HRT可以协助妇女远离与抽烟有关的癌症


  Sept. 9, 2003 -根据一篇发表于9月号Obstetrics & Gynecology的研究结果显示,荷尔蒙替代疗法 (HRT)可能可以减少人们罹患与抽烟有关的癌症机率。
  
  瑞典Lund大学医院的H.Olsson博士表示,研究中我们先假设HRT对于上皮组织有良好的影响,可以对抗抽烟的致癌物质,尤其是HRT可以维持上皮厚度和完整性,所以应该可以减少肿瘤发展。
  
  为了证实这项假设成不成立,研究人员从1990年到1992年,针对29,508个二十五岁到六十五岁的瑞典女性访视,当时这些妇女都没有癌症的病史。
  
  1999年12月31日正式结束研究时,共有1,145人诊断出恶性肿瘤,其中自然地渡过停经期,使用HRT治疗的女性罹患癌症的比率并未增加。
  
  研究中显示,有抽烟习惯同时长期使用HRT的女性,较同样抽烟的妇女罹患相关癌症的发生率降低,包括口腔癌、咽癌、下咽、喉、食道、肺、子宫和膀胱癌(发生率标准化,0.24 ;95% 信赖区间 [ CI ]。0.08-0.76),其中受试者所使用的HRT和抽的香烟数并未影响这项研究结果。
  
  研究显示,HRT似乎可以保护抽烟者和不抽烟者远离直肠癌,但是使用HRT的不抽烟者子宫癌的发生率却有增加的趋势。
  
  这项研究还是有其限制,其中包括相对上较小的病例数量和有限的追踪,作者建议在未来进行进一步的确认研究,另外作者也表示,这份报告的目的并非提倡女性抽烟,而是建议女性使用HRT以作为适当的疗程,同时戒烟。
  

HRT May Protect Against Smokin

By Laurie Barclay, MD
Medscape Medical News

Sept. 9, 2003 — Hormone replacement therapy (HRT) may protect against smoking-associated cancers, according to the results of a study published in the September issue of Obstetrics & Gynecology.

"We hypothesized that HRT use would favorably affect those epithelial tissues for which smoking is a carcinogen," write H. Olsson, MD, PhD, and colleagues from University Hospital in Lund, Sweden. "Specifically, HRT would maintain epithelial thickness and integrity, thus counteracting tumor development."

From 1990 to 1992, the investigators conducted baseline interviews in 29,508 Swedish women aged 25 to 65 years with no history of cancer. When follow-up ended on Dec. 31, 1999, 1,145 malignancies had been diagnosed. Women who went through natural menopause and had ever used HRT had no increased incidence of cancer overall.

Women who smoked and who used HRT long-term had a decreased incidence of smoking-related cancers, including cancer of the oral cavity, pharynx, hypopharynx, larynx, esophagus, lung, cervix, and bladder (standardized incidence ratio, 0.24; 95% confidence interval [CI]. 0.08 - 0.76). The type of HRT used and number of cigarettes smoked did not affect this finding.

HRT appeared to protect against colon cancer in both smokers and nonsmokers. Nonsmokers who used HRT had an increased incidence of endometrial cancer.

Because of study limitations, including relatively small sample size and limited follow-up, the authors recommend confirmation in future studies.

"The purpose of this report is not to advocate that women should smoke," the authors write. "We recommend that women use HRT as appropriate by the evolving standard of care and refrain from smoking."

The Swedish Cancer Society, Lund University, and the Gunnar Nillson Foundation helped support this study.

Obstet Gynecol. 2003;102:565-570

Reviewed by Gary D. Vogin, MD

    
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