Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD 20852-7234, USA.
Int J Epidemiol. 2010 Dec;39(6):1605-18. doi: 10.1093/ije/dyq120. Epub 2010 Jul 26.
We undertook a systematic review and meta-analysis of perinatal variables in relation to testicular cancer risk, with a specific focus upon characteristics of the son.
Literature databases Scopus, EMBASE, PubMed and Web of Science were searched using highly sensitive search strategies. Of 5865 references retrieved, 67 articles met the inclusion criteria, each of which was included in at least one perinatal analysis.
Random effects meta-analysis produced the following results for association with testicular cancer risk: birth weight [per kilogram, odds ratio (OR) = 0.94, 95% confidence interval (CI) 0.88-1.01, I(2)= 12%], low birth weight (OR = 1.34, 95% CI 1.08-1.67, I(2)= 51%), high birth weight (OR = 1.05, 95% CI 0.96-1.14, I(2)= 0%), gestational age (per week, OR = 0.95, 95% CI 0.92-0.98, I(2)= 38%; low vs not, OR = 1.31, 95% CI 1.07-1.59, I(2)= 49%), cryptorchidism (OR = 4.30, 95% CI 3.62-5.11, I(2)= 44%), inguinal hernia (OR = 1.63, 95% CI 1.37-1.94, I(2)= 38%) and twinning (OR = 1.22, 95% CI 1.03-1.44, I(2)= 22%). Meta-analyses of the variables birth length, breastfeeding and neonatal jaundice did not provide evidence for an association with testicular cancer risk. When low birth weight was stratified by data ascertainment (record/registry vs self-report), only the category of self-report was indicative of an association. Meta-regression of data ascertainment (record/registry vs self-report) inferred that record-/registry-based studies were less supportive of an association with gestational age (per week = 0.97, 95% CI 0.94-1.00, I(2)( )= 29%; low vs not = 1.08, 95% CI 0.91-1.28, I(2)= 32%).
In conclusion, this systematic review and meta-analysis finds evidence that cryptorchidism, inguinal hernia and twinning, and tentative evidence that birth weight and gestational age, are associated with risk of testicular cancer.
我们进行了一项系统评价和荟萃分析，研究围产期变量与睾丸癌风险的关系，特别关注儿子的特征。
使用高度敏感的搜索策略，在 Scopus、EMBASE、PubMed 和 Web of Science 文献数据库中进行了检索。在检索到的 5865 篇参考文献中，有 67 篇文章符合纳入标准，每篇文章都至少有一项围产期分析。
随机效应荟萃分析得出了与睾丸癌风险相关的以下结果：出生体重（每公斤，比值比（OR）=0.94，95%置信区间（CI）0.88-1.01，I²=12%）、低出生体重（OR=1.34，95%CI 1.08-1.67，I²=51%）、高出生体重（OR=1.05，95%CI 0.96-1.14，I²=0%）、胎龄（每增加一周，OR=0.95，95%CI 0.92-0.98，I²=38%；低 vs 不，OR=1.31，95%CI 1.07-1.59，I²=49%）、隐睾（OR=4.30，95%CI 3.62-5.11，I²=44%）、腹股沟疝（OR=1.63，95%CI 1.37-1.94，I²=38%）和双胞胎（OR=1.22，95%CI 1.03-1.44，I²=22%）。对出生长度、母乳喂养和新生儿黄疸等变量的荟萃分析没有提供与睾丸癌风险相关的证据。当根据数据确定（记录/登记 vs 自我报告）将低出生体重进行分层时，只有自我报告类别表明存在关联。对数据确定（记录/登记 vs 自我报告）的荟萃回归推断，基于记录/登记的研究不太支持与胎龄（每增加一周）的关联（OR=0.97，95%CI 0.94-1.00，I²（）=29%；低 vs 不，OR=1.08，95%CI 0.91-1.28，I²=32%）。
总之，本系统评价和荟萃分析发现，隐睾、腹股沟疝和双胞胎，以及出生体重和胎龄的初步证据与睾丸癌风险相关。
