ISSN:0959-8278    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0959-8278    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Epidemiological evidence implicating anthropometric risk factors in breast cancer aetiology is accumulating. For premenopausal women, breast cancer risk increases with increasing height, but decreases with higher weight or body mass index, and no association with increased central adiposity exists. For postmenopausal women, an increased risk of breast cancer is found with increasing levels of all the anthropometric variables including height, weight, body mass index, waist–hip ratio, waist circumference and weight gain. Weight loss appears to decrease risk, particularly if it occurs later in life. Breast size may be a risk factor for breast cancer, however, the current evidence is inconclusive. Several hypothesized biologic mechanisms exist to explain how anthropometric factors influence breast cancer risk. Obesity may increase levels of circulating endogenous sex hormones, insulin and insulin‐like growth factors that all, in turn, increase breast cancer risk. Genetic predisposition to obesity and to specific body fat distributions are also implicated. With obesity, there are increased levels of fat tissue that can store toxins and can serve as a continuous source of carcinogens. Recommendations for future research on anthropometric factors and breast cancer are provided. Sufficient evidence exists to support strategies to avoid weight gain throughout life as a means of reducing postmenopausal breast cancer risk.

ISSN:0959-8278    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Insulin resistance may be a risk factor for breast cancer, possibly through increased levels of oestrogens or insulin‐like growth factor I. Insulin resistance has been associated with obesity, hypertension, dyslipidaemia and impaired glucose tolerance. We studied the relation of these factors to breast cancer risk in a prospective cohort study of 9738 women. Menopausal status was defined a priori, and 112 cases of invasive breast carcinoma occurred in women who were premenopausal at baseline and 157 cases in subjects who were peri/postmenopausal. Relative risks (RR) for breast cancer were calculated by Cox's proportional hazards analysis for different quartiles of height, weight, body mass index, blood pressure, pulse rate and serum levels of total cholesterol, triglycerides, fasting blood glucose and glucose at 120 min after an oral dose of glucose. Peri/postmenopausal women had a significantly increased age‐adjusted relative risk of breast cancer associated with height (RR = 1.78 for the highest versus lowest quartile), and the RR was increased over quartiles of cholesterol levels (P‐value for trend: 0.05). No other significant associations were found. Adjustments for potential confounding factors or restriction of the analysis to cases and person‐years before 55 years of age (premenopausal women), or after 55 years (peri/postmenopausal women), did not change these results.

ISSN:0959-8278    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Cyclin D1 amplification and/or protein overexpression have been observed not only in breast cancer but also in the putative early stages of breast neoplasia. In a case–control study nested within a cohort of 4888 women, we investigated whether the occurrence of cyclin D1 gene amplification and/or protein overexpression in benign breast tissue might identify women at increased risk of subsequent breast cancer development. Cases were 92 women with a histological diagnosis of benign breast disease who subsequently developed breast cancer. Five controls (women with benign breast disease who had not developed breast cancer by the date of diagnosis of the corresponding case) were selected randomly for each case from those non‐cases available within strata defined by screening centre, National Breast Screening Study (NBSS) study arm, year of birth and age at diagnosis of benign breast disease. Paraffin blocks of benign tissue were suitable for immunostaining for 71 cases and 293 controls. Sufficient DNA for analysis was obtained from a total of 356 subjects (69 cases, 287 controls). The benign breast tissues and breast cancers were immunostained for cyclin D1 and also analysed for the presence of cyclin D1 gene amplification by differential polymerase chain reaction (PCR). Fifteen cases and 60 controls showed evidence of cyclin D1 immunostaining, and 12 cases and 29 controls showed cyclin D1 gene amplification. There was essentially no association between cyclin D1 protein overexpression in benign breast tissue and risk of subsequent breast cancer (adjusted odds ratio (OR) 1.06; 95% confidence interval (CI) 0.56–2.02). After adjustment for potential confounding, there was a statistically non‐significant 40% increase in risk of breast cancer in association with cyclin D1 gene amplification (adjusted OR 1.41; 95% CI 0.62–3.22). As multiple genetic changes are required to develop breast cancer, it may not be until the cascade of molecular alterations leading to breast cancer development is understood that identification of biomarkers of breast cancer risk will be possible.

ISSN:0959-8278    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Randomized trials of mammographic screening have provided strong evidence that early diagnosis and treatment of breast cancer can reduce the specific mortality. Moreover, in a recent systematic review of published studies, delays of 3–6 months between symptom onset and treatment have been clearly found to be associated with lower survival rates for breast cancer patients. The aim of this study was to examine delays registered among breast cancer patients in southern Italy, in order to recognize their determining factors so as to provide women with a better opportunity for survival. The variables examined were age (<50, 50–64, ≥65 years), education (≤5, >5 school years); symptom status at first presentation (symptomatic or asymptomatic); date of first symptom presentation; date of first consultation with a health provider; the type of health provider consulted; tumour size and nodal status according to the pTNM system. Time intervals were categorized into: <1 month, 1–3 months and >3 months for patient and medical delay; 1–3 months, 3–6 months, >6 months for overall delay. Patient delay was associated with age and education: a higher risk was found for women of over 65 years age (odds ratio (OR) 2.1, 95% confidence interval (CI) 1.2–3.5) and with ≤5 years school attendance (OR 3.3, 95% CI 2.0–5.6). Medical delay was seen to be associated with the professional figure: significant differences were found between senologists (oncologists exclusively dedicated to breast cancer operation) and other specialists (OR 3.5, 95% CI 1.5–8.4). Young age and symptomatic presentation were found to be high risk factors. Concerning tumour size in overall delay, in cases where the tumour was >2 cm the OR was 2.4 (95% CI 1.5–3.7). Our study suggests that diagnostic delay can be reduced by providing more efficient training programmes for members of the medical profession and by producing educational training programmes targeted specifically at each age category (i.e. in older women more attention to education in prevention; in younger women correct information about mammography and specialized structures).

