Parazzini F, Restelli C, La Vecchia C, Negri E, Chiari S, Maggi R, Mangioni C
Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy.
Int J Epidemiol. 1991 Dec;20(4):871-7. doi: 10.1093/ije/20.4.871.
A case-control study was conducted on 91 cases with histologically-confirmed borderline ovarian tumours and 237 control subjects in hospital for acute non-gynaecological, hormonal or neoplastic disease. Women reporting three or more births, compared to nulliparae, had a relative risk (RR) estimate of 0.6, but this finding was not statistically significant (95% confidence interval (CI): 0.2-1.4). The risk of borderline tumours increased, although not significantly, with later age at first birth: compared to women reporting first birth at age 24 or before, the RRs were 1.3 and 1.7 in those reporting respectively their first birth at age 25-29 and 30 years or more. No significant relationship emerged between borderline ovarian cancer and age at menarche, menopausal status and lifelong menstrual pattern. Cases tended to report a later age at menopause than controls, but the trend in risk was not statistically significant. Nine cases (9.9%) and 68 controls (24.9%) reported oral contraceptive use: compared with never users the multivariate RR for ever users was 0.3, and the risk dropped with duration of use to 0.2 in users for two years or more (chi 2 (1) trend = 12.70, p less than 0.001). This study provides epidemiological evidence of a pathogenetic continuum between borderline and invasive ovarian tumours.
对91例经组织学确诊的卵巢交界性肿瘤患者和237名因急性非妇科、激素或肿瘤疾病住院的对照者进行了一项病例对照研究。与未生育妇女相比，生育三次或三次以上的妇女相对风险（RR）估计值为0.6，但这一发现无统计学意义（95%置信区间（CI）：0.2 - 1.4）。首次生育年龄越大，交界性肿瘤的风险虽未显著增加，但有所上升：与首次生育年龄在24岁及以前的妇女相比，首次生育年龄在25 - 29岁和30岁及以上的妇女的RR分别为1.3和1.7。卵巢交界性癌与初潮年龄、绝经状态和终生月经模式之间未发现显著关系。病例组的绝经年龄往往比对照组晚，但风险趋势无统计学意义。9例（9.9%）病例和68名对照者（24.9%）报告使用过口服避孕药：与从未使用者相比，曾经使用者的多变量RR为0.3，使用两年或更长时间的使用者风险降至0.2（卡方检验（1）趋势 = 12.70，p < 0.001）。本研究提供了卵巢交界性肿瘤和浸润性卵巢肿瘤之间发病连续性的流行病学证据。
