Jordan Susan J, Whiteman David C, Purdie David M, Green Adèle C, Webb Penelope M
Cancer and Population Studies Group, Queensland Institute of Medical Research, School of Population Health, University of Queensland, Brisbane, Australia.
Gynecol Oncol. 2006 Dec;103(3):1122-9. doi: 10.1016/j.ygyno.2006.08.012. Epub 2006 Sep 26.
Although early reports suggested that smoking was not associated with ovarian cancer risk, recent studies have reported positive associations for cancers of the mucinous subtype. We sought to clarify the relationship between smoking and ovarian cancer by histological subtype.
We conducted a systematic literature review and meta-analysis of studies investigating the association between smoking and risk of the different histological subtypes of epithelial ovarian cancer. Eight population-based case-control studies, one pooled analysis of case-control studies, and one cohort study met the inclusion criteria. Summary relative risks (RR), 95% confidence intervals (CI), and tests for heterogeneity were generated from random effects models.
Combined, these studies included a total of 910 women with mucinous and 5564 with non-mucinous ovarian cancers. There was a significant doubling of risk of mucinous ovarian cancer in current smokers compared to never smokers (summary RR 2.1, 95% CI 1.7-2.7), but no increased risk of serous (1.0, 95% CI 0.8-1.2) or endometrioid (0.8, 95% CI 0.6-1.1) cancers and a significant risk reduction for clear cell cancers (0.6, 95% CI 0.3-0.9). The risk of mucinous cancer increased with increasing amount smoked but returned to that of never smokers within 20-30 years of stopping smoking.
Meta-analysis suggests that current smoking doubles a woman's risk of developing mucinous ovarian cancer. Stopping smoking returns the risk to normal in the long term. Smoking may thus be one of the few modifiable factors offering potential for primary prevention of mucinous ovarian cancer.
尽管早期报告表明吸烟与卵巢癌风险无关，但最近的研究报告了吸烟与黏液性亚型癌症之间存在正相关。我们试图按组织学亚型阐明吸烟与卵巢癌之间的关系。
我们对调查吸烟与上皮性卵巢癌不同组织学亚型风险之间关联的研究进行了系统的文献综述和荟萃分析。八项基于人群的病例对照研究、一项病例对照研究的汇总分析和一项队列研究符合纳入标准。从随机效应模型中得出汇总相对风险（RR）、95%置信区间（CI）以及异质性检验结果。
这些研究总共纳入了910例黏液性卵巢癌女性患者和5564例非黏液性卵巢癌女性患者。与从不吸烟者相比，当前吸烟者患黏液性卵巢癌的风险显著增加一倍（汇总RR 2.1，95%CI 1.7 - 2.7），但浆液性（1.0，95%CI 0.8 - 1.2）或子宫内膜样（0.8，95%CI 0.6 - 1.1）癌症的风险没有增加，而透明细胞癌的风险显著降低（0.6，95%CI 0.3 - 0.9）。黏液性癌症的风险随着吸烟量的增加而增加，但在戒烟20 - 30年内恢复到从不吸烟者的水平。
荟萃分析表明，当前吸烟会使女性患黏液性卵巢癌的风险增加一倍。长期来看，戒烟可使风险恢复正常。因此，吸烟可能是少数几个可为黏液性卵巢癌一级预防提供潜在机会的可改变因素之一。
