Endometriosis: a high-risk population for major chronic diseases?
Endometriosis: a high-risk population for major chronic diseases?
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DOI：
10.1093/humupd/dmv013
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发表时间：
2015-07-01
影响因子：
13.3
通讯作者：
Missmer, Stacey A.
中科院分区：
文献类型：
--
作者：
Kvaskoff, Marina;Mu, Fan;Missmer, Stacey A.
尽管估计在女性中的患病率为10%，但子宫内膜异位症的病因仍然知之甚少。近几十年来，子宫内膜异位症与多种慢性疾病的风险有关，如癌症、自身免疫性疾病、哮喘/特应性疾病和心血管疾病。需要更深入地了解这些关联，因为它们可能为了解子宫内膜异位症的原因或后果提供新的线索。这篇综述总结了关于子宫内膜异位症与其他慢性疾病之间关系的现有流行病学研究结果，并讨论了潜在的机制、潜在的偏见来源和方法复杂性的假设。我们对PubMed/Medline和ISI Web of Knowledge数据库进行了全面的搜索，以获取截至2014年5月的所有报道子宫内膜异位症与其他疾病之间的相关性的研究，使用了大量的搜索词。此外，我们还检查了所有已确定的论文的参考文献列表，以获取任何其他未通过计算机搜索确定的文章。我们确定了21篇关于子宫内膜异位症与卵巢癌之间的联系的研究，14篇关于乳腺癌的研究，8篇关于子宫内膜异位症与卵巢癌的研究，4篇关于宫颈癌的研究，12篇关于皮肤黑色素瘤的研究，3篇关于非霍奇金淋巴瘤的研究，以及9篇关于子宫内膜异位症与自身免疫性疾病之间的联系的研究，6篇关于哮喘和特应性疾病的研究，以及4篇关于心血管疾病的研究。据报道，子宫内膜异位症患者患卵巢癌和乳腺癌、皮肤黑色素瘤、哮喘以及一些自身免疫性疾病、心血管疾病和特应性疾病的风险较高，而患宫颈癌的风险较低。越来越多的证据表明，子宫内膜异位症患者患多种慢性病的风险较高。尽管其潜在的机制尚不清楚，但迄今已有的数据表明，就女性的长期健康而言，子宫内膜异位症并非无害。如果这些关系得到证实，这些发现可能会对筛查实践以及子宫内膜异位症患者的管理和护理产生重要影响。
Despite an estimated prevalence of 10% in women, the etiology of endometriosis remains poorly understood. Over recent decades, endometriosis has been associated with risk of several chronic diseases, such as cancer, autoimmune diseases, asthma/atopic diseases and cardiovascular diseases. A deeper understanding of these associations is needed as they may provide new leads into the causes or consequences of endometriosis. This review summarizes the available epidemiological findings on the associations between endometriosis and other chronic diseases and discusses hypotheses for underlying mechanisms, potential sources of bias and methodological complexities.We performed a comprehensive search of the PubMed/Medline and ISI Web of Knowledge databases for all studies reporting on the associations between endometriosis and other diseases published in English through to May 2014, using numerous search terms. We additionally examined the reference lists of all identified papers to capture any additional articles that were not identified through computer searches.We identified 21 studies on the associations between endometriosis and ovarian cancer, 14 for breast cancer, 8 for endometrial cancer, 4 for cervical cancer, 12 for cutaneous melanoma and 3 for non-Hodgkin's lymphoma, as well as 9 on the links between endometriosis and autoimmune diseases, 6 on the links with asthma and atopic diseases, and 4 on the links with cardiovascular diseases. Endometriosis patients were reported to be at higher risk of ovarian and breast cancers, cutaneous melanoma, asthma, and some autoimmune, cardiovascular and atopic diseases, and at decreased risk of cervical cancer.Increasing evidence suggests that endometriosis patients are at higher risk of several chronic diseases. Although the underlying mechanisms are not yet understood, the available data to date suggest that endometriosis is not harmless with respects to women's long-term health. If these relationships are confirmed, these findings may have important implications in screening practices and in the management and care of endometriosis patients.