有些更年期或絕經(jīng)后婦女會(huì)選擇服用雌激素和孕激素，來緩解這一時(shí)期體內(nèi)激素不足所產(chǎn)生的不適癥狀,。不過,，美國一項(xiàng)最新研究顯示，這種激素替代療法會(huì)增加?jì)D女患肺癌的風(fēng)險(xiǎn),。
美國加利福尼亞大學(xué)洛杉磯分校研究人員在9月刊的英國《柳葉刀》雜志上報(bào)告說,，他們對(duì)超過1．6萬名50歲至79歲絕經(jīng)后婦女的醫(yī)療數(shù)據(jù)進(jìn)行分析后，得出了上述結(jié)論,。這些婦女在參加一項(xiàng)健康調(diào)查期間,，被隨機(jī)分組，一組服用雌激素和孕激素的混合激素,，一組服用安慰劑,。在調(diào)查開始之前，這些婦女都沒有患肺癌,。
調(diào)查結(jié)果顯示,，8年之后，激素組有73名婦女患肺癌死亡,，而安慰劑組有40人死于肺癌,。研究人員因此認(rèn)為，選擇激素替代療法的婦女死于肺癌的風(fēng)險(xiǎn)大大高于不采用此療法的婦女,。
研究人員建議，在采取激素替代療法之前,，婦女應(yīng)該認(rèn)真權(quán)衡利弊,。尤其對(duì)于吸煙婦女或者曾經(jīng)有過長期吸煙史的婦女來說，更應(yīng)慎重行事,。（生物谷Bioon.com）
生物谷推薦原始出處：
The Lancet doi:10.1016/S0140-6736(09)61526-9
Oestrogen plus progestin and lung cancer in postmenopausal women (Women's Health Initiative trial): a post-hoc analysis of a randomised controlled trial
Prof Rowan T Chlebowski MDa, , , Prof Ann G Schwartz PhDb, Heather Wakelee MDc, Garnet L Anderson PhDd, Prof Marcia L Stefanick PhDc, Prof JoAnn E Manson MDe, Rebecca J Rodabough MSd, Jason W Chien MDd, Prof Jean Wactawski-Wende PhDf, Margery Gass MDg, Prof Jane Morley Kotchen MDh, Prof Karen C Johnson MDi, Prof Mary Jo O'Sullivan MDj, Prof Judith K Ockene PhDk, Prof Chu Chen PhDd, Prof F Allan Hubbell MDl and for the Women's Health Initiative Investigators
aLos Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
bDepartment of Internal Medicine, Karmanos Cancer Institute, Detroit, MI, USA
cDepartment of Medicine, Stanford University, Palo Alto, CA, USA
dFred Hutchinson Cancer Research Center, Seattle, WA, USA
eDepartment of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
fDepartment of Social and Preventive Medicine, State University of New York, Buffalo, NY, USA
gUniversity of Cincinnati, Cincinnati, OH, USA
hDepartment of Population Health, Medical College of Wisconsin, Milwaukee, WI, USA
iDepartment of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
jDepartment of Obstetrics and Gynecology, University of Miami, Miami, FL, USA
kDepartment of Medicine, University of Massachusetts, Fallon Clinic, Worcester, MA, USA
lDepartment of Medicine, University of California, Irvine, CA, USA
Background
In the post-intervention period of the Women's Health Initiative (WHI) trial, women assigned to treatment with oestrogen plus progestin had a higher risk of cancer than did those assigned to placebo. Results also suggested that the combined hormone therapy might increase mortality from lung cancer. To assess whether such an association exists, we undertook a post-hoc analysis of lung cancers diagnosed in the trial over the entire follow-up period.
Methods
The WHI study was a randomised, double-blind, placebo-controlled trial undertaken in 40 centres in the USA. 16 608 postmenopausal women aged 50–79 years with an intact uterus were randomly assigned by a computerised, stratified, permuted block algorithm to receive a once-daily tablet of 0·625 mg conjugated equine oestrogen plus 2·5 mg medroxyprogesterone acetate (n=8506) or matching placebo (n=8102). We assessed incidence and mortality rates for all lung cancer, small-cell lung cancer, and non-small-cell lung cancer by use of data from treatment and post-intervention follow-up periods. Analysis was by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00000611.
Findings
After a mean of 5·6 years (SD 1·3) of treatment and 2·4 years (0·4) of additional follow-up, 109 women in the combined hormone therapy group had been diagnosed with lung cancercompared with 85 in the placebo group (incidence per year 0·16% vs 0·13%; hazard ratio [HR] 1·23, 95% CI 0·92–1·63, p=0·16). 96 women assigned to combined therapy had non-small-cell lung cancer compared with 72 assigned to placebo (0·14% vs 0·11%; HR 1·28, 0·94–1·73, p=0·12). More women died from lung cancer in the combined hormone therapy group than in the placebo group (73 vs 40 deaths; 0·11% vs 0·06%; HR 1·71, 1·16–2·52, p=0·01), mainly as a result of a higher number of deaths from non-small-cell lung cancer in the combined therapy group (62 vs 31 deaths; 0·09% vs 0·05%; HR 1·87, 1·22–2·88, p=0·004). Incidence and mortality rates of small-cell lung cancer were similar between groups.
Interpretation
Although treatment with oestrogen plus progestin in postmenopausal women did not increase incidence of lung cancer, it increased the number of deaths from lung cancer, in particular deaths from non-small-cell lung cancer. These findings should be incorporated into risk–benefit discussions with women considering combined hormone therapy, especially those with a high risk of lung cancer.
Funding
National Heart, Lung and Blood Institute, National Institutes of Health.
