A TYPICAL HYPERPLASIA AND BREAST-CANCER RISK - A CRITIQUE
A TYPICAL HYPERPLASIA AND BREAST-CANCER RISK - A CRITIQUE
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DOI：
10.1007/bf00052748
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发表时间：
1992-11-01
影响因子：
2.3
通讯作者：
BOYD, NF
中科院分区：
文献类型：
--
作者：
MA, L;BOYD, NF
本文的目的是严格审查的证据表明，不典型增生（AH）是乳腺癌的危险因素。首先，我们评估了研究AH和乳腺癌风险之间的关联的研究，以确保其遵守广泛接受的研究标准。第二，我们检查了现有的证据，以确定AH和乳腺癌风险之间的关联性，使用布拉德福德山提出的指南。从1960年1月至1992年3月，共有18项研究（11项队列研究，2项病例对照研究和5项横断面研究）以英语发表，研究AH作为一个独特的实体与乳腺癌风险之间的关系。采用系统的方法来检查所收集的研究是否符合方法学标准，结果显示研究之间存在很大差异。基于182，980名女性的总样本量进行了荟萃分析。在16项给出风险点估计的研究中，14项超过了1，12项与1有显著差异。所有关于AH与乳腺癌之间关联的研究的汇总估计值得出的总体优势比（OR）为3.67（95%置信区间= 3.16-4.26）。同质关联假设的检验被拒绝（chi 2 = 151.6，df = 14，P < 0.0001），表明个体研究的OR之间存在显著差异。应用Bradford Hill标准得出的结论强烈表明AH是乳腺癌的危险因素。
The purpose of this paper is to examine critically the evidence that atypical hyperplasia (AH) is a risk factor for breast cancer. First, we appraised studies that have examined the association between AH and breast cancer risk for their adherence to widely accepted standards for the conduct of research. Second, we examined the available evidence to determine the plausibility of an association between AH and breast cancer risk using the guidelines proposed by Bradford Hill. A total of 18 studies (11 cohort studies, two case-control studies, and five cross-sectional studies) were found that were published in the English language from january 1960 to March 1992 that examined the association of AH as a distinct entity and breast cancer risk. A systematic approach was adopted to examine the collected studies for their adherence to methodologic standards, which showed wide variation among studies. A meta-analysis was carried out, based on a total sample size of 182,980 women. Of 16 studies that gave point estimates of risk, 14 exceeded unity and 12 were significantly different from unity. The pooled estimate from all studies of the association between AH and breast cancer, gave an overall odds ratio (OR) of 3.67 (95 percent confidence interval = 3.16-4.26). The test of the hypothesis of homogeneous association was rejected (chi2 = 151.6, df = 14, P < 0.0001), indicating significant variability among the ORs of individual studies. The conclusions from the application of the Bradford Hill criteria indicated strongly that AH is a risk factor for breast cancer.