Ovarian Cancer Risk Factors by Histologic Subtype: An Analysis From the Ovarian Cancer Cohort Consortium
Ovarian Cancer Risk Factors by Histologic Subtype: An Analysis From the Ovarian Cancer Cohort Consortium
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DOI：
10.1200/jco.2016.66.8178
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发表时间：
2016-08-20
影响因子：
45.3
通讯作者：
Tworoger, Shelley S.
中科院分区：
文献类型：
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作者：
Wentzensen, Nicolas;Poole, Elizabeth M.;Tworoger, Shelley S.
目的了解卵巢癌的病因异质性对提高预防、早期发现和治疗方法具有重要意义。我们评估了14个激素，生殖，和生活方式因素的组织学亚型卵巢癌队列Consortium（OC 3）。患者和MethodsAmong 1.3万名妇女从21项研究中，5,584浸润性上皮性卵巢癌被确定（3,378浆液，606类，331粘液，269透明细胞，1,000其他）。通过使用竞争风险考克斯比例风险回归，按研究和出生年份分层，并调整年龄、产次和口服避孕药的使用，我们评估了组织学与所有浸润性癌症的相关性。Heterogeneity进行了评估似然比test.ResultsMost危险因素表现出显着的异质性，组织学。较高的产次与类甲状腺癌（相对危险度[RR]，每次出生，0.78; 95%CI，0.74 - 0.83）和透明细胞癌（RR，0.68; 95%CI，0.61 - 0.76）密切相关（异质性P值[P-het] < .001）。同样地，绝经年龄、子宫内膜异位症和输卵管结扎仅与卵巢样癌和透明细胞肿瘤相关（P-het
PurposeAn understanding of the etiologic heterogeneity of ovarian cancer is important for improving prevention, early detection, and therapeutic approaches. We evaluated 14 hormonal, reproductive, and lifestyle factors by histologic subtype in the Ovarian Cancer Cohort Consortium (OC3).Patients and MethodsAmong 1.3 million women from 21 studies, 5,584 invasive epithelial ovarian cancers were identified (3,378 serous, 606 endometrioid, 331 mucinous, 269 clear cell, 1,000 other). By using competing risks Cox proportional hazards regression stratified by study and birth year and adjusted for age, parity, and oral contraceptive use, we assessed associations for all invasive cancers by histology. Heterogeneity was evaluated by likelihood ratio test.ResultsMost risk factors exhibited significant heterogeneity by histology. Higher parity was most strongly associated with endometrioid (relative risk [RR] per birth, 0.78; 95% CI, 0.74 to 0.83) and clear cell (RR, 0.68; 95% CI, 0.61 to 0.76) carcinomas (P value for heterogeneity [P-het] < .001). Similarly, age at menopause, endometriosis, and tubal ligation were only associated with endometrioid and clear cell tumors (P-het