Type I and II Endometrial Cancers: Have They Different Risk Factors?
Type I and II Endometrial Cancers: Have They Different Risk Factors?
复制标题
DOI：
10.1200/jco.2012.48.2596
复制
发表时间：
2013-07-10
影响因子：
45.3
通讯作者：
Horn-Ross, Pamela L.
中科院分区：
文献类型：
--
作者：
Setiawan, Veronica Wendy;Yang, Hannah P.;Horn-Ross, Pamela L.
目的子宫内膜癌长期以来被分为雌激素依赖型I型和临床上不常见的侵袭性雌激素非依赖型II型。关于II型肿瘤的危险因素知之甚少，因为大多数研究缺乏足够的病例来分别研究这些不太常见的肿瘤。我们研究了是否所谓的经典子宫内膜癌的危险因素也影响II型肿瘤的风险。患者和MethodsIndividual-level数据从10个队列和14个病例对照研究的子宫内膜癌联盟的流行病学进行了汇总。共纳入14，069例子宫内膜癌病例和35，312例对照。我们把类神经胶质（n = 7，246），未另行说明的腺癌（n = 4，830），鳞状分化腺癌（n = 777）为I型肿瘤，浆液性（n = 508）和混合细胞（n = 346）为II型肿瘤。糖尿病与I型和II型肿瘤的相关程度相似。然而，体重指数对I型肿瘤的影响大于II型肿瘤：I型肿瘤每增加2 kg/m2的比值比（OR）为1.20（95% CI，1.19至1.21），II型肿瘤为1.12（95% CI，1.09至1.14）（P异质性< .0001）。高级别子宫内膜样瘤和II型肿瘤的危险因素模式相似。ConclusionThe结果汇总分析表明，这两种类型的子宫内膜癌有许多共同的病因因素。因此，II型肿瘤的病因可能不像以前认为的那样完全不依赖于雌激素。(C)2013年美国临床肿瘤学会
PurposeEndometrial cancers have long been divided into estrogen-dependent type I and the less common clinically aggressive estrogen-independent type II. Little is known about risk factors for type II tumors because most studies lack sufficient cases to study these much less common tumors separately. We examined whether so-called classical endometrial cancer risk factors also influence the risk of type II tumors.Patients and MethodsIndividual-level data from 10 cohort and 14 case-control studies from the Epidemiology of Endometrial Cancer Consortium were pooled. A total of 14,069 endometrial cancer cases and 35,312 controls were included. We classified endometrioid (n = 7,246), adenocarcinoma not otherwise specified (n = 4,830), and adenocarcinoma with squamous differentiation (n = 777) as type I tumors and serous (n = 508) and mixed cell (n = 346) as type II tumors.ResultsParity, oral contraceptive use, cigarette smoking, age at menarche, and diabetes were associated with type I and type II tumors to similar extents. Body mass index, however, had a greater effect on type I tumors than on type II tumors: odds ratio (OR) per 2 kg/m(2) increase was 1.20 (95% CI, 1.19 to 1.21) for type I and 1.12 (95% CI, 1.09 to 1.14) for type II tumors (P-heterogeneity < .0001). Risk factor patterns for high-grade endometrioid tumors and type II tumors were similar.ConclusionThe results of this pooled analysis suggest that the two endometrial cancer types share many common etiologic factors. The etiology of type II tumors may, therefore, not be completely estrogen independent, as previously believed. (C) 2013 by American Society of Clinical Oncology