Differences in risk factors for epithelial ovarian cancer by histologic type - Results of a case-control study
Differences in risk factors for epithelial ovarian cancer by histologic type - Results of a case-control study
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DOI：
10.1093/oxfordjournals.aje.a008937
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发表时间：
1996-08-15
影响因子：
5
通讯作者：
Howe, GR
中科院分区：
文献类型：
--
作者：
Risch, HA;Marrett, LD;Howe, GR
1989-1992年在加拿大多伦多和安大略南部的邻近地区进行了一项饮食和生殖因素与卵巢癌关系的病例对照研究。在同一时期，还采访了564名随机选择的人口对照，根据三个15岁年龄组与病例频率相匹配。采用连续非条件Logistic回归方法进行分析。研究发现，除粘液性肿瘤外，生育和口服避孕药的使用与所有主要组织学类型的上皮性卵巢癌风险的显著下降趋势相关。对于每个足月妊娠，优势比为0.76（95%置信区间（CI）0.69-0.85），非粘液性肿瘤和1.03（95% CI 0.88-1.21）为粘液性肿瘤;每使用一年口服避孕药，优势比为0.89（95% CI 0.85-0.93），非粘液性肿瘤为0.98（95% CI 0.93-1.04）（粘液性和非粘液性肿瘤之间比值比差异分别为p=0.00051和p=0.0040）。与其他组织学类型的肿瘤相比，饱和脂肪摄入似乎也会使患有粘液性肿瘤的女性的风险增加（p=0.029）。在患有非粘液性肿瘤的女性中，使用非避孕雌激素时，浸润性浆液性癌（p=0.018），特别是类浆液性癌（p=0.0041）的风险呈增加趋势。除此之外，边缘性恶性肿瘤似乎与浸润性癌具有相似的风险因素相关谱。根据这项研究和其他一些研究，作者认为粘液性卵巢肿瘤可能与其他类型的上皮性肿瘤的病因无关，因此在卵巢癌的研究中应单独考虑。
A case-control study of associations between dietary and reproductive factors and cancer of the ovary was conducted during 1989-1992 in metropolitan Toronto and nearby areas of southern Ontario, Canada, In total, 450 women aged 35-79 years with histologically verified new primary epithelial ovarian cancers were interviewed concerning their reproductive history and dietary practices. Over the same time period, 564 randomly selected population controls, frequency-matched to the cases according to three 15-year age groups, were also interviewed. Continuous unconditional logistic regression methods were used for analysis. It was found that childbearing and use of oral contraceptives were associated with significant decreasing trends in the risk of epithelial ovarian cancer of all principal histologic types except mucinous tumors. For each full-term pregnancy, the odds ratio was 0.76 (95% confidence interval (CI) 0.69-0.85) for nonmucinous tumors and 1.03 (95% CI 0.88-1.21) for mucinous tumors; for each year of oral contraceptive use, the odds ratio was 0.89 (95% CI 0.85-0.93) for nonmucinous tumors and 0.98 (95% CI 0.93-1.04) for mucinous tumors (p=0.00051 and p=0.0040, respectively, for the difference in odds ratios between mucinous and nonmucinous tumors). Saturated fat intake also appeared to convey greater increased risk for women with mucinous tumors than for women with neoplasms of other histologic types (p=0.029). Among women with nonmucinous tumors, increasing trends in risk of invasive serous cancer (p=0.018), and particularly endometrioid cancer (p=0.0041), were seen with use of noncontraceptive estrogens, Otherwise, borderline-malignant neoplasms seemed to have a similar spectrum of risk factor associations as invasive cancers. On the basis of this study and a number of others, the authors suggest that mucinous ovarian tumors may be etiologically unrelated to other types of epithelial tumors, and thus should be considered separately in studies of ovarian cancer.