Effects of Reproductive Factors on Lauren Intestinal-Type Gastric Cancers in Females: A Multicenter Retrospective Study in South Korea
0
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Background/Aims: Gastric cancers (GCs), particularly the Lauren intestinal type, show a male predominance. The aim of this study was to investigate the effects of reproductive factors on GCs in females, according to Lauren classification. Methods: Medical records of 1,849 males and 424 females who underwent radical gastrectomy or endoscopic resection for GCs between 2010 and 2018 were reviewed. The incidences of intestinal-type GCs were compared between males and groups of females stratified according to postmenopausal period. Associations between reproductive factors in females and intestinaltype GCs were analyzed using multivariate models. Results: The proportions of intestinal-type GCs were significantly lower in premenopausal (19%), less than 10 years postmenopausal (30.4%), and 10 to 19 years postmenopausal females (44.1%) than in males (61.0%) (p<0.05 for all). Females ≥20 years postmenopause had a proportion of intestinal-type GCs similar to that in males (60.6% vs 61.0%; p=0.948). Multivariate analysis revealed that age (odds ratio [OR], 1.075; 95% confidence interval [CI], 1.039 to 1.113; p<0.001) and parity ≥3 (OR, 1.775; 95% CI, 1.012 to 3.114; p=0.045) were positively associated with an increased risk of intestinal-type GCs in postmenopausal females, while long fertility duration (OR, 1.147; 95% CI, 1.043 to 1.261; p=0.005) was positively associated with an increased risk of intestinal-type GCs in premenopausal females. Conclusions: There were no significant differences in the proportions of intestinal-type GCs between males and females ≥20 years postmenopause, suggesting that female reproductive factors play a role in the prevention of intestinal-type GC.
Abstract
Background/Aims: Gastric cancers (GCs), particularly the Lauren intestinal type, show a male predominance. The aim of this study was to investigate the effects of reproductive factors on GCs in females, according to Lauren classification. Methods: Medical records of 1,849 males and 424 females who underwent radical gastrectomy or endoscopic resection for GCs between 2010 and 2018 were reviewed. The incidences of intestinal-type GCs were compared between males and groups of females stratified according to postmenopausal period. Associations between reproductive factors in females and intestinaltype GCs were analyzed using multivariate models. Results: The proportions of intestinal-type GCs were significantly lower in premenopausal (19%), less than 10 years postmenopausal (30.4%), and 10 to 19 years postmenopausal females (44.1%) than in males (61.0%) (p<0.05 for all). Females ≥20 years postmenopause had a proportion of intestinal-type GCs similar to that in males (60.6% vs 61.0%; p=0.948). Multivariate analysis revealed that age (odds ratio [OR], 1.075; 95% confidence interval [CI], 1.039 to 1.113; p<0.001) and parity ≥3 (OR, 1.775; 95% CI, 1.012 to 3.114; p=0.045) were positively associated with an increased risk of intestinal-type GCs in postmenopausal females, while long fertility duration (OR, 1.147; 95% CI, 1.043 to 1.261; p=0.005) was positively associated with an increased risk of intestinal-type GCs in premenopausal females. Conclusions: There were no significant differences in the proportions of intestinal-type GCs between males and females ≥20 years postmenopause, suggesting that female reproductive factors play a role in the prevention of intestinal-type GC.
참고문헌 (37)
- Global Burden of Disease Cancer Collaboration, "Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 1990to 2017 : a systematic analysis for the Global Burden of Disease study", JAMA Oncol, 5, pp.1749~1768 (2019)
- Freedman ND, "Male predominance of upper gastrointestinal adenocarcinoma cannot be explained by differences in tobacco smoking in men versus women", Eur J Cancer, 46, pp.2473~2478 (2010)
- Ibrahim A, "Sexdifferences in the prevalence of Helicobacter pylori infection in pediatric and adult populations : systematic review and meta-analysis of 244 studies", Dig Liver Dis, 49, pp.742~749 (2017)
- Sipponen P, "Delayed rise in incidence of gastric cancer in females results in unique sex ratio(M", F)pattern : etiologic hypothesis, 2002, pp.5, 213~219
- Wong TS, "Reproductive factors, obesity and risk of colorectal cancer in a cohort of Asian women", Cancer Epidemiol, 58, pp.33~43 (2019)
- Gruber CJ, "Production and actions of estrogens", N Engl J Med, 346, pp.340~352 (2002)
- Camargo MC, "Sex hormones, hormonal interventions, and gastric cancer risk : a meta-analysis", Cancer Epidemiol Biomarkers Prev, 21, pp.20~38 (2012)
- Sanikini H, "Anthropometric and reproductive factors and risk of esophageal and gastric cancer by subtype and subsite : results from the European Prospective Investigation into Cancer and Nutrition(EPIC)cohort", Int J Cancer, 146, pp.929~942 (2020)
