血浆类固醇性激素水平与女性乳腺癌危险性的关系

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。     

广东地区妇女乳腺癌高危因素分析与对策

目的 分析广东地区妇女乳腺癌的危险因素,为建立乳腺癌风险模型,有针对性地筛查高危人群进行早期干预提供依据.方法 采用成组配对的病例对照研究,对绝经前和绝经后妇女分别进行乳腺癌人群和非乳腺癌人群危险因素的单因素分析和Logistic多元回归分析.结果 绝经前妇女中,服用避孕药、亲属中有乳腺癌患者、有不良情绪、有不良事件、劳动强度大等因素是乳腺癌的危险因素;有乳腺增生病史、有乳腺组织活检史、有相对剧烈的运动等因素可能是乳腺癌的保护因素.绝经后妇女中,亲属中有乳腺癌患者是危险因素,情绪调节能力强是保护因素.结论 绝经前后乳腺癌的危险因素和保护因素不完全相同,根据不同的影响因素,建立绝经前后不同的乳腺癌预报模型,更有针对性地进行乳腺癌的早期干预应是今后工作的重点.

Abstract：

Objective To screen high-risk population of breast cancer by analyzing the risk factors of breast cancer in Guangdong Province.Methods A case-control study was performed to identify the risk factors of breast cancer between premenopausal women and postmenopausal women. Chi-square test and unconditional logistic regression were used to analyze the data. Results In premenopansal women,prophylactic, family history of breast cancer, bad mood, bad life incidence and work load were the risk factors,and breast hyperplasia history,breast tissue examination history,regular exercise and sleeping without bm were the protective factors.In postmenopausal women,family history of breast cancer was the risk factor, and breast hyperplasia history and mood adjustment were the protective factors. Conclusion The risk and protective factors of breast cancer differ between premenopausal and postmenopausal women,which highlights the importance of using different risk models to screen the high-risk populations.     

化疗对绝经前乳腺癌妇女卵巢功能的影响

目的:研究不同化疗方案对绝经前雌激素受体(ER)或伴孕激素受体(PR)阳性乳腺癌妇女卵巢功能的影响.方法:对我院2004年1月-2005年12月绝经前雌激素受体(ER)或伴孕激素受体(PR)阳性乳腺癌妇女行AC(ADM CTX)和CEF CTX EPI 5-FU)化疗50例,分析不同年龄组患者不同化疗方案及剂量与卵巢功能的关系.结果:不同年龄组绝经前乳腺癌妇女在化疗进程中闭经率不同,差异有显著性;含CTX的不同化疗方案对妇女闭经率分别为AC(达81.8%)和CEF(达78.6%),差异无显著性.CTX累积剂量与化疗所致的闭经率呈正相关.结论:提示化疗所致的闭经机制为卵巢的原发性损害;对ER(阳性)或伴PR阳性的绝经前乳腺癌患者在化疗时应选用对卵巢功能破坏较大的药物,或适当增加药物的累积剂量.     

绝经前后妇女性激素水平与血脂和免疫的关系

To investigate the relationship between sex hormone levels and blood lipids/immunity and to evaluate the therapeutical effects of nylestriol, 96 women without coronary heart disease(CHD) were studied during their perimenopausal period. The estimation of serum biochemical components included serum 17 beta-estradiol(E2), testosterone(T), total cholesterol(TC), triglyceride (TC), high density lipoprotein cholesterol(HDL-C), low density protein cholesterol(LDL-C), apolipoprotein A-I(ApoAI), apolipoprotein B(ApoB), lipoprotein (a)[Lp(a)], immunoglobulin G(IgG), and IgG antibody against cardiolipin(ACAIgG). Thirty-six postmenopausal volunteers were divided into two groups and randomized to treat with either 2 mg nylestriol or placebo. In postmenopausal women, serum levels of E2, E2/T, HDL, and ApoAI decreased, while those of T, TC, TG, LDL, ApoB, Lp(a), IgG, and ACAIgG increased. Serum level of E2 was positively correlated to HDL-C and negatively correlated to TC, ApoB, LDL, IgG, and ACAIgG. Serum level of T was positively correlated to LDL, IgG, and ACAIgG and negatively correlated to HDL. In the nylestriol group, as compared with the results before treatment, serum levels of TG, TC, LDL, IgG, and ACAIgG decreased and that of HDL-C increased after treatment. We conclude that estradiol is a protective factor of CHD, whereas testerone is a dangerous factor. After menopause, the imbalance of the estradiol/testosterone ratio increases the incidence of CHD. Nylestriol is an effective substitute for estradiol to prevent CHD in post menopausal women.     

