Placental weight and risk of invasive epithelial ovarian cancer with an early age of onset.
Placental weight and risk of invasive epithelial ovarian cancer with an early age of onset.
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DOI：
10.1158/1055-9965.epi-08-0390
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发表时间：
2008-09
影响因子：
3.8
通讯作者：
Johansson, Anna L. V.
中科院分区：
文献类型：
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作者：
Cnattingius, Sven;Eloranta, Sandra;Adami, Hans-Olov;Axelsson, Ove;Dickman, Paul W.;Hsieh, Chung-cheng;Mucci, Lorelei A.;Trichopoulos, Dimitrios;Lambe, Mats;Johansson, Anna L. V.
上皮性卵巢癌与生殖因素有关，但我们不知道怀孕期间的激素因素是否会影响母亲的风险。由于妊娠激素主要由胎盘产生，胎盘重量可能是妊娠期间激素暴露的间接标志。在一项全国性的瑞典队列研究中，我们纳入了1982年至1989年间的单胎妇女。这些妇女被跟踪调查浸润性上皮性卵巢癌的发生、死亡或移民情况，直到2004年。使用Cox模型的风险比（HR）和95%置信区间（95% CI）来估计妊娠暴露与上皮性卵巢癌之间的关联。在395,171名首次分娩时有胎盘重量信息的妇女中，316名妇女患上了浸润性上皮性卵巢癌。诊断时平均年龄44岁。与胎盘重量在500 ~ 699 g的女性相比，胎盘重量高（≥700 g）的女性患上皮性卵巢癌的风险增加（HR, 1.47; 95% CI, 1.14-1.90）。与足月妊娠（40-41周）妇女相比，足月妊娠（≥42周）妇女发生上皮性卵巢癌的风险增加（HR, 1.48; 95% CI, 1.00-2.19）。当我们纳入女性首次生育的总体信息时，这些关联略强，当我们纳入1982年至1989年最后一次记录的分娩或最后一次分娩的信息时，这些关联略弱。由于妊娠激素水平随着胎盘重量的增加而增加，我们的研究支持了怀孕期间激素暴露会影响年轻女性患侵袭性上皮性卵巢癌风险的假设。
Epithelial ovarian cancer is associated with reproductive factors, but we lack knowledge if hormonal factors during pregnancy influence the mother’s risk. Because pregnancy hormones are primarily produced by the placenta, placental weight may be an indirect marker of hormone exposure during pregnancy. In a nationwide Swedish cohort study, we included women with singleton births from 1982 to 1989. Women were followed for occurrence of invasive epithelial ovarian cancer, death, or emigration through 2004. Hazard ratios (HR) with 95% confidence intervals (95% CI) from Cox models were used to estimate associations between pregnancy exposures and epithelial ovarian cancer. Among 395,171 women with information on placental weight in their first recorded birth, 316 women developed invasive epithelial ovarian cancer. Mean age at diagnosis was 44 years. Compared with women with a placental weight of 500 to 699 g, women with a high (≥700 g) placental weight had an increased riskof developing epithelial ovarian cancer (HR, 1.47; 95% CI, 1.14–1.90). Compared with women with term pregnancies (40–41 weeks), women with post-term (≥42 weeks) pregnancies had an increased risk of developing epithelial ovarian cancer (HR, 1.48; 95% CI, 1.00–2.19). These associations were slightly stronger when we included information about women’s overall first birth, and slightly weaker when we included information about last recorded birth or ever last birth from 1982 to 1989. Because pregnancy hormone levels increase with placental weight, our study supports the hypothesis that hormone exposures during pregnancy influence the risk of invasive epithelial ovarian cancer among young women.