Bjørge Tone, Engeland Anders, Tretli Steinar, Weiderpass Elisabete
Department of Public Health and Primary Health Care, Section for Epidemiology and Medical Statistics, University of Bergen, N-5018 Bergen, Norway.
Int J Cancer. 2007 Jan 15;120(2):378-83. doi: 10.1002/ijc.22260.
A positive association between overweight/obesity and endometrial cancer has been observed. It has been hypothesized that obesity is mostly associated with a subtype described as estrogen-dependent (Type I tumors), constituting about 80% of the endometrial tumors. Few epidemiologic studies have, however, analyzed different histological subtypes separately. The present study aimed at exploring the relations between body size and histological subtypes of cancer of the uterine corpus. Height and weight were measured in over 1 million Norwegian women aged 20-74 during 1963-2001. During follow-up, 9,227 cancers of the uterine corpus were diagnosed. The tumors were classified as Type I tumors (mostly endometrial adenocarcinomas with subgroups), Type II tumors (papillary, serous, and clear cell adenocarcinomas and some poorly differentiated carcinomas), sarcomas, and mixed tumors. Relative risks (RRs) of cancer of the uterine corpus were estimated using Cox proportional hazards regression. Compared with women with normal BMI, overweight and obese women had an overall RR of cancer of the uterine corpus of 1.36 (95% CI: 1.29-1.42) and 2.51 (95% CI: 2.83-2.66). The increase in risk was most pronounced for Type I tumors, but was also seen for Type II tumors, sarcomas and mixed tumors. The overall RR of corpus uteri cancer associated with a 10-cm increase in height was 1.09 (95% CI: 1.05-1.13), and was mostly observed for Type I tumors.
超重/肥胖与子宫内膜癌之间已观察到存在正相关关系。据推测，肥胖主要与一种被描述为雌激素依赖型的亚型（I型肿瘤）相关，这种类型约占子宫内膜肿瘤的80%。然而，很少有流行病学研究分别分析不同的组织学亚型。本研究旨在探讨体型与子宫体癌组织学亚型之间的关系。在1963年至2001年期间，对100多万名年龄在20 - 74岁的挪威女性测量了身高和体重。在随访期间，诊断出9227例子宫体癌。这些肿瘤被分类为I型肿瘤（主要是伴有亚组的子宫内膜腺癌）、II型肿瘤（乳头状、浆液性和透明细胞腺癌以及一些低分化癌）、肉瘤和混合性肿瘤。使用Cox比例风险回归估计子宫体癌的相对风险（RRs）。与体重指数正常的女性相比，超重和肥胖女性子宫体癌的总体RR分别为1.36（95%置信区间：1.29 - 1.42）和2.51（95%置信区间：2.83 - 2.66）。风险增加在I型肿瘤中最为明显，但在II型肿瘤、肉瘤和混合性肿瘤中也可见到。身高每增加10厘米，子宫体癌的总体RR为1.09（95%置信区间：1.05 - 1.13），且主要在I型肿瘤中观察到。
