusted model). However, among patients diagnosed with localized prostate cancer, compared to men who consumed <1 servings/day of high‐fat milk, those who drank ≥3 servings/day had an increased hazard of prostate cancer mortality (HR = 6.10; 95% CI: 2.14, 17.37; p‐trend = 0.004; multivariate‐adjusted model). Low‐fat milk intake was associated with a borderline reduction in prostate cancer death among patients with localized prostate cancer. These associations were not observed among patients diagnosed with advanced stage prostate cancer. Our data suggest a positive association between high‐fat milk intake and prostate cancer progression among patients diagnosed with localized prostate cancer. Further studies are warranted to investigate this association and elucidate the mechanisms by which high‐fat milk intake may promote prostate cancer progression.     

A meta-analysis of studies of dietary fat and breast cancer risk.

There is strong evidence that breast cancer risk is influenced by environmental factors, and animal experiments and human ecological data suggest that increased dietary fat intake increases the incidence of the disease. Epidemiological evidence on the relationship of dietary fat to breast cancer from cohort and case control studies has however been inconsistent. To examine the available evidence we have carried out a meta-analysis to summarise quantitatively the large published literature on dietary fat in the aetiology of breast cancer. After assembling all of the published case control and cohort studies, we extracted the relative risk in each study that compared the highest to the lowest level of intake. We then calculated a summary relative risk for all studies. The summary relative risk for the 23 studies that examined fat as a nutrient was 1.12 (95% CI 1.04-1.21). Cohort studies had a summary relative risk of 1.01 (95% CI 0.90-1.13) and case control studies a relative risk of 1.21 (95% CI 1.10-1.34). Summary estimates of risk for specific types of fat excluded unity for only saturated fat. For the 19 studies that examined food intake, the summary relative risks were 1.18 (95% CI 1.06-1.32) for meat, 1.17 (95% CI 1.04-1.31) for milk, and 1.17 (95% CI 1.02-1.36) for cheese. Summary relative risks for total fat intake were examined for several potential modifying factors. Regression analysis showed that European studies were more likely than studies done in other countries to show an increased relative risk associated with dietary fat and breast cancer, after taking into account potential modifying factors that included study design and quality.     

Epidemiology and prevention of Breast Cancer in the 21 st century

The incidence and mortality of breast cancer are high in Western industrialized countries and relatively low in Japan and other Asian countries. In Japan the incidence and mortality of breast cancer have gradually been increasing. Marrying later, having fewer children, a larger intake of fat, dairy products and meats and a larger body mass index in menopausal women may be related to the increased incidence of breast cancer in Japan. A review of risk factors identified from recent epidemiological studies in Japan indicates that obesity after 50 years of age is an important risk factor for postmenopausal breast cancer. Future estimations of cancer mortality and incidence predict that breast cancer will further increase to become a leading cancer in Japan in the 21 st century.