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目的:探讨北京女性年龄、危险因素及内源性类固醇性激素与乳腺癌的关系,以及性激素与乳腺密度的关系。方法:随机选取493例北京市女性,年龄25～76岁,中位年龄44岁。分为≤40岁组(165名)、>40岁组(242名)和绝经后组(86名)。对全体受检者进行问卷调查及危险因素统计,行数字化乳腺X射线检查,并用半定量方法计算乳腺密度百分比,检测血浆雌二醇和孕酮水平。结果:乳腺癌及良性病变的检出率分别是1.2%和7.3%。除去乳腺癌患者,共有危险因素者146名。绝经后组有危险因素组的乳腺密度显著高于无危险因素组,P<0.05。绝经后组乳腺密度与雌二醇及孕酮之间存在轻度正相关(r=0.315,P=0.003;r=0.256,P=0.017)。多远逻辑回归分析显示,乳腺癌检出率随着年龄及危险因素呈递增趋势(χ2=5.7,P=0.017;χ2=4.7,P=0.03)。乳腺癌检出率在高年龄组是低年龄组的4.2倍,有危险因素组是无危险因素组的4.9倍。结论:乳腺癌检出率随年龄增长上升,有危险因素者检出率高于无危险因素者。绝经后组有危险因素女性的乳腺密度显著高于同龄的无危险因素者。乳腺密度应作为乳腺癌普查的观察指标。
Objective: To investigate the relationship between age, risk factors, endogenous steroid hormones and breast cancer in Beijing women and the relationship between sex hormones and breast density. METHODS: A total of 493 Beijing women aged 25-76 years, with a median age of 44 years, were randomly selected. Divided into 40 years old group (165),> 40 years old group (242) and postmenopausal group (86). All subjects were surveyed and risk factors statistics, digital mammography, and semi-quantitative methods to calculate the percentage of breast density, plasma estradiol and progesterone levels. Results: The detection rates of breast cancer and benign lesions were 1.2% and 7.3% respectively. Remove breast cancer patients, a total of 146 risk factors. The density of breast in risk group in postmenopausal group was significantly higher than that in non-risk group, P <0.05. There was a mild positive correlation between breast density and estradiol and progesterone in the postmenopausal group (r = 0.315, P = 0.003; r = 0.256, P = 0.017). Logistic regression analysis showed that the detection rate of breast cancer showed an increasing trend with age and risk factors (χ2 = 5.7, P = 0.017; χ2 = 4.7, P = 0.03). The detection rate of breast cancer was 4.2 times higher in the younger age group and 4.9 times higher in the risk group than in the non-risk group. Conclusion: The detection rate of breast cancer increased with age, the detection rate of risk factors were higher than those without risk factors. Women with risk factors in postmenopausal women had significantly higher breast density than those of the same age without risk factors. Breast density should be used as an indicator of breast cancer census.