绝经前女性冠心病患者特点分析

目的：探讨绝经前女性冠心病患者的发病特点,为绝经前冠心病防治提供理论依据。方法：回顾性分析2011年1月至2015年7月行冠脉造影诊断为冠心病的绝经前女性患者168例发病特点,找到其发病规律。结果：绝经前女性急性心肌梗死独立相关的危险因素依次是高血压、体重指数、高甘油三酯、冠心病家族史、人格气质类型及吸烟。结论：高血压、体重指数、高甘油三酯、冠心病家族史、人格气质类型、吸烟是绝经前女性急性心肌梗死重要危险因素。     

绝经前乳腺癌35例临床分析

目的探讨绝经前乳腺癌的诊治。方法回顾性分析35例绝经前乳腺癌患者的临床资料。结果35例患者病理结果以浸润性癌为主,共30例,占85．71％,其中浸润性导管癌11例,占31．43％,单纯癌19例,占54．29％;19例有腋下淋巴结转移,占54．28％;2例为妊娠哺乳期癌,35例全部手术,均得到随访。术后3年生存率75．31％,5年生存率52．85％。结论绝经前乳腺癌因雌激素水平高,肿瘤以浸润癌为主,病程长,淋巴结转移率高,肿瘤分期晚,许多患者因手术范围趋小,术后化放疗及内分泌治疗不规范,影响预后。     

绝经前乳腺癌患者月经周期内手术时间选择与预后的关系

乳腺癌是内分泌靶器官肿瘤 ,它的发生、发展及预后与机体性激素水平变化有明显关系 ,因此月经周期雌、孕激素水平的周期性变化可影响肿瘤组织的生长状态。笔者通过观察在月经周期不同阶段手术的８７例乳腺癌患者预后情况 ,以探讨绝经前乳腺癌患者月经周期内手术时机选择与预后的关系。１．１对象１９９０～１９９５年在本院进行乳腺癌手术的绝经前患者８７例 ,将手术时间在月经周期第３～１２天的患者作为卵泡期组 ,共２８例 ;将手术时间在月经周期第０～２天或第１３～３２天的患者作为黄体期组 ,共５９例。两组患者的年龄、病程、临床分期…     

绝经前女性冠心病的临床特点及危险因素分析

目的:探讨绝经前女性冠心病的临床特点及相关危险因素,为女性冠心病的预防和治疗提供依据.方法:回顾性分析2006年1月至2012年6月在我院住院行冠状动脉造影手术明确诊断为冠心病的绝经前女性62例的临床资料,选择同期住院行冠状动脉造影排除冠心病的绝经前女性60例作为对照组,观察其临床特点、主要冠心病危险因素(吸烟、高血压病、2型糖尿病、血脂异常、肥胖、早发冠心病家族史)及血红蛋白、白细胞计数及分类、总胆红素、直接胆红素、空腹血糖、血脂、尿酸、超敏C反应蛋白等与冠心病发病关系.结果:(1)绝经前女性冠心病的临床症状多不典型,冠状动脉造影显示双支及多支病变较多见.(2)与对照组比较,女性冠心病组合并高血压病、2型糖尿病、血脂异常较多(P﹤0.05),空腹血糖、甘油三脂、尿酸、超敏C反应蛋白、白细胞计数、中性粒细胞计数及单核细胞计数较高(P﹤0.05),高密度脂蛋白胆固醇、血红蛋白较低(P﹤0.05).结论:绝经前女性冠心病症状多不典型,冠状动脉病变以双支及多支病变为主.高血压、糖尿病、高脂血症仍是绝经前女性冠心病的主要危险因素,并且与血红蛋白、中性粒细胞计数、单核细胞计数、超敏C反应蛋白相关,提示绝经前女性冠心病的发生可能更多有炎症及免疫机制参与.     

