Endometrioid and clear cell ovarian cancers - A comparative analysis of risk factors
Endometrioid and clear cell ovarian cancers - A comparative analysis of risk factors
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DOI：
10.1016/j.ejca.2008.07.009
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发表时间：
2008-11-01
影响因子：
8.4
通讯作者：
Green, Adele C.
中科院分区：
文献类型：
--
作者：
Nagle, Christina M.;Olsen, Catherine M.;Green, Adele C.
卵巢癌的子宫内膜样癌和透明细胞亚型都被认为与子宫内膜异位症和子宫内膜病理密切相关，因此在病因研究中经常被结合起来。在我们以人群为基础的全澳大利亚病例对照研究中，我们分别检查了这些卵巢癌的潜在不同危险因素，研究对象包括142名发生侵袭性子宫内膜样变的女性、90名卵巢透明细胞癌患者和1508名对照人群。用多因素Logistic回归计算优势比(OR)和95%可信区间(CI)。产次增加和激素避孕药的使用时间为5年，大大降低了这两种亚型的风险。母乳喂养和输卵管结扎术也呈负相关，但仅对子宫内膜样亚型有显著影响。不出所料，子宫内膜异位症增加了这两种亚型的风险(子宫内膜样变OR2.2，95%可信区间1.2~3.9，透明细胞型OR 3.0，95%可信区间1.5~5.9)。肥胖只与透明细胞癌有关，我们观察到这种癌症的风险增加了两倍(OR 2.2，95%CI 1.2-4.1)。此外，随着吸烟强度的增加(p趋势0.02)和高中以后的教育程度，风险降低的显着趋势仅与减少透明细胞癌的发生有关。子宫内膜样癌和透明细胞癌有一些共同的危险因素，也有一些不同的危险因素，因此在卵巢癌的研究中应该分开考虑。(C)2008爱思唯尔有限公司。保留所有权利。
Endometrioid and clear cell subtypes of ovarian cancer are both known to be closely associated with endometriosis and endometrial pathology, and so have often been combined in studies of causation. We have examined these ovarian cancers separately for potentially distinct risk factors in our population-based, Australia-wide case control study of 142 women with incident invasive endometrioid, 90 with clear cell ovarian cancers and 1508 population controls. Multivariate logistic regression was used to calculated odds ratios (ORs) and 95% confidence intervals (CIs). Increasing parity, and hormonal contraceptive use for >= 5 years, strongly decreased the risks of both subtypes. Breast feeding and tubal ligation were also inversely associated, but significantly so only for the endometrioid subtype. As expected endometriosis increased the risk of both subtypes (OR 2.2, 95%CI 1.2-3.9 for endometrioid and OR 3.0, 95%CI 1.5-5.9 for clear cell). Obesity was associated only with clear cell cancers, where we observed a two-fold increased risk (OR 2.2, 95%CI 1.2-4.1). Also a significant trend of decreasing risk with increasing intensity of smoking (p trend 0.02) and education beyond high school was associated with decreased development of clear cell cancers only. Endometrioid and clear cell ovarian cancers have some shared as well as some distinct risk factors, and therefore should be considered separately in studies of ovarian cancer. (C) 2008 Elsevier Ltd. All rights reserved.