Although previous studies have suggested a potential role of sex hormones in the etiology of colorectal cancer (CRC), no study has yet examined the associations between circulating sex hormones and survival among CRC patients. We prospectively assessed the associations of prediagnostic plasma concentrations of estrone, estradiol, free estradiol, testosterone, free testosterone and sex hormone‐binding globulin (SHBG) with CRC‐specific and overall mortality among 609 CRC patients (370 men and 239 postmenopausal women not taking hormone therapy at blood collection) from four U.S. cohorts. Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard regression. We identified 174 deaths (83 CRC‐specific deaths) in men and 106 deaths (70 CRC‐specific deaths) in women. In men, higher circulating level of free testosterone was associated with lower risk of overall (the highest vs . lowest tertiles, HR = 0.66, 95% CI, 0.45–0.99, p _trend = 0.04) and possibly CRC‐specific mortality (HR = 0.73, 95% CI, 0.41–1.29, p _trend = 0.27). We generally observed nonsignificant inverse associations for other sex steroids, and a positive association for SHBG with CRC‐specific mortality among male patients. In women, however, we found a suggestive positive association of estrone with overall (HR = 1.54, 95% CI, 0.92–2.60, p _trend = 0.11) and CRC‐specific mortality (HR = 1.96, 95% CI, 1.01–3.84, p _trend = 0.06). Total estradiol, free estradiol and free testosterone were generally suggestively associated with higher risk of mortality among female patients, although not statistically significant. These findings implicated a potential role of endogenous sex hormones in CRC prognosis, which warrant further investigation.

中文翻译：

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内源性激素和大肠癌在男性和女性中的存活率。

尽管先前的研究表明性激素在结直肠癌（CRC）的病因中具有潜在作用，但尚无研究检查循环性激素与CRC患者生存之间的关系。我们前瞻性评估了609例CRC患者（370例男性和239例绝经后女性未服用CRC）的雌激素，雌二醇，游离雌二醇，睾丸激素，游离睾丸激素和性激素结合球蛋白（SHBG）的诊断前血浆浓度与CRC特异性和总死亡率的相关性。来自美国四个队列的血液收集激素疗法）。使用Cox比例风险回归估算多变量风险比（HRs）和95％置信区间（CIs）。我们确定了男性的174例死亡（83例CRC特定死亡）和女性的106例死亡（70例CRC特定死亡）。在男人里与。最低三分位数，HR = 0.66，95％CI，0.45–0.99，p_趋势= 0.04），可能还有CRC特异性死亡率（HR = 0.73，95％CI，0.41–1.29，p_趋势= 0.27）。我们通常观察到男性患者中其他性类固醇的无显着负相关，而SHBG与CRC特异性死亡率呈正相关。然而，在女性中，我们发现雌酮与总体（HR = 1.54，95％CI，0.92-2.60，p_趋势= 0.11）和CRC特异性死亡率（HR = 1.96，95％CI，1.01-3.84）呈正相关。 ，p_趋势= 0.06）。总雌二醇，游离雌二醇和游离睾丸激素通常提示女性患者较高的死亡风险，尽管无统计学意义。这些发现暗示了内源性激素在CRC预后中的潜在作用，值得进一步研究。