乳腺良恶性疾病患者血清催乳素、雌二醇水平的比较及其临床意义

目的:比较乳腺良恶性疾病患者雌二醇(E2)、催乳素(PRL)的水平,并探讨其临床意义。方法:采用放射免疫法分别测定44例乳腺癌患者术前、术后和17例乳腺良性疾病患者体内PRL、E2水平,并进行比较。结果:乳腺癌患者术后1周PRL均高于乳腺癌术前和术后4～12个月及乳腺良性疾病患者(P<0.01)。乳腺癌术后1周和术后4～12个月E2均低于术前(P<0.05)及乳腺良性疾病患者(P<0.05)。结论:PRL、E2水平升高可能是乳腺癌患者的发病原因之一;手术可使PRL暂时性升高而后下降,使雌激素下降;监测乳腺癌患者手术治疗后的PRL水平可能有助于早期发现乳腺癌复发或转移。     

女性乳腺癌个体危险度评估

目的：建立女性乳腺癌个体危险度评估模型,预测个体乳腺癌发生风险。方法：查阅2009-2011年发表的有关我国女性乳腺癌危险因素的系统评价或大样本的重大项目研究报道,筛选阳性结果变量为研究指标,最终纳入观察的指标包括初潮年龄、初产年龄、流产次数、是否哺乳喂养、绝经年龄、主动/被动吸烟、良性乳腺疾病史、肿瘤家族史、是否服用...     

PRL促进乳腺癌细胞增殖及与microRNA表达谱变化的相关性研究

目的:探讨基于催乳素(prolactin,PRL)反应的人乳腺癌细胞microRNA (miRNA)表达谱变化,以了解其在乳腺癌发生和发展中的潜在作用?方法:人重组PRL处理高表达催乳素受体(PRLR)的人乳腺癌T-47D细胞系,MTT法检测细胞增殖能力变化,流式细胞术检测细胞周期和凋亡变化情况?利用Solexa高通量测序技术检测PRL处理组和未处理组的T-47D细胞 miRNAs表达谱,荧光定量PCR法进行初步验证,同时进行相关的生物信息学分析?结果:PRL作用于T-47D细胞后,MTT结果显示细胞增殖能力增强,细胞周期检测结果表明PRL处理后,G1期的细胞比例减少,S期的细胞比例升高,而G2/M期没有变化?细胞凋亡分析结果则显示PRL可抑制细胞凋亡,导致细胞凋亡率下降?通过Solexa高通量测序技术成功检测了PRL处理和未处理组的人乳腺癌T-47D细胞miRNA表达谱,两组中分别检测到821个和798个miRNAs成熟体,其中428个共表达,42个为两组间明显差异表达?选取的4个miRNAs分子经荧光定量PCR法证实其细胞内的表达与测序结果一致?两组miRNA表达谱中同时也检测到86个和115个novel miRNAs 成熟体,其中46个novel miRNAs在两组细胞中共表达?结论:在初期实验明确PRL对人乳腺癌T-47D细胞产生促增殖作用的基础上,利用Solexa高通量测序技术检测两类T-47D细胞miRNAs表达谱,获得了一系列与PRLR信号通路高度相关的miRNAs分子,为进一步研究miRNAs分子在人乳腺癌发生发展中的作用奠定重要的研究基础?     

