Division of Cancer Prevention and Population Science, University of Pittsburgh Cancer Institute, 5150 Centre Avenue, Suite 4-C, Pittsburgh, PA 15232, USA.
Cancer Causes Control. 2010 Nov;21(11):1851-6. doi: 10.1007/s10552-010-9612-8. Epub 2010 Jul 14.
We investigated risk factors for Type II (n = 176) vs. Type I (n = 1,576) endometrial cancer (EC) in cases treated at Magee-Womens Hospital between 1996 and 2008.
Clinical data were available from the University of Pittsburgh Medical Center (UPMC) Network Cancer Registry. Logistic regression was used to estimate the adjusted odds of having Type II EC vs. Type I EC. Risk factors of interest in this analysis were age, race, body mass index (BMI), year of diagnosis, parity, menopausal status, and history of additional primary tumors.
Relative to women with Type I EC, women with Type II EC were more likely to be older at diagnosis (OR: 1.03 per 1 year increase in age, 95% CI 1.01-1.05), of non-white race (OR: 2.95, 95% CI 1.66-5.27), have a history of additional primary tumors (OR: 1.56, 95% CI 1.05-2.32), and less likely to be obese (OR: 0.45, 95% CI 0.29-0.70).
In this large retrospective cohort of patients with EC, the striking difference in risk factors associated with Type II vs. Type I tumors suggests that these subtypes represent different disease entities that require different treatment modalities. Currently, Type II cases have a significantly worse prognosis compared to Type I. Further characterization of risk factors associated with developing Type II tumors is needed to prevent this aggressive malignancy.
我们调查了 1996 年至 2008 年间在 Magee-Womens 医院治疗的病例中,2 型(n=176)与 1 型(n=1576)子宫内膜癌(EC)的危险因素。
临床数据来自匹兹堡大学医学中心(UPMC)网络癌症登记处。使用逻辑回归估计 2 型 EC 与 1 型 EC 的调整比值比。本分析中感兴趣的危险因素包括年龄、种族、体重指数(BMI)、诊断年份、产次、绝经状态和其他原发性肿瘤史。
与 1 型 EC 患者相比,2 型 EC 患者的诊断年龄更大(OR:年龄每增加 1 岁,95%CI 为 1.01-1.05),非白种人(OR:2.95,95%CI 为 1.66-5.27),有其他原发性肿瘤史(OR:1.56,95%CI 为 1.05-2.32),肥胖的可能性较小(OR:0.45,95%CI 为 0.29-0.70)。
在这项大型回顾性 EC 患者队列研究中,2 型与 1 型肿瘤相关的危险因素存在显著差异,表明这两种亚型代表不同的疾病实体,需要不同的治疗方式。目前,2 型病例的预后明显比 1 型差。需要进一步研究与 2 型肿瘤发生相关的危险因素,以预防这种侵袭性恶性肿瘤。