通過(guò)測(cè)量一名婦女的骨密度,，可以提供額外的信息，從而更準(zhǔn)確地判定該名婦女罹患乳腺癌的風(fēng)險(xiǎn),。這是即將于9月1日在美國(guó)癌癥學(xué)會(huì)期刊《癌癥》（Cancer）上發(fā)表的一項(xiàng)最新研究得出的結(jié)論,。該項(xiàng)研究認(rèn)為，在當(dāng)前的風(fēng)險(xiǎn)評(píng)估中納入骨密度測(cè)試,，也許可顯著提高醫(yī)生預(yù)測(cè)絕經(jīng)后中老年婦女罹患乳腺癌風(fēng)險(xiǎn)的能力,。
骨密度測(cè)試用于骨質(zhì)疏松癥診斷，并可幫助評(píng)估骨折風(fēng)險(xiǎn),。骨密度低一般與較高的骨折風(fēng)險(xiǎn)密切相關(guān),，而正常的骨密度也意味著較低的骨折風(fēng)險(xiǎn)。女人一生中,，因?yàn)樵斐筛吖敲芏鹊募に睾推渌蛩?，而?dǎo)致罹患乳腺癌的更高風(fēng)險(xiǎn)是可能的。研究發(fā)現(xiàn),，在高骨密度和高乳腺癌風(fēng)險(xiǎn)間存在關(guān)聯(lián),，因此骨密度測(cè)試被提議作為乳腺癌風(fēng)險(xiǎn)模型的附加內(nèi)容。在美國(guó)禮來(lái)公司的支持下,，該研究首先調(diào)查了骨密度,、傳統(tǒng)乳腺癌評(píng)估工具的結(jié)果及同一組絕經(jīng)后婦女的乳腺癌發(fā)病率這幾者之間的關(guān)系。
為了調(diào)查這些關(guān)系,，美國(guó)亞利桑那大學(xué)公共衛(wèi)生學(xué)院趙晨（音譯）博士及其同事對(duì)參與“婦女健康倡議”的近10000名絕經(jīng)后婦女（平均年齡為63歲）進(jìn)行了研究,，“婦女健康倡議”由美國(guó)國(guó)立衛(wèi)生院心臟、肺和血液研究所贊助,，在全美40個(gè)臨床中心進(jìn)行,。研究人員評(píng)估了這些婦女的初始骨密度水平及蓋爾（Gail）風(fēng)險(xiǎn)模型系數(shù)。蓋爾風(fēng)險(xiǎn)模型是一個(gè)用來(lái)預(yù)估35歲及以上年齡婦女罹患侵入性乳腺癌后5年預(yù)后壽命的常用工具,。隨后,，他們對(duì)這些婦女進(jìn)行了平均約8年的跟蹤調(diào)查，觀(guān)察哪些婦女最后發(fā)展成乳腺癌,。
研究發(fā)現(xiàn),，具有高蓋爾系數(shù)的婦女與低蓋爾系數(shù)的婦女相比，罹患乳腺癌的風(fēng)險(xiǎn)要高35%,。研究還發(fā)現(xiàn),，總的髖部骨密度T值每增加一個(gè)單位,，發(fā)展成乳腺癌的風(fēng)險(xiǎn)就增加25%。而上述兩個(gè)值是相互獨(dú)立的,，那些兩個(gè)評(píng)估分值都很高的婦女罹患乳腺癌的風(fēng)險(xiǎn)就要高得多,。
調(diào)查結(jié)果顯示，在目前采用的風(fēng)險(xiǎn)評(píng)估工具中增加骨密度測(cè)試,，可顯著改進(jìn)乳腺癌的風(fēng)險(xiǎn)預(yù)測(cè),。研究人員表示，未來(lái)的研究中將調(diào)查是否將骨密度和蓋爾系數(shù)與其他風(fēng)險(xiǎn)因子一起納入,，如乳腺密度,，這將能進(jìn)一步提高識(shí)別婦女罹患乳腺癌高風(fēng)險(xiǎn)的能力。（生物谷Bioon.com）
生物谷推薦原始出處：
Cancer,，doi：10.1002/cncr.23674,，Zhao Chen，Rowan Chlebowski
Hip bone density predicts breast cancer risk independently of Gail score
Zhao Chen, PhD, MPH 1 *§, Leslie Arendell, MS 1, Mikel Aickin, PhD 2, Jane Cauley, PhD 3, Cora E. Lewis, MD, MSPH 4, Rowan Chlebowski, MD, PhD 5¶
1Division of Epidemiology and Biostatistics, University of Arizona College of Public Health, Tucson, Arizona
2Department of Family and Community Medicine, University of Arizona, Tucson, Arizona
3Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
4Division of Preventive Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama
5Los Angeles Biomedical Research Institute at Harbor-University of California at Los Angeles Medical Center (LABioMed), Torrance, California
Abstract
BACKGROUND.
The Gail model has been commonly used to estimate a woman's risk of breast cancer within a certain time period. High bone mineral density (BMD) is also a significant risk factor for breast cancer, but it appears to play no role in the Gail model. The objective of the current study was to investigate whether hip BMD predicts postmenopausal breast cancer risk independently of the Gail score.
METHODS.
In this prospective study, 9941 postmenopausal women who had a baseline hip BMD and Gail score from the Women's Health Initiative were included in the analysis. Their average age was 63.0 ± 7.4 years at baseline.
RESULTS.
After an average of 8.43 years of follow-up, 327 incident breast cancer cases were reported and adjudicated. In a multivariate Cox proportional hazards model, the hazards ratios (95% confidence interval [95% CI]) for incident breast cancer were 1.35 (95% CI, 1.05-1.73) for high Gail score (1.67%) and 1.25 (95% CI, 1.11-1.40) for each unit of increase in the total hip BMD T-score. Restricting the analysis to women with both BMD and a Gail score above the median, a sharp increase in incident breast cancer for women with the highest BMD and Gail scores was found (P < .05).
CONCLUSIONS.
The contribution of BMD to the prediction of incident postmenopausal breast cancer across the entire population was found to be independent of the Gail score. However, among women with both high BMD and a high Gail score, there appears to be an interaction between these 2 factors. These findings suggest that BMD and Gail score may be used together to better quantify the risk of breast cancer. Cancer 2008. © 2008 American Cancer Society.