Polymorphisms of estrogen-metabolizing genes and breast cancer risk: a multigenic study

Background Endogenous estrogen plays a very important role in the carcinogenesis and progression of breast cancer. The enzymes involved in the biosynthesis and metabolism of estrogen have been proposed to contribute to this effect. To examine this hypothesis, we conducted a case-control study to investigate the relationship between polymorphisms of genes responsible for estrogen biosynthesis (CYP17, cytochrome P450c17a and CYP19, aromatase cytochrome P450) and estrogen sulfation of inactivation (SULT1A1, sulfotransferase1A1) and the risk of breast cancer in Chinese women. Methods This study involved 213 breast cancer patients and 430 matched controls. PCR-based restriction fragment length polymorphism (RFLP) and short tandem repeat polymorphism (STRP) assays were used to detect the mononucleotide transition of CYP17 and SULT1A1 and tandem repeat polymorphism of CYP19. Logistic regression analyses were used to determine OR and 95% CI of each and all three high-risk genotypes, of all three genotypes combined, and of estrogen exposure factors. The relationship between each high-risk genotype and clinicalpathological characteristics were also assessed. Results The frequency of A2 allele of CYP17 was 49.8% in cases and 49.1% in controls (P=0.82). The frequency of His allele of SULT1A1 was significantly higher in cases (13.6%) than in controls (9.5%) (P&lt;0.05). There was also significant difference of the (TTTA)10 allele of CYP19 which was 12.4% in cases and 8.2% in controls (P&lt;0.05). When the CYP17 A2 allele, CYP19 (TTTA)10 and SULT1A1 His allele were considered as the “putative high-risk” genotype, there was an increased risk of breast cancer with the number of high-risk genotypes in a dose-response effect (trend, P=0.05). In multivariate analysis, the SULT1A1 genotype remained the most significant determinant for breast cancer, with OR=2.37 (95% CI 1.23–4.74), followed by CYP19, with OR=1.75 (95% CI 1.27–3.56). The (TTTA)10 allele of CYP19 was associated with tumor size, and the His allele of SULT1A1 associated with status of lymph node metastasis. Conclusions This study supports the hypothesis that breast cancer can be initiated by estrogen exposure and that estrogen metabolizing genes are involved in this mechanism. This multigenic model is useful for identifying individuals who are at higher risks of breast cancer.     

GATA3与乳腺癌发生发展关系的研究进展

GATA3转录因子在正常乳腺的生长分化中起重要作用,与乳腺癌的发生发展也密切相关,GATA3在不同乳腺癌亚型发生中的作用有所不同。本文综述了GATA3与正常乳腺及乳腺癌发生发展关系的研究现状,为今后研究GATA3在乳腺癌中的临床应用提供理论依据。     

雌激素受体基因多态性与乳腺癌的关系

目的：研究雌激素受体α（ESR1）基因单核苷酸多态性（SNPs）与乳腺癌患者临床病理特征和乳腺癌易感性的关系。 方法：运用聚合酶链反应（PCR）和限制性片段长度多态性（RFLP）分析的方法检测193例中国汉族女性乳腺癌患者和71名正常女性对照者ESR1基因上RS2077647位点的基因型,以SPSS 11.0软件卡方检验处理数据。 结果：①RS2077647位点等位基因频率符合Hardy-Weinberg遗传平衡定律;②RS2077647位点的等位基因及基因型与患者年龄、肿瘤大小及PR表达相关,不同年龄组、不同肿瘤大小组和孕激素受体（PR）阴性与阳性组间,RS2077647的等位基因和基因型的频率不同,差异有显著性（P＜0.05）;③RS2077647位点等位基因及基因型频率在乳腺癌人群与正常对照者间分布差异无显著性（P＞0.05）。 结论:RS2077647位点基因的多态性与乳腺癌患者的年龄、肿瘤大小及PR表达相关,与乳腺癌易感性无关。     

乳腺癌危险因素分析

目的调查分析乳腺癌危险因素,为制定预防措施提供科学依据。方法7518例乳腺钼靶X线受检者中232例经病理证实的乳腺癌患者与对照组1:1配对进行病例对照研究,统计分析其月经生育史、乳腺良性疾病史、肿瘤家族史与乳腺癌关系。结果月经初潮年龄、第一胎生育年龄与乳腺癌发生无显著相关;流产次数增多,乳腺癌危险性增加;良性乳腺疾病史、肿瘤家族史与乳腺癌正相关;而哺乳则与乳腺癌负相关。结论乳腺癌发病重要危险因素为良性乳腺疾病史、肿瘤家族史及流产次数多。     

