{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T12:25:53Z","timestamp":1789475153537,"version":"build-2803163510"},"reference-count":33,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,4,6]],"date-time":"2017-04-06T00:00:00Z","timestamp":1491436800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Pancreatic neuroendocrine tumours (<jats:styled-content style=\"fixed-case\">PNET<\/jats:styled-content>s) are the most common cause of death in patients with multiple endocrine neoplasia type 1 (<jats:styled-content style=\"fixed-case\">MEN<\/jats:styled-content>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 <jats:styled-content style=\"fixed-case\">PNET<\/jats:styled-content> tumourigenesis, tumour growth and survival in female <jats:styled-content style=\"fixed-case\">MEN<\/jats:styled-content>1 patients with these tumours.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>We performed a retrospective chart review of the existing <jats:styled-content style=\"fixed-case\">MEN<\/jats:styled-content>1 database in our institution. Detailed information about female patients\u2019 menstrual and reproductive history, and <jats:styled-content style=\"fixed-case\">PNET<\/jats:styled-content> clinicopathologic characteristics was collected. Questionnaires regarding estrogen exposure were used to collect information that was missing in the database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>Of 293 confirmed <jats:styled-content style=\"fixed-case\">MEN<\/jats:styled-content>1 cases, 141 women met the inclusion criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>We used measures of cumulative estrogen exposure time (<jats:styled-content style=\"fixed-case\">CEET<\/jats:styled-content>), parity, live birth pregnancies and bilateral oophorectomy to estimate estrogen exposure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was no significant association between <jats:styled-content style=\"fixed-case\">CEET<\/jats:styled-content> and time to <jats:styled-content style=\"fixed-case\">PNET<\/jats:styled-content> diagnosis (hazard ratio\u00a0=\u00a00\u00b7966, <jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b7380). For the correlation between estrogen exposure and <jats:styled-content style=\"fixed-case\">PNET<\/jats:styled-content> type, size, numbers, distant metastasis, lymph node metastasis, lymphovascular invasion, <jats:styled-content style=\"fixed-case\">AJCC<\/jats:styled-content> (American Joint Committee on Cancer) stage and overall survival, only <jats:styled-content style=\"fixed-case\">CEET<\/jats:styled-content> was significantly correlated with <jats:styled-content style=\"fixed-case\">PNET<\/jats:styled-content> size (<jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b7043).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In female patients with <jats:styled-content style=\"fixed-case\">MEN<\/jats:styled-content>1, estrogen exposure may inhibit <jats:styled-content style=\"fixed-case\">PNET<\/jats:styled-content> growth. A demonstrable protective effect against <jats:styled-content style=\"fixed-case\">PNET<\/jats:styled-content> tumourigenesis, tumour growth and survival of patients with these tumours may require a larger cohort.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.13324","type":"journal-article","created":{"date-parts":[[2017,3,8]],"date-time":"2017-03-08T18:46:57Z","timestamp":1488998817000},"page":"791-797","source":"Crossref","is-referenced-by-count":17,"title":["Is estrogen exposure a protective factor for pancreatic neuroendocrine tumours in female patients with multiple endocrine neoplasia syndrome type 1?"],"prefix":"10.1111","volume":"86","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1562-9197","authenticated-orcid":false,"given":"Wei","family":"Qiu","sequence":"first","affiliation":[{"name":"Department of Hepatobiliary Pancreatic Surgery The First Hospital of Jilin University Changchun Jilin China"},{"name":"Department of Surgical Oncology The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Christakis","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley A.","family":"Stewart","sequence":"additional","affiliation":[{"name":"Department of Surgery Levine Cancer Institute Charlotte NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danica M.","family":"Vodopivec","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelica","family":"Silva\u2010Figueroa","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiqin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Biostatistics The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terri L.","family":"Woodard","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology and Reproductive Medicine The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel M.","family":"Halperin","sequence":"additional","affiliation":[{"name":"Departments of Gastrointestinal Medical Oncology The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey E.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James C.","family":"Yao","sequence":"additional","affiliation":[{"name":"Departments of Gastrointestinal Medical Oncology The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy D.","family":"Perrier","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,4,6]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-009-0290-1"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2012-0434"},{"key":"e_1_2_9_4_1","first-page":"364","article-title":"Pancreas\u2010a sex steroid\u2010dependent tissue","volume":"3","author":"Robles\u2010Diaz G.","year":"2001","journal-title":"The Israel Medical Association Journal: IMAJ"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1677\/ERC-07-0093"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2009.0079"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.4161\/cbt.8.22.9740"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0000000000000203"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-1230"},{"key":"e_1_2_9_10_1","volume-title":"AJCC Cancer Staging Handbook: From the AJCC Cancer Staging Manual","author":"Edge S.","year":"2010"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2013.08.005"},{"key":"e_1_2_9_13_1","first-page":"144","volume-title":"The Postpartum Period. 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