绝经后激素治疗与非霍奇金淋巴瘤：InterLymph 病例对照研究的汇总分析。
Postmenopausal hormone therapy and non-Hodgkin lymphoma: a pooled analysis of InterLymph case-control studies.
机构信息
Epidemiology and Genetics Unit, Department of Health Sciences, University of York, York, UK.
Department of Population Sciences, Division of Cancer Etiology, City of Hope National Medical Center, Duarte.
出版信息
Ann Oncol. 2013 Feb;24(2):433-441. doi: 10.1093/annonc/mds340. Epub 2012 Sep 11.
BACKGROUND
Non-Hodgkin lymphoma (NHL) subtypes, diffuse large B-cell (DLBCL) and follicular lymphoma (FL) have different sex ratios and are diagnosed at ages over 60 years; DLBCL is more common in men and diagnosed at older ages than FL, which occurs more among women. This analysis of postmenopausal women examines the relationship between postmenopausal hormone therapy and NHL.
DESIGN
Self-reported use of postmenopausal hormone therapy from 2094 postmenopausal women with NHL and 2731 without were pooled across nine case-control studies (1983-2005) from North America, Europe and Japan. Study-specific odds ratios (OR) and 95% confidence intervals (CI) estimated using logistic regression were pooled using random-effects meta-analyses.
RESULTS
Postmenopausal women who used hormone therapy were at decreased risk of NHL (pooled OR = 0.79, 95% CI 0.69-0.90). Risks were reduced when the age of starting was 50 years or older. There was no clear trend with number of years of use. Current users were at decreased risk while those stopping over 2 years before diagnosis were not. Having a hysterectomy or not did not affect the risk. Favourable effects were present for DLBCL (pooled OR = 0.66, 95% CI 0.54-0.80) and FL (pooled OR = 0.82, 95% CI 0.66-1.01).
CONCLUSION
Postmenopausal hormone therapy, particularly used close to menopause, is associated with a decreased risk of NHL.
背景
非霍奇金淋巴瘤（NHL）亚型弥漫性大 B 细胞淋巴瘤（DLBCL）和滤泡性淋巴瘤（FL）的性别比例不同，发病年龄均超过 60 岁；DLBCL 多见于男性，发病年龄大于 FL，而 FL 多见于女性。本分析研究了绝经后女性的绝经后激素治疗与 NHL 的关系。
设计
来自北美、欧洲和日本的 9 项病例对照研究（1983-2005 年）汇总了 2094 例 NHL 绝经后妇女和 2731 例非 NHL 绝经后妇女的绝经后激素治疗使用情况。使用逻辑回归估计研究特异性比值比（OR）和 95%置信区间（CI），并采用随机效应荟萃分析进行汇总。
结果
使用激素治疗的绝经后妇女患 NHL 的风险降低（汇总 OR=0.79，95%CI0.69-0.90）。起始年龄为 50 岁或以上时，风险降低。使用年限与风险之间没有明显的趋势。目前使用者的风险降低，而诊断前停止使用 2 年以上者则不然。是否行子宫切除术并不影响风险。对于 DLBCL（汇总 OR=0.66，95%CI0.54-0.80）和 FL（汇总 OR=0.82，95%CI0.66-1.01），也存在有利影响。
结论
绝经后激素治疗，特别是接近绝经时使用，与 NHL 风险降低相关。
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