Adipocytokines and breast cancer risk

Background Many researches suggested that obesity increased the risk of breast cancer, but the mechanism was currently unknown. Adipocytokines might mediate the relationship. Our study was aimed to investigate the relationship between serum levels of resistin, adiponectin and leptin and the onset, invasion and metastasis of breast cancer. Methods Blood samples were collected from 80 newly diagnosed, histologically confirmed breast cancer patients and 50 age-matched healthy controls. Serum levels of resistin, adiponectin and leptin were determined by enzyme-linked immunosorbent assays (ELISA); fasting blood glucose (FBG), lipids, body mass index (BMI), and waist circumference (WC) were assayed simultaneously.Results Serum levels of adiponectin ((8.60±2.92) mg/L vs (10.37±2.81) mg/L, P=0.001) and HDL-c were significantly decreased in breast cancer patients in comparison to controls. Serum levels of resistin ((26.35±5.36) μg/L vs (23.32±4.75) μg/L, P=0.000), leptin ((1.35±0.42) μg/L vs (1.06±0.39) μg/L, P=0.003), FBG and triglyceride (TG) in breast cancer patients were increased in contrast to controls, respectively. However, we did not find the significant difference of the serum levels of resistin, adiponectin and leptin between premenopausal breast cancer patients and healthy controls (P＝0.091, 0.109 and 0.084, respectively). The serum levels of resistin, adiponectin and leptin were significantly different between patients with lymph node metastasis (LNM) and those without LNM (P=0.001, 0.000 and 0.006, respectively). The stepwise regression analysis indicated that the tumor size had the close correlation with leptin (R(2)=0.414, P=0.000) and FBG (R(2)=0.602, P=0.000). Logistic regression analysis showed that reduced serum levels of adiponectin (OR: 0.805; 95%CI: 0.704–0.921; P＝0.001), HDL (OR: 0.087; 95%CI: 0.011–0.691, P＝0.021), elevated leptin (OR: 2.235; 95%CI:1.898–4.526; P＝0.004) and resistin (OR: 1.335; 95%CI: 1.114–2.354; P＝0.012) increased the risk for breast cancer; Reduced serum levels of adiponectin (OR: 0.742; 95%CI: 0.504–0.921; P=0.003) and elevated leptin (OR: 2.134; 95%CI:1.725–3.921; P= 0.001) were associated with lymph node metastasis of breast cancer. Conclusions The decreased serum adiponectin levels and increased serum resistin and leptin levels are risk factors of breast cancer. The low serum adiponectin levels and high serum leptin levels are independent risk factors for metastasis of cancer. The association between obesity and breast cancer risk might be explained by adipocytokines.     

卵巢功能抑制联合芳香化酶抑制剂或他莫昔芬治疗绝经前HR阳性乳腺癌的研究进展

绝经前激素受体(hormone receptor,HR)阳性乳腺癌的辅助内分泌治疗是近年的热点问题.绝经前HR阳性乳腺癌的内分泌治疗包括选择性雌激素受体调节剂(selective estrogen receptor modulator,SERM),例如他莫昔芬(tamoxifen,T AM);卵巢功能抑制(ovaria...     

微量元素与乳腺肿瘤关系的分析及其临床意义

目的：探讨部分微量元素与乳腺肿瘤的关系。方法：采用原子吸收分光光度计对100例健康女性志愿者血清，91例乳腺良性肿瘤和86例乳腺癌患者手术前后血清，肿瘤组织及非病变组织中Cu,Zn,Fe,Mg,Ca等5种微量元素的含量进行测定。结果：3组的血清及肿瘤组织中微量元素有显著差异，乳癌组血清，肿瘤组织中Cu,Fe比值明显高于良性瘤组，健康对照组和非病变组织（P＜0．05），而Zn,Mg,Ca水平则明显低于良组，健康对照组和非病变组织（P＜0．05）。结论：结果提示Zn,Mg,Ca可能是乳癌保护因素，而Cu,Fe为危险因素。