北京市女性乳腺癌危险因素与乳腺癌相关性的探讨  

Relation between breast cancer and risk factors in Beijing women

作　　者：杜铁桥[1] 王永利[1] 于盛会[1] 张超[1] 闫羽翔[2] 王军[1] 桑春玉[1] 丁宝枝[1] 

机构地区：[1]首都医科大学附属复兴医院放射科,北京100038 [2]首都医科大学流行病与卫生统计学系,北京100069

出　　处：《中华肿瘤防治杂志》2010年第1期5-8,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:探讨北京女性年龄、危险因素及内源性类固醇性激素与乳腺癌的关系,以及性激素与乳腺密度的关系。方法:随机选取493例北京市女性,年龄25～76岁,中位年龄44岁。分为≤40岁组(165名)、>40岁组(242名)和绝经后组(86名)。对全体受检者进行问卷调查及危险因素统计,行数字化乳腺X射线检查,并用半定量方法计算乳腺密度百分比,检测血浆雌二醇和孕酮水平。结果:乳腺癌及良性病变的检出率分别是1.2%和7.3%。除去乳腺癌患者,共有危险因素者146名。绝经后组有危险因素组的乳腺密度显著高于无危险因素组,P<0.05。绝经后组乳腺密度与雌二醇及孕酮之间存在轻度正相关(r=0.315,P=0.003;r=0.256,P=0.017)。多远逻辑回归分析显示,乳腺癌检出率随着年龄及危险因素呈递增趋势(χ2=5.7,P=0.017;χ2=4.7,P=0.03)。乳腺癌检出率在高年龄组是低年龄组的4.2倍,有危险因素组是无危险因素组的4.9倍。结论:乳腺癌检出率随年龄增长上升,有危险因素者检出率高于无危险因素者。绝经后组有危险因素女性的乳腺密度显著高于同龄的无危险因素者。乳腺密度应作为乳腺癌普查的观察指标。OBJECTIVE：To observe the relation between ages,risk factors and endogenous sex steroid hormones of Beijing women and the breast cancer as well as endogenous sex steroid hormones and mammographic density. METHODS：There were 493 women,age range was 25-76 years old （median age 44）. Subjects of ≤40 years,〉40 years and postmenopausal were 165,242 and 86,respectively. The subjects were conducted questionnaire for statistics of risk factor,mammography in order to calculate the percentage of mammographic density by semi-quantitative method and detection of plasma estradiol and progesterone. RESULTS：The detection rate of breast cancer and benign lesion in the group were 1.2% and 7.3%,respectively. There were 146 subjects with risk factors in the group excluding cases with breast cancer. Mammographic density of postmenopausal group with risk-factor was significantly higher than that of group with no-risk-factor（P〈0.05）. A mild positive correlation between mammographic density and plasma levels of estradiol（r=0.315,P=0.003）and progesterone（r=0.256,P=0.017）in postmenopausal group was observed. Multinomial logistic regressive analysis displayed that the detection rate of breast cancer trended increasing with age （χ^2=5.7,P=0.017） and risk factor （χ^2=4.7,P=0.03）. The detection rate of breast cancer was 4.2 times in older age group compared with that of the younger age group and 4.9 times in group with risk factors compared with that of no-risk factors. CONCLUSIONS：The detection rate of breast cancer is increasing with age,and the detection rate in group with risk-factor is higher than that of non-risk-factor group. The mammographic density of women with risk-factor in postmenopausal period is higher than that of age cohorts without the risk factors. Mammographic density should become a monitoring indicator for breast screening.

关 键 词：乳腺肿瘤/流行病学 北京/流行病学 普查 乳腺肿瘤/放射摄影术 危险因素 

分 类 号：R737.9[医药卫生—肿瘤]