Perfluoroalkyl substances (PFASs) as risk factors for breast cancer: a case-control study in Chinese population.

Xuejun Li, Fengju Song, Xiaotu Liu, Anqi Shan, Yubei Huang, Zhengjun Yang, Haixin Li, Qiaoyun Yang, Yue Yu, Hong Zheng, Xu-Chen Cao, Da Chen, Ke-Xin Chen, Xi Chen, Nai-Jun Tang
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引用次数: 1

Abstract

Background: Perfluoroalkyl substances (PFASs) are a large family of synthetic chemicals, some of which are mammary toxicants and endocrine disruptors. Recent studies have implicated exposure to PFASs as a risk factor for breast cancer in Europe and America. Little is known about the role of PFASs with respect to breast cancer in the Chinese population.

Methods: Participants who were initially diagnosed with breast cancer at Tianjin Medical University Cancer Institute and Hospital between 2012 and 2016 were recruited as cases. The controls were randomly selected from the participants with available blood samples in the Chinese National Breast Cancer Screening Program (CNBCSP) cohort. Ultimately, we enrolled 373 breast cancer patients and 657 controls. Plasma PFASs were measured by an ultra-performance liquid chromatography (UPLC) system coupled to a 5500 Q-Trap triple quadrupole mass spectrometer. A logistic regression model with least absolute shrinkage and selection operator (LASSO) regularization was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) to assess the relationships between PFASs and breast cancer. The three most predictive variables in the LASSO model were selected from 17 PFASs, which was based on the optimal penalty coefficient (λ = 0.0218) identified with the minimum criterion. Additionally, Bayesian kernel machine regression (BKMR) and quantile g-computation models were applied to evaluate the associations between separate and mixed exposure to PFASs and breast cancer.

Results: Perfluorooctanesulfonic acid (PFOS) exhibited the highest concentration in both the cases and controls. Perfluorooctanoic acid (PFOA) and perfluoro-n-decanoic acid (PFDA) were positively associated with breast cancer, and perfluoro-n-tridecanoic acid (PFTrDA) was negatively associated with breast cancer according to both the continuous-PFASs and the quartile-PFASs logistic regression models. Of note, PFOA was associated with the occurrence of estrogen receptor (ER)-, progesterone receptor (PR)-, and human epidermal growth factor receptor 2 (HER2)-positive breast cancer (ORER+  = 1.47, 95% CI: 1.19, 1.80; ORPR+  = 1.36, 95% CI: 1.09, 1.69; ORHER2 = 1.62, 95% CI: 1.19, 2.21).

Conclusions: Overall, we observed that PFASs were associated with breast cancer in Chinese women. Prospective cohort studies and mechanistic experiments are warranted to elucidate whether these associations are causal.

Abstract Image

Abstract Image

全氟烷基物质(PFASs)作为乳腺癌的危险因素:中国人群的病例对照研究
背景:全氟烷基物质(PFASs)是一大类合成化学品,其中一些是乳腺毒物和内分泌干扰物。最近的研究表明,在欧洲和美国,全氟磺酸暴露是乳腺癌的一个危险因素。在中国人群中,人们对PFASs在乳腺癌中的作用知之甚少。方法:选取2012 - 2016年在天津医科大学肿瘤研究所医院首次诊断为乳腺癌的患者作为病例。对照从中国国家乳腺癌筛查计划(CNBCSP)队列中具有可用血液样本的参与者中随机选择。最终,我们招募了373名乳腺癌患者和657名对照者。采用超高效液相色谱(UPLC)联用5500 Q-Trap三重四极杆质谱仪对血浆全氟磺酸进行了测定。采用最小绝对收缩和选择算子(LASSO)正则化的逻辑回归模型计算比值比(ORs)和95%置信区间(CIs),以评估PFASs与乳腺癌之间的关系。从17个PFASs中选取预测能力最强的3个变量,以最小准则识别出最优惩罚系数(λ = 0.0218)作为LASSO模型的预测变量。此外,贝叶斯核机回归(BKMR)和分位数g计算模型应用于评估单独和混合暴露于PFASs与乳腺癌之间的关系。结果:全氟辛烷磺酸(PFOS)浓度在病例组和对照组均最高。根据连续pfass和四分位pfass logistic回归模型,全氟辛酸(PFOA)和全氟正癸酸(PFDA)与乳腺癌呈正相关,全氟正癸酸(PFTrDA)与乳腺癌负相关。值得注意的是,PFOA与雌激素受体(ER)-、孕激素受体(PR)-和人表皮生长因子受体2 (HER2)阳性乳腺癌的发生相关(over + = 1.47, 95% CI: 1.19, 1.80;Orpr + = 1.36, 95% ci: 1.09, 1.69;Orher2 = 1.62, 95% ci: 1.19, 2.21)。结论:总体而言,我们观察到PFASs与中国女性乳腺癌相关。前瞻性队列研究和机械实验是必要的,以阐明这些关联是否有因果关系。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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