雌激素和乳腺癌的作用
J Kim1, P N Munster2
1Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, USA.
概括
孕激素,而不是雌激素,是激素相关乳腺癌风险的主要驱动因素. 雌激素疗法单独可以为更年期妇女和幸存者提供好处,而孕激素是关键的危险因素.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 妇女健康 妇女健康
背景情况:
- 雌激素传统上与乳腺癌风险增加有关.
- 新兴证据表明孕激素 (孕激素或孕激素) 是乳腺癌风险的主要激素驱动因素.
- 雌激素可能通过对孕激素受体进行上调来间接增加风险.
研究的目的:
- 重新评估雌激素与孕激素在乳腺癌风险中的作用.
- 评估雌激素单独的激素替代疗法 (HRT) 的安全性和益处.
- 探索雌激素在特定环境中的影响,如辅助生殖技术 (ART) 和BRCA1/2载体.
主要方法:
- 审查大型临床研究,包括使用激素避孕药和妇女健康倡议 (WHI) 试验.
- 对荷尔蒙信号通路的实验证据的分析.
- 对辅助生殖技术 (ART) 和抗雌激素疗法数据的检查.
主要成果:
- 激素避孕药的乳腺癌风险主要与孕激素有关,而不是雌激素.
- 雌激素加孕激素HRT增加乳腺癌风险;雌激素单独HRT显示最小的影响或潜在益处.
- 在WHI试验中,仅用雌激素的HRT表明了益处.
- 在ART期间的雌激素对乳腺癌风险的影响很小.
- 抑制孕激素信号传递是抗雌激素疗效的关键.
结论:
- 孕激素是乳腺癌风险的主要激素驱动因素,而不是雌激素.
- 雌激素单独的HRT对更年期妇女有好处,对乳腺癌幸存者和年轻的BRCA1/2携带者可能有好处.
- 雌激素治疗,特别是没有孕激素的治疗,可能对各种女性健康方面有好处.
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