Twinning and maternal risk of ovarian cancer
Twinning and maternal risk of ovarian cancer
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DOI：
10.1016/s0140-6736(99)02000-0
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发表时间：
1999-06-05
期刊：
影响因子：
168.9
通讯作者：
Hsieh, CC
中科院分区：
文献类型：
--
作者：
Lambe, M;Wuu, J;Hsieh, CC
流行病学研究一致表明，生育和长期口服避孕药的独立使用可降低随后发生卵巢癌的风险。提出的解释这些现象的生物学机制包括持续排卵和促性腺激素升高的假说。1 .在怀孕期间和整个生育期，自然多胎妇女的生理特征与单胎妇女的生理特征不同。特别是，异卵双胞胎的母亲似乎暴露于更高水平的促卵泡激素（FSH） 2，也可能更频繁地双排卵。基于这两个主要假设，双胞胎母亲患卵巢癌的风险不仅可以通过卵巢细胞的过度激素刺激（促性腺激素假说）来预测，还可以通过终生的排卵模式来预测，这种模式容易导致恶性变化（持续排卵假说）。一个庞大的瑞典数据库使我们有机会探索双胞胎出生与母亲患上皮性卵巢癌风险之间的关系。研究人群由全国生育登记册定义，该登记册包含1925年以来出生的270多万瑞典妇女的活产数量、性别和日期信息。这些妇女的卵巢癌病例是通过与瑞典癌症登记处1961-1995年的联系确定的。生育登记数据的质量很高。然而，由于双胞胎的围产期死亡率较高，估计多胞胎少报了约10%。允许进行有效的分析
Epidemiological studies have consistently shown that childbearing and long-term oral contraceptive use independently reduce subsequent risk of developing ovarian cancer. Biological mechanisms proposed to explain these phenomena include the incessant ovulation and the raised gonadotropin hypotheses. 1 During pregnancy, and throughout reproductive life, women with naturally occurring multiple births have physiological features different from those of mothers of singletons. In particular, mothers of dizygotic twins appear to be exposed to higher levels of follicle stimulating hormone (FSH) 2 and may also double-ovulate more frequently. 3 Based on the two main hypotheses, risk of ovarian cancer in mothers of twins could be predicted to be elevated not only by excessive hormonal stimulation of ovarian cells (the gonadotropin hypothesis), but also due to lifelong patterns of ovulation that predispose to malignant change (the incessant ovulation hypothesis). A large Swedish database gave us the opportunity to explore associations between twin births and maternal risk of epithelial ovarian cancer. The study population was defined by a nationwide fertility register that contains information on number, gender, and dates of live births for more than 2· 7 million Swedish women born from 1925. Ovarian cancer cases among these women were identified through a linkage to the Swedish Cancer Register for 1961–1995. The quality of data in the fertility register is high. However, multiple births are estimated to be underreported by approximately 10% because of the higher perinatal mortality among twins. To allow efficient analyses