Women's College Research Institute, 790 Bay Street, Toronto, Ontario, Canada.
Gynecol Oncol. 2010 Aug 1;118(2):155-9. doi: 10.1016/j.ygyno.2010.03.009. Epub 2010 May 10.
The purpose of this study was to identify risk factors for fallopian tube cancer in women with and without a BRCA mutation.
Subjects with fallopian tube cancer were identified from two sources: 1) a large international registry of women who carry a BRCA1 or BRCA2 mutation (n=56), and; 2) a population-based study of ovarian and fallopian tube cancer conducted in Ontario, Canada (n=66). BRCA mutation status was established for all subjects. Each subject was matched to one or more unaffected controls, for date of birth (within four years), for BRCA mutation status (negative, BRCA1, and BRCA2), for country of residence and for past history of breast cancer (yes/no). All subjects completed a questionnaire about medical history and lifestyle factors. Odds ratios and 95% confidence intervals were calculated for parity, oral contraceptive use, tubal ligation, hormone replacement therapy and body mass index, using conditional logistic regression.
We studied 103 women with fallopian tube cancer (48 with a BRCA1 mutation, 12 with a BRCA2 mutation and 43 with no identified BRCA mutation) and 980 matched controls. Increasing parity was associated with a decreased risk of fallopian tube cancer in non-carriers (trend per birth odds ratio 0.71 (95% CI 0.52-0.97), p=0.03), in BRCA1 carriers (OR=0.79 (0.62-1.02) p=0.07) and in BRCA2 carriers (OR=0.62 (0.34-1.15), p=0.13), but was statistically significant only for non-carriers. Oral contraceptive use was associated with a reduced risk in BRCA1 carriers (trend per year of use odds ratio=0.91 (0.83-0.99), p=0.03) but not for non-carriers (OR=0.97 (0.87-1.09), p=0.64) or for BRCA2 carriers (OR=0.94 (0.80-1.11), p=0.47). Hormone replacement therapy was associated with an increased risk for fallopian tube cancer in all subjects (OR=1.07 (1.01-1.13), p=0.03), and in the subgroups stratified by mutation, however the association was not significant in the subgroups. Tubal ligation was associated with a decreased risk of fallopian tube cancer for all subjects (OR=0.64 (0.31-1.28), p=0.21), however the reduction was not significant.
Parity and oral contraceptive use are associated with reduced risks of fallopian tube cancer. In contrast, hormone replacement therapy may be associated with an increase in the risk of fallopian tube cancer.
本研究旨在确定有和无 BRCA 突变的女性发生输卵管癌的风险因素。
从两个来源确定输卵管癌患者：1）携带 BRCA1 或 BRCA2 突变的大型国际妇女登记处（n=56）；2）在加拿大安大略省进行的卵巢和输卵管癌的基于人群的研究（n=66）。对所有受试者均确定 BRCA 突变状态。为每位受试者匹配一个或多个无影响的对照，以出生日期（四年内）、BRCA 突变状态（阴性、BRCA1 和 BRCA2）、居住国和既往乳腺癌史（是/否）进行匹配。所有受试者均完成了关于病史和生活方式因素的问卷。使用条件逻辑回归计算产次、口服避孕药使用、输卵管结扎、激素替代疗法和体重指数的比值比和 95%置信区间。
我们研究了 103 名输卵管癌患者（48 名携带 BRCA1 突变，12 名携带 BRCA2 突变，43 名无明确 BRCA 突变）和 980 名匹配对照。非携带者的产次增加与输卵管癌风险降低相关（每出生一次的趋势比值比为 0.71（95%CI 0.52-0.97），p=0.03），在 BRCA1 携带者中（OR=0.79（0.62-1.02），p=0.07）和 BRCA2 携带者中（OR=0.62（0.34-1.15），p=0.13），但仅在非携带者中具有统计学意义。口服避孕药使用与 BRCA1 携带者的风险降低相关（每年使用的趋势比值比=0.91（0.83-0.99），p=0.03），但与非携带者（OR=0.97（0.87-1.09），p=0.64）或 BRCA2 携带者（OR=0.94（0.80-1.11），p=0.47）无关。激素替代疗法与所有受试者的输卵管癌风险增加相关（OR=1.07（1.01-1.13），p=0.03），并且在按突变分层的亚组中也是如此，但在亚组中无统计学意义。输卵管结扎与所有受试者的输卵管癌风险降低相关（OR=0.64（0.31-1.28），p=0.21），但降低无统计学意义。
产次和口服避孕药的使用与降低输卵管癌的风险相关。相比之下，激素替代疗法可能与输卵管癌风险的增加相关。
