Obesity as a potential risk factor for adenocarcinomas and squamous cell carcinomas of the uterine cervix
Obesity as a potential risk factor for adenocarcinomas and squamous cell carcinomas of the uterine cervix
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DOI：
10.1002/cncr.11567
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发表时间：
2003-08-15
期刊：
影响因子：
6.2
通讯作者：
Hildesheim, A
中科院分区：
文献类型：
--
作者：
Lacey, JV;Swanson, CA;Hildesheim, A
背景。与鳞状细胞癌相比，激素因素在宫颈腺癌中可能发挥更重要的作用。作者评估了可影响激素水平的肥胖是否与腺癌和鳞状细胞癌相关。方法。这项病例对照研究包括 124 名腺癌患者、139 名匹配的鳞状细胞癌患者和 307 名匹配的社区对照参与者。所有参与者均完成了访谈并提供了宫颈阴道样本以进行人乳头瘤病毒 (HPV) 检测。对两种组织学类型的自我报告身高和体重、体重指数（BMI；kg/m(2)）和测量的腰臀比（WHR）进行多元逻辑回归生成的比值比（OR）和95％置信区间（95％CI），并针对HPV和其他混杂因素进行调整和分层。结果。身高、体重、BMI 和腰臀比与腺癌呈正相关。 BMI 大于或等于 30 kg/m(2)（对比 BMI < 25 kg/m(2)；OR，2.1 和 95% CI，1.1-3.8）和最高三分位数的腰臀比（对比最低三分位数；OR，1.8 和 95% CI，0.97-3.3）与腺癌相关。身高和体重均未发现与鳞状细胞癌相关，BMI≥30 kg/m(2)（OR，1.6）和最高三分位数的腰臀比（OR，1.6）的相关性较弱，且无统计学意义。仅使用 HPV 阳性对照进行的分析显示出类似的关联。数据根据筛查进行了调整和分层，但较高的 BMI 和 WHR 与诊断时较高的疾病阶段相关，即使在最近经常筛查的腺癌患者中也是如此。因此，不能排除筛选产生的残留混杂因素作为对相关性的解释。结论。肥胖和身体脂肪分布与腺癌的相关性比与鳞状细胞癌的相关性更强。尽管关于筛查的问题仍然存在，但肥胖可能对腺性宫颈癌的风险有特殊影响。
BACKGROUND. Hormonal factors may play a more prominent role in cervical adenocarcinoma than squamous cell carcinoma. The authors evaluated whether obesity, which can influence hormone levels, was associated with adenocarcinoma and squamous cell carcinoma.METHODS. This case-control study included 124 patients with adenocarcinoma, 139 matched patients with squamous cell carcinoma, and 307 matched community control participants. All participants completed interviews and provided cervicovaginal samples for human papillomavirus (HPV) testing. Polytomous logistic regression-generated odds ratios (ORs) and 95% confidence intervals (95% CIs) for self-reported height and weight, body mass index (BMI; kg/m(2)), and measured waist-to-hip ratio (WHR) for both histologic types were adjusted and stratified for HPV and other confounders.RESULTS. Height, weight, BMI, and WHR were positively associated with adenocarcinoma. BMI greater than or equal to30 kg/m(2) (vs. BMI < 25 kg/m(2); OR, 2.1 and 95% Cl, 1.1-3.8) and WHR in the highest tertile (vs. the lowest tertile; OR, 1.8 and 95% CI, 0.97-3.3) were associated with adenocarcinoma. Neither height nor weight was found to be associated with squamous cell carcinoma, and associations for BMI >= 30 kg/m(2) (OR, 1.6) and WHR in the highest tertile (OR, 1.6) were weaker and were not statistically significant. Analyses using only HPV positive controls showed similar associations. The data were adjusted for and stratified by screening, but higher BMI and WHR were associated with higher disease stage at diagnosis, even among recently and frequently screened patients with adenocarcinoma. Thus, residual confounding by screening could not be excluded as an explanation for the associations.CONCLUSIONS. Obesity and body fat distribution were associated more strongly with adenocarcinoma than with squamous cell carcinoma. Although questions about screening remain, obesity may have a particular influence on the risk of glandular cervical carcinoma.