據(jù)英國(guó)媒體25日?qǐng)?bào)道,，研究人員在經(jīng)過真對(duì)挪威女性患乳腺癌幾率的調(diào)查之后,，近日提出爭(zhēng)議性觀點(diǎn)：部分乳腺癌可能會(huì)自動(dòng)痊愈,；有一些乳房X光造影檢查下的腫瘤如果未被查出來,，也許本來就有可能自動(dòng)消失,。此項(xiàng)研究結(jié)果刊登在最新一期的《內(nèi)科學(xué)文獻(xiàn)集》上,。
乳腺癌是女性最常見的惡性腫瘤之一，它會(huì)嚴(yán)重影響婦女身心健康甚至危及生命,。據(jù)資料統(tǒng)計(jì),，發(fā)病率占全身各種惡性腫瘤的7-10%，對(duì)婦女來講僅次于子宮癌,。它的發(fā)病常與遺傳有關(guān),，在40—60歲之間、絕經(jīng)期前后的婦女發(fā)病率較高,。
但是,，癌癥專家對(duì)此觀點(diǎn)表示懷疑，并敦促女性繼續(xù)接受常規(guī)的乳房X光造影檢查,，稱該技術(shù)可以幫助及早發(fā)現(xiàn)乳腺癌,，趕上最佳治療時(shí)間。乳腺細(xì)胞發(fā)生突變后便喪失了正常細(xì)胞的特性,，組織結(jié)構(gòu)紊亂,、細(xì)胞連接松散；癌細(xì)胞很容易脫落游離,，隨血液或淋巴液等播散全身,，形成早期的遠(yuǎn)端轉(zhuǎn)移，這給乳腺癌的臨床治愈增加了很大的困難。
挪威奧斯陸公共衛(wèi)生研究所漢瑞克-扎爾醫(yī)師及其美國(guó)同事對(duì)近12萬名年齡在50-64歲,、婦女患上侵入性乳腺癌的幾率進(jìn)行了跟蹤研究,。這12萬名女性每?jī)赡杲邮芤淮稳榉縓光造影檢查，這種習(xí)慣持續(xù)6年,。另一組年齡相仿,、背景相似的11萬挪威女性之中，研究人員只在第6年年底對(duì)她們進(jìn)行檢查,；然后將兩組人群的數(shù)據(jù)加以對(duì)比,。
研究人員表示，他們?cè)疽詾?，兩組人群患癌幾率不會(huì)有所不同,。但事實(shí)上卻是，在兩年接受一次乳房X光造影檢查的人群患侵入性乳腺癌的幾率比另一組人群高22%,。扎爾表示,，這一發(fā)現(xiàn)顯示了某些腫瘤會(huì)自動(dòng)消失的可能，但目前還無法對(duì)此做出生物學(xué)解釋,。
扎爾在電話采訪中說：“我們首次發(fā)表了這種理論,，我們認(rèn)為，有很多腫瘤可能已經(jīng)自動(dòng)消失,，因而在之后的檢查中沒有再查出,。但現(xiàn)在，我并無法從生物學(xué)角度解釋這一問題,。”（生物谷Bioon.com）
生物谷推薦原始出處：
Arch Intern Med. 2008;168(21):2311-2316.
The Natural History of Invasive Breast Cancers Detected by Screening Mammography
Per-Henrik Zahl, MD, PhD; Jan M?hlen, MD, PhD; H. Gilbert Welch, MD, MPH
Background The introduction of screening mammography has been associated with sustained increases in breast cancer incidence. The natural history of these screen-detected cancers is not well understood.
Methods We compared cumulative breast cancer incidence in age-matched cohorts of women residing in 4 Norwegian counties before and after the initiation of biennial mammography. The screened group included all women who were invited for all 3 rounds of screening during the period 1996 through 2001 (age range in 1996, 50-64 years). The control group included all women who would have been invited for screening had there been a screening program during the period 1992 through 1997 (age range in 1992, 50-64 years). All women in the control group were invited to undergo a 1-time prevalence screen at the end of their observation period. Screening attendance was similar in both groups (screened, 78.3%, and controls, 79.5%). Counts of incident invasive breast cancers were obtained from the Norwegian Cancer Registry (in situ cancers were excluded).
Results As expected, before the age-matched controls were invited to be screened at the end of their observation period, the cumulative incidence of invasive breast cancer was significantly higher in the screened group than in the controls (4-year cumulative incidence: 1268 vs 810 per 100 000 population; relative rate, 1.57; 95% confidence interval, 1.44-1.70). Even after prevalence screening in controls, however, the cumulative incidence of invasive breast cancer remained 22% higher in the screened group (6-year cumulative incidence: 1909 vs 1564 per 100 000 population; relative rate, 1.22; 95% confidence interval, 1.16-1.30). Higher incidence was observed in screened women at each year of age.
Conclusions Because the cumulative incidence among controls never reached that of the screened group, it appears that some breast cancers detected by repeated mammographic screening would not persist to be detectable by a single mammogram at the end of 6 years. This raises the possibility that the natural course of some screen-detected invasive breast cancers is to spontaneously regress.
Author Affiliations: Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway (Dr Zahl); Department of Pathology, Ullev?l University Hospital, Oslo (Dr M?hlen); and the VA Outcomes Group, Department of Veterans Affairs Medical Center, White River Junction, Vermont, and the Dartmouth Institute for Health Policy and Clinical Practice, Hanover, New Hampshire (Dr Welch).
