盆腔炎女性患卵巢癌的风险：一项基于人群的研究。

Risk of ovarian cancer in women with pelvic inflammatory disease: a population-based study.

机构信息

Department of Mathematics, Soochow University, Taipei, Taiwan.

出版信息

Lancet Oncol. 2011 Sep;12(9):900-4. doi: 10.1016/S1470-2045(11)70165-6. Epub 2011 Aug 9.

DOI:10.1016/S1470-2045(11)70165-6

PMID:21835693

Abstract

BACKGROUND

Ovarian cancer is commonly fatal and incidence has persistently risen in Taiwan over the past 20 years. Prevention strategies, however, are limited. Pelvic inflammatory disease (PID) has been suggested to increase the risk of developing ovarian cancer, but the results of studies have been inconsistent. Therefore, we investigated whether PID increases the risk of developing ovarian cancer in a large, nationwide cohort.

METHODS

From the Longitudinal Health Insurance Database 2005 (LHID2005) in Taiwan, we obtained data for women aged 13-65 years for whom a diagnosis of PID, confirmed by multiple episodes, had been recorded between Jan 1, 2004, and Dec 31, 2005. We also obtained data for two controls per patient, matched for age and the year of first entry into the LHID2005. All patients were followed up from the date of entry in the LHID2005 until they developed ovarian cancer or to the end of 2006, whichever was earlier. We used Cox's regression models to assess the risk of developing ovarian cancer, with adjustment for age, comorbid disorders, and socioeconomic characteristics.

FINDINGS

We identified 67,936 women with PID and 135,872 controls. Among these 90 had developed ovarian cancer during the 3-year follow-up period (42 patients with PID and 48 controls, incidence 2·78 and 1·44 per 10,000 person-years, respectively). The adjusted hazard ratio for ovarian cancer in patients with PID was 1·92 (95% CI 1·27-2·92) compared with controls, which rose to 2·46 (1·48-4·09) in women who had had at least five episodes of PID. The adjusted hazard ratio was slightly higher for women aged 35 years or younger with PID than in older women with PID (2·23, 1·02-4·79 vs 1·82, 1·10-3·04).

INTERPRETATION

We found an association between PID and ovarian cancer. PID might, therefore, be a useful marker for ovarian cancer, and early treatment could help to improve prognosis. Whether pelvic inflammation itself accelerates the growth of ovarian cancers or affects cancer-cell differentiation in ways that adversely alter prognosis needs to be investigated.

FUNDING

None.

摘要

背景

卵巢癌通常是致命的，在过去 20 年中，台湾的发病率持续上升。然而，预防策略有限。盆腔炎（PID）已被认为会增加患卵巢癌的风险，但研究结果并不一致。因此，我们调查了在一个大型全国队列中，PID 是否会增加患卵巢癌的风险。

方法

我们从台湾的纵向健康保险数据库 2005 年（LHID2005）中获得了年龄在 13-65 岁之间的女性的数据，这些女性在 2004 年 1 月 1 日至 2005 年 12 月 31 日期间被确诊患有 PID，且有多次发病记录。我们还为每位患者获得了两名对照者的数据，对照者与患者的年龄和首次进入 LHID2005 年的年份相匹配。所有患者从进入 LHID2005 年之日起接受随访，直到她们患上卵巢癌或 2006 年底，以先发生者为准。我们使用 Cox 回归模型评估了患卵巢癌的风险，调整了年龄、合并症和社会经济特征。

结果

我们确定了 67936 名患有 PID 的女性和 135872 名对照者。在这 90 名患者中，有 90 名在 3 年的随访期间患上了卵巢癌（42 名患有 PID，48 名对照者，发病率分别为每 10000 人年 2.78 和 1.44）。患有 PID 的患者患卵巢癌的调整后危险比为 1.92（95%CI 1.27-2.92），而对照组为 2.46（1.48-4.09）。患有至少五次 PID 的女性的调整后危险比略高于年龄在 35 岁或以下的患有 PID 的女性（2.23，1.02-4.79 比 1.82，1.10-3.04）。