更年期荷尔蒙治疗和乳腺癌之间的关系:全国性基于人口的队列研究
1Department of Obstetrics and Gynecology, Sanggye Paik Hospital, School of Medicine, Inje University, Seoul, Republic of Korea.
概括
更年期激素治疗 (MHT) 增加了乳腺癌的风险,特别是某些结合疗法,如雌二醇半酸/德罗斯皮伦. 在这项研究中,单独的雌激素和tibolone并没有显示增加风险.
科学领域:
- 生殖医学 生殖医学
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 更年期激素治疗 (MHT) 被广泛用于管理更年期症状.
- 了解与不同MHT配方相关的各种风险,特别是关于乳腺癌的风险,对于患者的安全至关重要.
- 孕激素是联合MHT的关键成分,对乳腺组织有不同的影响.
研究的目的:
- 调查更年期激素治疗 (MHT) 使用与乳腺癌风险之间的关联.
- 为了区分各种MHT配方的乳腺癌风险概况,包括不同的孕激素.
- 为了确定可能提高乳腺癌风险的特定MHT组合.
主要方法:
- 一项大规模的回顾性队列研究,使用韩国国家医疗保险数据库数据 (2011-2014).
- 包括40岁以上的绝经后妇女,倾向性得分匹配,以比较MHT使用者 (≥6个月) 和非使用者.
- 随访到2020年,使用Cox比例危险分析来评估乳腺癌风险.
主要成果:
- 总体而言,使用MHT与乳腺癌风险增加22%有关 (HR1.22,95% CI 1.15-1.3).
- 特定的联合疗法显示显著增加风险:雌二醇半酸/德罗斯皮伦 (EH/DRSP) (HR 1.51),EH/诺列酸 (EH/NETA) (HR 1.66),EH/二esterone (EH/DYD) (HR 1.37) 和雌二酸/cyproterone酸 (EV/CPA) (HR 1.74).
- 仅用雌激素治疗,提博隆和其他几种联合MHTs并没有显示乳腺癌风险增加.
结论:
- 更年期激素治疗 (MHT) 与乳腺癌的整体风险增加有关.
- 某些MHT组合,特别是那些与特异性孕激素 (如多司匹伦,NETA,DYD和CPA) 结合的组合,与更高的风险有关.
- 仅含雌激素的配方和tibolone似乎在这个人群中具有中性或较低的乳腺癌风险概况.
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