JAMA:绝经后激素干预对女性乳腺癌发病率及死亡率的影响

2020-07-29 MedSci原创 MedSci原创

长期随访发现,对于子宫切除的绝经后女性,接受结合雌激素可降低乳腺癌发病率和死亡率,但对于保留子宫的参与者,激素干预会增加乳腺癌发病率

近日研究人员考察了绝经期激素治疗对乳腺癌发病率和死亡率的影响。
 
本次长期随访对照随机临床试验,涉及27347名年龄在50岁至79岁之间的绝经后女性,参与者既往无乳腺癌史,基线乳腺癌X光片筛查呈阴性。参与者招募从1993年到1998年,随访到2017年12月31日。对于16608名子宫未切除的参与者,8506人随机接受0.625mg/天的结合雌激素(CEE)联合2.5mg/天的醋酸甲羟孕酮(MPA),8102接受安慰剂。在10739名子宫切除术患者中,5310人接受0.625毫mg/天的CEE单独治疗,5429人接受安慰剂。CEE+ MPA激素干预的中位持续时间为5.6年, CEE单药干预的中位持续时间为7.2年。研究的主要结果是乳腺癌发病率,次要结果是乳腺癌死亡。
 
参与者基线平均年龄63.4岁。在10739名子宫切除参与者中,与安慰剂相比,单纯的CEE治疗与乳腺癌发病率降低相关:238例(年化率为0.30%)vs296例(年化率为0.37%;危险比[HR]为0.78),且与乳腺癌死亡率降低相关:30例死亡(年化死亡率为0.031%)vs 46例死亡(年死亡率为0.046%;HR:0.60)。相比之下,对于16608名子宫未切除的女性,与安慰剂相,CEE+MPA治疗导致乳腺癌发病率显著增高,584例(年化率为0.45%)vs 447例(年化率为0.36%;HR:1.28),但与乳腺癌死亡率无显著相关:71例(年化死亡率0.045%)vs 53例死亡(年死亡率0.035%;HR,1.35)。
 
长期随访发现,对于子宫切除的绝经后女性,接受结合雌激素可降低乳腺癌发病率和死亡率,但对于保留子宫的参与者,结合雌激素联合醋酸甲羟孕酮激素干预会增加乳腺癌发病率。
 
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    2020-07-31 ms3000000449926787

    学习

    0

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    2020-07-31 zxxiang
  8. [GetPortalCommentsPageByObjectIdResponse(id=1823654, encodeId=4ae1182365499, content=<a href='/topic/show?id=b2873e9220e' target=_blank style='color:#2F92EE;'>#发病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37922, encryptionId=b2873e9220e, topicName=发病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa0e14, createdName=lifestar, createdTime=Tue Dec 29 18:17:06 CST 2020, time=2020-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2079281, encodeId=937020e928170, content=<a href='/topic/show?id=659ce1280ee' target=_blank style='color:#2F92EE;'>#癌发病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71280, encryptionId=659ce1280ee, topicName=癌发病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1777154, createdName=chenhongpeng, createdTime=Sat Jul 10 13:17:06 CST 2021, time=2021-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1984218, encodeId=53071984218ba, content=<a href='/topic/show?id=5445e889395' target=_blank style='color:#2F92EE;'>#绝经后激素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78893, encryptionId=5445e889395, topicName=绝经后激素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c8f4467, createdName=AspirantSuo, createdTime=Fri Oct 16 15:17:06 CST 2020, time=2020-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1799881, encodeId=6adc1e9988193, content=<a href='/topic/show?id=9e3fe127909' target=_blank style='color:#2F92EE;'>#癌发病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71279, encryptionId=9e3fe127909, topicName=癌发病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2c92500045, createdName=12498636m49(暂无昵称), createdTime=Sun Oct 18 23:17:06 CST 2020, time=2020-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=805380, encodeId=3e438053803a, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f435296195, createdName=ms3000000449926787, createdTime=Fri Jul 31 14:58:11 CST 2020, time=2020-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1257250, encodeId=a865125e25021, content=<a href='/topic/show?id=cdfce8879b1' target=_blank style='color:#2F92EE;'>#绝经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78879, encryptionId=cdfce8879b1, topicName=绝经)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=yeye5224612, createdTime=Fri Jul 31 10:17:06 CST 2020, time=2020-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1631634, encodeId=128e1631634b1, content=<a href='/topic/show?id=6395e888343' target=_blank style='color:#2F92EE;'>#绝经后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78883, encryptionId=6395e888343, topicName=绝经后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=32b921798518, createdName=zxxiang, createdTime=Fri Jul 31 10:17:06 CST 2020, time=2020-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036197, encodeId=b5b5103619e9c, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Wed Jul 29 22:17:06 CST 2020, time=2020-07-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=805106, encodeId=e7f680510626, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b972455532, createdName=1240394fm61暂无昵称, createdTime=Wed Jul 29 21:15:46 CST 2020, time=2020-07-29, status=1, ipAttribution=)]
    2020-07-29 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1823654, encodeId=4ae1182365499, content=<a href='/topic/show?id=b2873e9220e' target=_blank style='color:#2F92EE;'>#发病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37922, encryptionId=b2873e9220e, topicName=发病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa0e14, createdName=lifestar, createdTime=Tue Dec 29 18:17:06 CST 2020, time=2020-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2079281, encodeId=937020e928170, content=<a href='/topic/show?id=659ce1280ee' target=_blank style='color:#2F92EE;'>#癌发病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71280, encryptionId=659ce1280ee, topicName=癌发病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1777154, createdName=chenhongpeng, createdTime=Sat Jul 10 13:17:06 CST 2021, time=2021-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1984218, encodeId=53071984218ba, content=<a href='/topic/show?id=5445e889395' target=_blank style='color:#2F92EE;'>#绝经后激素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78893, encryptionId=5445e889395, topicName=绝经后激素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c8f4467, createdName=AspirantSuo, createdTime=Fri Oct 16 15:17:06 CST 2020, time=2020-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1799881, encodeId=6adc1e9988193, content=<a href='/topic/show?id=9e3fe127909' target=_blank style='color:#2F92EE;'>#癌发病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71279, encryptionId=9e3fe127909, topicName=癌发病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2c92500045, createdName=12498636m49(暂无昵称), createdTime=Sun Oct 18 23:17:06 CST 2020, time=2020-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=805380, encodeId=3e438053803a, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f435296195, createdName=ms3000000449926787, createdTime=Fri Jul 31 14:58:11 CST 2020, time=2020-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1257250, encodeId=a865125e25021, content=<a href='/topic/show?id=cdfce8879b1' target=_blank style='color:#2F92EE;'>#绝经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78879, encryptionId=cdfce8879b1, topicName=绝经)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=yeye5224612, createdTime=Fri Jul 31 10:17:06 CST 2020, time=2020-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1631634, encodeId=128e1631634b1, content=<a href='/topic/show?id=6395e888343' target=_blank style='color:#2F92EE;'>#绝经后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78883, encryptionId=6395e888343, topicName=绝经后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=32b921798518, createdName=zxxiang, createdTime=Fri Jul 31 10:17:06 CST 2020, time=2020-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036197, encodeId=b5b5103619e9c, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Wed Jul 29 22:17:06 CST 2020, time=2020-07-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=805106, encodeId=e7f680510626, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b972455532, createdName=1240394fm61暂无昵称, createdTime=Wed Jul 29 21:15:46 CST 2020, time=2020-07-29, status=1, ipAttribution=)]
    2020-07-29 1240394fm61暂无昵称

    学习了

    0

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