Risk factors for developing endometrial cancer after benign endometrial sampling.
Risk factors for developing endometrial cancer after benign endometrial sampling.
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DOI：
10.1097/aog.0b013e31826b9fef
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发表时间：
2012-11
影响因子：
7.2
通讯作者：
Mariani A
中科院分区：
文献类型：
--
作者：
Torres ML;Weaver AL;Kumar S;Uccella S;Famuyide AO;Cliby WA;Dowdy SC;Gostout BS;Mariani A
子宫内膜活检或刮宫术 (D&C) 良性结果后确定子宫内膜癌的危险因素。来自罗切斯特流行病学项目数据的巢式病例对照研究。在明尼苏达州奥姆斯特德县 1970 年至 2008 年间接受子宫内膜癌诊断的 370 名居民中，我们确定了 90 名患者 (24.5%) 之前有良性子宫内膜活检或 D&C 结果（无非典型增生）。我们将他们与 172 名匹配的对照进行了比较，这些对照有良性子宫内膜活检或 D&C 结果，但没有随后患子宫内膜癌。使用多变量条件逻辑回归模型，我们发现口服避孕药的使用具有保护作用（比值比 [OR]，0.18；95% 置信区间 [CI]，0.08-0.45；P<.001），以及结直肠癌个人病史（OR，4.44；95% CI，1.02-19.31；P<.05）、子宫内膜息肉（OR， 4.12；95% CI，1.40-12.17；P=0.01）和病态肥胖（OR，3.40；95% CI，1.18-9.78；P<0.03）与随后的子宫内膜癌独立相关。与不存在危险因素相比，存在一种和两种或两种以上危险因素使子宫内膜癌的风险分别增加8.12（95% CI，3.08-21.44）和17.87（95% CI，5.57-57.39）倍。假设 EC 终生风险为 2.6%，上述 4 个风险因素中的 1 个和 2 个或以上的 OR 分别为 8.12 和 17.87，则终生风险分别约为 18% 和 32%。四分之一的子宫内膜癌患者既往有良性子宫内膜活检或 D&C 结果。结直肠癌个人史、子宫内膜息肉的存在和病态肥胖是良性子宫内膜活检或 D&C 结果后患子宫内膜癌的最强危险因素，而口服避孕药的使用是最强的保护因素。
To identify risk factors for endometrial cancer after benign results of endometrial biopsy or dilatation and curettage (D&C). Nested case-control study from Rochester Epidemiology Project data. Among 370 Olmsted County, Minnesota, residents who received an endometrial cancer diagnosis between 1970 and 2008, we identified 90 patients (24.5%) who had previous benign endometrial biopsy or D&C results (no atypical hyperplasia). We compared them with 172 matched controls who had benign endometrial biopsy or D&C results without subsequent endometrial cancer. Using a multivariable, conditional logistic regression model, we found that oral contraceptive use was protective (odds ratio [OR], 0.18; 95% confidence interval [CI], 0.08-0.45; P<.001), and personal history of colorectal cancer (OR, 4.44; 95% CI, 1.02-19.31; P<.05), endometrial polyp (OR, 4.12; 95% CI, 1.40-12.17; P=.01), and morbid obesity (OR, 3.40; 95% CI, 1.18-9.78; P<.03) were independently associated with subsequent endometrial cancer. Compared with the presence of no risk factor, presence of one and two or more risk factors increased the risk of endometrial cancer by 8.12 (95% CI, 3.08-21.44) and 17.87 (95% CI, 5.57-57.39) times, respectively. Assuming a 2.6% lifetime risk of EC, OR’s of 8.12 and 17.87 for 1 and 2 or more of the 4 afore-mentioned risk factors confer a lifetime risk of approximately 18% and 32%, respectively. One-fourth of patients with endometrial cancer had previous benign endometrial biopsy or D&C results. Personal history of colorectal cancer, presence of endometrial polyps, and morbid obesity are the strongest risk factors for having endometrial cancer after a benign endometrial biopsy or D&C result, and oral contraceptive use is the strongest protective factor.
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影响因子：
168.9
作者：
Renehan, Andrew G.;Tyson, Margaret;Zwahlen, Marcel
通讯作者：
Zwahlen, Marcel
影响因子：
158.5
作者：
Hampel, H;Frankel, WL;Papadopoulos, N
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Papadopoulos, N
影响因子：
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作者：
Zaino, RJ;Kauderer, J;Gallup, DG
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45.3
作者：
Zighelboim, Israel;Goodfellow, Paul J.;Mutch, David G.
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影响因子：
4.7
作者：
Leitao, Mario M., Jr.;Kehoe, Siobhan;Abu-Rustum, Nadeern R.
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Abu-Rustum, Nadeern R.