CHARACTERISTICS OF WOMEN WITH A FAMILY HISTORY OF OVARIAN-CANCER .2. FOLLICULAR PHASE HORMONE LEVELS

Background. Although there is a basis for linking pituitary or ovarian hormones with experimentally induced ovarian cancer, establishing the ir role in women is complicated because the usual case-control methods cannot be applied. In this study, hormonal levels in women with a fam ily history of ovarian cancer (FOC) and who are at higher risk for the disease are compared with women without such a history. Methods. The authors studied 106 unrelated women (FOC patients) with at least one p rimary or two second-degree relatives with ovarian cancer compared wit h 116 age- and residence-matched controls without a family history of ovarian cancer (FOC control subjects). All women were premenopausal, b etween the ages of 25 and 49 years, not currently using oral contracep tives, and had blood drawn during the early follicular phase for gonad otropins, estradiol (E(2)), and CA-125. Results. Women with a family h istory of ovarian cancer and control subjects did not differ significa ntly in follicle stimulating hormone (FSH) levels, E(2), or CA-125. Pa tients with a family history of ovarian cancer had significantly lower luteinizing hormone (LH) levels compared with control subjects and pr oduced more E(2) and FSH relative to their level of LH. The ratios of LH to E(2) and LH to FSH were correlated with the enzymatic activity o f galactose-1-phosphate uridyl transferase, which was shown previously to differ between FOC patients and control subjects. Conclusion. Lowe r LH and higher E(2) are reported in women with breast, endometrial, a nd ovarian cancer (before surgery). The authors speculate that these o bservations reflect greater LH binding and estradiol production in ova ries at risk for these cancers-the ovarian cortical hyperplasia postul ated in older gynecologic literature as the precursor to estrogen depe ndent neoplasia.