Risk factors for atypical hyperplasia and endometrial cancer in the infertility population: a case-control study.
Risk factors for atypical hyperplasia and endometrial cancer in the infertility population: a case-control study.
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不孕人群中子宫内膜不典型增生和子宫内膜癌的危险因素：病例对照研究。
DOI：
10.1016/j.xfre.2020.10.005
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发表时间：
2021-03
期刊：
影响因子：
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通讯作者：
Shah DK
中科院分区：
文献类型：
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作者：
Kahn JL;Buckingham L;Koelper NC;Sammel MD;Shah DK
评估接受不孕评估的美国妇女中子宫内膜非典型增生（AH）和子宫内膜癌（EC）的发病率并确定其危险因素。病例对照研究。学术生殖内分泌学和不孕不育实践。2009年1月1日至2018年12月1日寻求不孕症评估的女性患者（18-50岁）。排除了具有已知的癌症遗传易感性或既往癌症诊断的患者。病例定义为不孕症检查期间诊断为AH或EC的患者（n = 22）。对照组无AH或EC，随机选择在10：1的比例（n = 220），所有妇女在同一年进行不孕症评估。没有。AH或EC的发生率和AH或EC的几率考虑了年龄、种族、体重指数（BMI）和排卵功能障碍。在11，569名接受不孕症评估的妇女中确定了22例AH或EC病例（发病率为2/1，000名妇女，95%置信区间[CI]为1.2-2.9/1，000）。在这些女性中，68%的BMI ≥30 kg/m2，而对照组为25%。在多变量分析中，BMI ≥30 kg/m2的女性被诊断为AH或EC的可能性是其他女性的5.9倍（校正比值比5.9，95% CI 2.0-17.2）。有排卵功能障碍的女性被诊断为AH或EC的可能性是正常女性的3.4倍（校正比值比3.4，95% CI 1.1-10.1）。接受不孕症评估的妇女人群中AH和EC的发生率是绝经前妇女一般人群的10倍。肥胖是不孕妇女AH和EC最强的独立危险因素。
To estimate the incidence and identify risk factors for atypical endometrial hyperplasia (AH) and endometrial cancer (EC) in American women undergoing infertility evaluation. Case-control study. Academic reproductive endocrinology and infertility practice. Female patients (18–50 years) seeking infertility evaluation from January 1, 2009 to December 1, 2018. Patients with known genetic predisposition to cancer or prior cancer diagnosis were excluded. Cases were defined as patients diagnosed with AH or EC during infertility workup (n = 22). Controls without AH or EC were randomly selected in a 10:1 ratio (n = 220) from all women undergoing infertility evaluation in the same year. None. Incidence of AH or EC and odds of AH or EC accounting for age, race, body mass index (BMI), and ovulatory dysfunction. Twenty-two cases of AH or EC were identified among 11,569 women undergoing infertility evaluation (incidence 2 per 1,000 women, 95% confidence interval [CI] 1.2–2.9 per 1,000). Of these women, 68% had a BMI ≥30 kg/m2 compared with 25% of controls. In multivariable analyses, women with a BMI ≥30 kg/m2 were 5.9 times more likely to be diagnosed with AH or EC (adjusted odds ratio 5.9, 95% CI 2.0–17.2). Women with ovulatory dysfunction were 3.4 times more likely to be diagnosed with AH or EC (adjusted odds ratio 3.4, 95% CI 1.1–10.1). The incidence of AH and EC in a population of women undergoing infertility evaluation is 10 times that in the general population of premenopausal women. Obesity is the strongest independent risk factor for AH and EC in women with infertility.