ISSN:0959-8278    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

In Japan stomach cancer remains the leading cause of cancer‐related mortality. We analysed the annual mortality rate of stomach cancer in relation to age, gender and life expectancy in Japan between 1970 and 1995. The adjusted stomach cancer‐related mortality rates decreased from 88.9 in 1970 to 45.4 per 100 000 in 1995 in males and from 46.5 to 18.5 per 100 000 in females. The male–female ratio for stomach cancer‐related mortality in all ages was 1.9–2.5 during this 25‐year period, and the mortality rate was higher in females than in males at young age. The negative contribution to life expectancy for stomach cancer in males was 0.65 years and 0.42 years in females, which is consistent with a higher mortality rate in males. This negative contribution was 41.8% of total cancer in 1970 and 39.4% in 1995 in males and 34.4% and 16.0%, respectively, in females. Our results demonstrated the need to take into consideration the characteristics of stomach cancer in young women and the effects of ageing when designing programmes aimed at prevention and control of this malignancy.

ISSN:0959-8278    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

To assess the association between specific types of human leukocyte antigen and the risk of Epstein–Barr virus (EBV)‐associated gastric carcinoma, serological typing for major histocompatibility complex class I and class II antigens was performed for 110 EBV‐positive and 155 EBV‐negative gastric carcinoma cases. In class I analysis, the frequency of B59 in the EBV‐positive cases was higher than for the EBV‐negative cases (odds ratio (OR) 3.06; 95% confidence interval (CI) 1.02–9.23). For class II antigens, DQ3 and DR9 frequencies in the EBV‐positive cases were higher (OR 1.94; 95% CI 1.16–3.24 and OR 1.93; 95% CI 1.11–3.37, respectively), whereas DR11 frequency was lower than found in the EBV‐negative cases (OR 0.10; 95% CI 0.01–0.79). After adjusting for multiple comparisons, only DR11 frequency remained significantly lower in the EBV‐positive cases (P = 0.04), and the association of DQ3 was marginally significant (P = 0.05). These results suggest that the presence of DR11‐restricted cytotoxic T cells (CTLs) related to EBV‐associated gastric carcinoma, or a deficiency of DR11 and a high frequency of DQ3 may be genetic markers for a population at greater risk of EBV‐associated gastric carcinoma. However, further extensive studies to more cases and DNA typing are needed because our findings in this study are exploratory.

ISSN:0959-8278    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Metastatic carcinoma of unknown primary is a common problem, accounting for up to 10–15% of all solid tumours at presentation. Proper identification of the site of origin has prognostic and therapeutic significance. Prior immunohistochemical methods to identify the site of origin have been useful in a limited number of cases. Differential cytokeratin staining may be useful in this setting, particularly in identifying metastases from lung cancer. We have identified 144 cases of metastatic carcinoma of unknown primary to bone, lung or liver at Brigham and Women's Hospital between 1 January 1997 and 1 July 1998. Cytokeratin (CK) 7 and CK20 were used in 75 of these cases to narrow down the possible sites of the primary tumours. All of these cases were ambiguous as to the site of the primary tumour. Forty‐five cases were CK7+/CK20–, 15 cases were CK7–/CK20–, 9 cases were CK7–/CK20+ and 6 cases were CK7+/CK20+. Three of the cases were selected for detailed presentation and discussion as well as a discussion of the pertinent literature. Overall, the CK7+/CK20– phenotype favours a lung primary, the CK7+/CK20+ phenotype strongly favours transitional cells (urothelial) carcinoma, the CK7–/CK20+ phenotype favours colorectal carcinoma, while the CK7–/CK20– profile is not helpful.

ISSN:0959-8278    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The Swedish Family‐Cancer Database was used to analyse familial relationships in mothers and daughters with invasive andin situcervical cancers by histological type during the years 1958–1996, including a total of 21 727 and 191 081 cases, respectively. Familial standardized incidence ratios (SIRs) were calculated separately for mothers and daughters and for invasive andin situsquamous cell carcinoma (SCC) and adenocarcinoma. Familial risks were about 2.0 in invasive SCC and less inin situSCC. Limited analyses could be carried out on adenocarcinoma because the number of cases was small. However, familial risks were not much smaller in families where only SCC was diagnosed compared with those where both SCC and adenocarcinoma were present. A comparison of cancers between mothers and daughters showed an association between cervical cancer and SCC of skin, and between cervical cancer and smoking‐related cancers. The familial risks were unaffected in Poisson regression analysis on many possible intervening variables. The data suggest that host factors modulate an individual's response to human papillomavirus infections.

ISSN:0959-8278    

出版商:OVID    

年代:2001

数据来源: OVID