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Is estrogen exposure a protective factor for pancreatic neuroendocrine tumours in female patients with multiple endocrine neoplasia syndrome type 1?
Author(s) -
Qiu Wei,
Christakis Ioannis,
Stewart Ashley A.,
Vodopivec Danica M.,
SilvaFigueroa Angelica,
Chen Huiqin,
Woodard Terri L.,
Halperin Daniel M.,
Lee Jeffrey E.,
Yao James C.,
Perrier Nancy D.
Publication year - 2017
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.13324
Subject(s) - medicine , estrogen , endocrine system , oncology , hazard ratio , cohort , lymphovascular invasion , metastasis , cancer , hormone , confidence interval
Summary Objective Pancreatic neuroendocrine tumours ( PNET s) are the most common cause of death in patients with multiple endocrine neoplasia type 1 ( MEN 1). Women have been shown to have improved survival, which may suggest a possible protective effect of female sex hormones. The aim of this study was to evaluate the relationship between estrogen exposure and PNET tumourigenesis, tumour growth and survival in female MEN 1 patients with these tumours. Design We performed a retrospective chart review of the existing MEN 1 database in our institution. Detailed information about female patients’ menstrual and reproductive history, and PNET clinicopathologic characteristics was collected. Questionnaires regarding estrogen exposure were used to collect information that was missing in the database. Patients Of 293 confirmed MEN 1 cases, 141 women met the inclusion criteria. Measurements We used measures of cumulative estrogen exposure time ( CEET ), parity, live birth pregnancies and bilateral oophorectomy to estimate estrogen exposure. Results There was no significant association between CEET and time to PNET diagnosis (hazard ratio = 0·966, P = 0·380). For the correlation between estrogen exposure and PNET type, size, numbers, distant metastasis, lymph node metastasis, lymphovascular invasion, AJCC (American Joint Committee on Cancer) stage and overall survival, only CEET was significantly correlated with PNET size ( P = 0·043). Conclusions In female patients with MEN 1, estrogen exposure may inhibit PNET growth. A demonstrable protective effect against PNET tumourigenesis, tumour growth and survival of patients with these tumours may require a larger cohort.