文章：

子宫内暴露于己烯雌酚（DES）的女性其后代的良性及恶性结局：美国国家癌症研究所第三代研究的最新进展

Benign and Malignant Outcomes in the Offspring of Females Exposed In Utero to Diethylstilbestrol (DES): An Update from the NCI Third Generation Study

原文发布日期：18 July 2024

DOI: 10.3390/cancers16142575

类型: Article

开放获取: 是

英文摘要：

Background: Females exposed prenatally to diethylstilbestrol (DES) have an elevated risk of cervical dysplasia, breast cancer, and clear cell adenocarcinoma (CCA) of the cervix/vagina. Testicular cancer risk is increased in prenatally exposed males. Epigenetic changes may mediate the transmission of DES effects to the next (“third”) generation of offspring. Methods: Using data self-reported by third-generation females, we assessed DES in relation to the risk of cancer and benign breast and reproductive tract conditions. Using data from prenatally DES-exposed and unexposed mothers, we assessed DES in relation to cancer risk in their female and male offspring. Cancer risk was assessed by standardized incidence ratios (SIR) and 95% confidence intervals (CI); the risks of benign and malignant diagnoses were assessed by hazard ratios (HR) and 95% CI. Results: In self-reported data, DES exposure was not associated with an increased risk of overall cancer (HR 0.83; CI 0.36–1.90), breast cancer, or severe cervical dysplasia. No females reported CCA. The risk of borderline ovarian cancer appeared elevated, but the HR was imprecise (3.46; CI 0.37–32.42). Based on mothers’ reports, DES exposure did not increase the risk of overall cancer (HR 0.80; CI 0.49–1.32) or of other cancers in third-generation females. Overall cancer risk in exposed males appeared elevated (HR 1.41; CI 0.70–2.86), but the CI was wide. The risk of testicular cancer was not elevated in exposed males; no cases of prostate cancer were reported. Conclusions: To date, there is little evidence that DES is associated with cancer risk in third-generation females or males, but these individuals are relatively young, and further follow-up is needed.

摘要翻译： 

背景：产前暴露于己烯雌酚（DES）的女性患宫颈发育不良、乳腺癌及宫颈/阴道透明细胞腺癌（CCA）的风险升高。产前暴露的男性睾丸癌风险增加。表观遗传变化可能介导DES效应向下一代（"第三代"）子代的传递。方法：通过第三代女性自我报告数据，评估DES暴露与癌症及乳腺/生殖道良性病变风险的关系。通过产前DES暴露组与未暴露组母亲的报告数据，评估DES暴露与其子代（包括女性和男性）癌症风险的关系。癌症风险采用标准化发病率比（SIR）及95%置信区间（CI）评估；良恶性病变风险采用风险比（HR）及95%CI评估。结果：自我报告数据显示，DES暴露与总体癌症风险（HR 0.83；CI 0.36–1.90）、乳腺癌或重度宫颈发育不良风险升高无显著关联。无女性报告CCA病例。卵巢交界性肿瘤风险呈升高趋势，但HR值不精确（3.46；CI 0.37–32.42）。基于母亲报告数据，DES暴露未增加第三代女性总体癌症风险（HR 0.80；CI 0.49–1.32）或其他癌症风险。暴露组男性总体癌症风险呈升高趋势（HR 1.41；CI 0.70–2.86），但置信区间较宽。暴露组男性睾丸癌风险未升高；无前列腺癌病例报告。结论：目前尚无充分证据表明DES暴露与第三代女性或男性的癌症风险相关，但该人群年龄相对较轻，仍需进一步随访观察。

原文链接：

Benign and Malignant Outcomes in the Offspring of Females Exposed In Utero to Diethylstilbestrol (DES): An Update from the NCI Third Generation Study