- Lauren P, "The two histological main types of gastric carcinoma : diffuse and so-called intestinal-type carcinoma. an attempt at a histo-clinical classification", Acta Pathol Microbiol Scand, 64, pp.31~49 (1965)
- Kim KW, "Different effects of p53 protein overexpression on the survival of gastric cancer patients according to Lauren histologic classification : a retrospective study", Gastric Cancer, 24, pp.844~857 (2021)
- 이정원, "위암의 임상적, 병리학적 특성 변화: 한국 단일 기관에서의 최근 16년 동안의 보고", Korean Journal of Helicobacter Upper Gastrointestinal Research, 19(2), pp.120~126 (2019), 대한상부위장관ㆍ헬리코박터학회[DOI]
- Correa P, "Human gastric carcinogenesis : a multistep and multifactorial process. First American Cancer Society Award lecture on cancer epidemiology and prevention", Cancer Res, 52, pp.6735~6740 (1992)
- "Exploring the biological contributions to human health: does sex matter?", J Womens Health Gend Based Med, 10, pp.433~439 (2001)
- Chang L, "Gender, age, society, culture, and the patient's perspective in the functional gastrointestinal disorders", Gastroenterology, 130, pp.1435~1446 (2006)
- Annandale E, "a critical discourse analysis of publications in the field of gender-specific medicine", Health(London), 15, pp.571~587 (2011)
- Kilminster S, "Women in medicine : is there a problem? A literature review of the changing gender composition, structures and occupational cultures in medicine", Med Educ, 41, pp.39~49 (2007)
- Frise S, "Menstrual and reproductive risk factors and risk for gastric adenocarcinoma in women : findings from the Canadian National Enhanced Cancer Surveillance System", Ann Epidemiol, 16, pp.908~916 (2006)
- Persson C, "Female reproductive factors and the risk of gastric cancer in a large-scale population-based cohort study in Japan(JPHC study)", Eur J Cancer Prev, 17, pp.345~353 (2008)
- 김수미, "Protective Effects of Female Reproductive Factors on Lauren Intestinal-Type Gastric Adenocarcinoma", Yonsei Medical Journal, 59(1), pp.28~34 (2018), 연세대학교의과대학[DOI]
- Endogenous Hormones, "Circulating sex hormones and breast cancer risk factors in postmenopausal women : reanalysis of 13 studies", Br J Cancer, 105, pp.709~722 (2011)
- Chen J, "Parity and gastric cancer risk : a systematic review and dose-response meta-analysis of prospective cohort studies", Sci Rep, 6, pp.18766~ (2016)
- Freedman ND, "Menstrual and reproductive factors and gastric cancer risk in a large prospective study of women", Gut, 56, pp.1671~1677 (2007)
- Bahmanyar S, "Parity and risk of stomach cancer by sub-site : a national Swedish study", Br J Cancer, 98, pp.1295~1300 (2008)
- Petrakis NL, "Influence of pregnancy and lactation on serum and breast fluid estrogen levels : implications for breast cancer risk", Int J Cancer, 40, pp.587~591 (1987)
- Chavez-MacGregor M, "Lifetime cumulative number of menstrual cycles and serum sex hormone levels in postmenopausal women", Breast Cancer Res Treat, 108, pp.101~112 (2008)
- Heys M, "Life long endogenous estrogen exposure and later adulthood cognitive function in a population of naturally postmenopausal women from Southern China : the Guangzhou Biobank Cohort Study", Psychoneuroendocrinology, 36, pp.864~873 (2011)
- Prince MJ, "Reproductive period, endogenous estrogen exposure and dementia incidence among women in Latin America and China : a 10", 66 population-based cohort study, 2018, pp.13, e0192889~
- Jang H, "Differential effects of completed and incomplete pregnancies on the risk of Alzheimer disease", Neurology, 91, pp.e643~e651 (2018)
- Kwon YJ, "The prevalence of histologic atrophy and intestinal metaplasia in the corpus has decreased over 15 years in females in the Korean population", Helicobacter, 24, pp.e12579~ (2019)
- Lim SH, "Trends in the seroprevalence of Helicobacter pylori infection and its putative eradication rate over 18 years in Korea : a cross-sectional nationwide multicenter study", PLoS One, 13, pp.e0204762~ (2018)
- Wang M, "Altered expression of estrogen receptor alpha and beta in advanced gastric adenocarcinoma : correlation with prothymosin alpha and clinicopathological parameters", Eur J Surg Oncol, 33, pp.195~201 (2007)
- Yi JH, "Anti-tumor efficacy of fulvestrant in estrogen receptor positive gastric cancer", Sci Rep, 4, pp.7592~ (2014)
- Park SH, "Estrogen regulates Snail and Slug in the down-regulation of Ecadherin and induces metastatic potential of ovarian cancer cells through estrogen receptor alpha", Mol Endocrinol, 22, pp.2085~2098 (2008)
- Helguero LA, "Different roles of estrogen receptors alpha and beta in the regulation of E-cadherin protein levels in a mouse mammary epithelial cell line", Cancer Res, 68, pp.8695~8704 (2008)
- Oesterreich S, "Estrogen-mediated down-regulation of E-cadherin in breast cancer cells", Cancer Res, 63, pp.5203~5208 (2003)
- Lanciers S, "Increased susceptibility to Helicobacter pylori infection in pregnancy", Infect Dis Obstet Gynecol, 7, pp.195~198 (1999)
- Freedman ND, "The association of menstrual and reproductive factors with upper gastrointestinal tract cancers in the NIH-AARP cohort", Cancer, 116, pp.1572~1581 (2010)