目的:几种病毒与人类癌症有偶然的联系,包括子宫颈,鼻咽,肝脏,肉瘤,和默克尔细胞癌。然而,病毒感染对乳腺癌的病因学贡献,全球女性中排名第一的癌症,不是很确定。在探索病毒与乳腺癌关联的研究中,乳腺癌和五种病毒之间的潜在联系已经被确定:β逆转录病毒,(即,小鼠乳腺肿瘤病毒),人乳头瘤病毒,爱泼斯坦巴尔病毒.牛白血病病毒,和人巨细胞病毒.
方法:在这篇综述中,我们提供流行病学生态学的全面评估,病例控制,仅大小写,和队列研究调查这些关联。我们讨论了一些现有综述和荟萃分析的结果,评估过去五年发表的流行病学研究,并评估这些病毒与乳腺肿瘤临床病理因素之间的关系。
结果:关于病毒在乳腺癌中的作用的最强有力的流行病学证据存在于MMTV和HPV中,尽管局限性包括缺乏对MMTV的前瞻性研究以及HPV研究中潜在的检测偏倚。病毒检测挑战限制了对EBV和HCMV的研究。很少有研究评估BLV,尽管它与乳腺癌的高风险有关,样本量相当小。结论:虽然流行病学证据表明这五种病毒与乳腺癌之间存在关联,各种方法学问题和缺乏前瞻性研究排除了强有力的结论。未来的研究应该优先考虑建立感染和疾病之间的时间关系,最大限度地减少检测分析的错误分类,并进一步探讨共感染的影响。
OBJECTIVE: Several viruses have been casually linked to human cancers, including cervical, nasopharyngeal, liver, sarcoma, and Merkel cell carcinomas. However, the etiologic contribution of viral infections to breast cancer, the number one incident cancer among women worldwide, is not well established. Among studies exploring associations of viruses with breast cancer, potential linkages have been identified between breast cancer and five viruses: beta retrovirus, (i.e., mouse mammary tumor virus), human papillomavirus, Epstein Barr virus. bovine leukemia virus, and human cytomegalovirus.
METHODS: In this review, we provide a comprehensive evaluation of epidemiological ecologic, case-control, case-only, and cohort studies investigating these associations. We discuss results from several existing reviews and meta-analyses, evaluate epidemiological studies published in the past five years, and assess the relationship between these viruses and breast tumor clinicopathological factors.
RESULTS: The strongest epidemiological evidence for a viral role in breast cancer exists for MMTV and HPV, though limitations include lack of prospective studies for MMTV and potential detection bias in HPV studies. Viral detection challenges have limited studies of EBV and HCMV. Fewer studies have evaluated BLV, and though it has been associated with higher risk of breast cancer, sample sizes are quite small. CONCLUSION: While epidemiologic evidence exists for an association between these five viruses and breast cancer, various methodological issues and lack of prospective studies preclude robust conclusions. Future research should prioritize establishing a temporal relationship between infection and disease, minimizing misclassification of detection assays, and further exploring the influence of co-infections.