Holly E A, Aston D A, Ahn D K, Kristiansen J J, Char D H
Program in Epidemiology, Northern California Cancer Center, Belmont 94002.
Cancer Res. 1991 Mar 1;51(5):1370-2.
In a case-control study, we explored a potential association between uveal melanoma and reproductive factors in women. Responses from telephone interviews of 186 women diagnosed with uveal melanoma were compared with responses of 423 women without this disease. All women resided in 11 U.S. western states. We observed a decreased risk of uveal melanoma for women who had ever been pregnant [relative risk (RR) = 0.60, 95% confidence interval (CI) = 0.37 -0.95], with an increase in this protective effect with more live births after adjustment for age, menopausal status, eye color, and skin sensitivity to the sun (1-2 births, RR = 0.47,95% CI 0.29-0.78; 3-4 births, RR = 0.38, 95% CI = 0.22-0.64; 5 or more births, RR = 0.33, 95% CI = 0.15-0.71). The largest effect was observed between nulliparous and parous women. No other reproductive factors, including use of oral contraceptives or postmenopausal estrogens, were shown to be related to risk for uveal melanoma. We conclude that most reproductive factors in this population play little or no role in the etiology of uveal melanoma. The association with number of live births must be confirmed in other studies to assure that it is unrelated to confounding factors not measured in this study.
在一项病例对照研究中，我们探讨了女性葡萄膜黑色素瘤与生殖因素之间的潜在关联。对186名被诊断为葡萄膜黑色素瘤的女性进行电话访谈的结果，与423名未患此病的女性的回答进行了比较。所有女性均居住在美国西部的11个州。我们观察到，曾经怀孕的女性患葡萄膜黑色素瘤的风险降低[相对风险（RR）=0.60，95%置信区间（CI）=0.37-0.95]，在调整年龄、绝经状态、眼睛颜色和皮肤对阳光的敏感性后，随着活产次数的增加，这种保护作用增强（1-2次分娩，RR=0.47，95%CI 0.29-0.78；3-4次分娩，RR=0.38，95%CI=0.22-0.64；5次或更多次分娩，RR=0.33，95%CI=0.15-0.71）。在未生育和已生育的女性之间观察到最大的影响。未发现其他生殖因素，包括使用口服避孕药或绝经后雌激素，与葡萄膜黑色素瘤的风险有关。我们得出结论，该人群中的大多数生殖因素在葡萄膜黑色素瘤的病因中作用很小或没有作用。与活产次数的关联必须在其他研究中得到证实，以确保其与本研究中未测量的混杂因素无关。
