Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut 06520, USA.
J Neurosurg. 2013 Mar;118(3):649-56. doi: 10.3171/2012.9.JNS12811. Epub 2012 Oct 26.
The 2-fold higher incidence of meningioma in women compared with men has long suggested a role for hormonally mediated risk factors, but specific mechanisms remain elusive.
The study included data obtained in 1127 women 29-79 years of age with intracranial meningioma diagnosed among residents of Connecticut, Massachusetts, North Carolina, the San Francisco Bay Area, and 8 Texas counties between May 1, 2006, and October 6, 2011, and data obtained in 1092 control individuals who were frequency matched for age group and geography with meningioma patients.
No association was observed for age at menarche, age at menopause, or parity and meningioma risk. Women who reported breastfeeding for at least 6 months were at reduced risk of meningioma (OR 0.78, 95% CI 0.63-0.96). A significant positive association existed between meningioma risk and increased body mass index (p < 0.01) while a significant negative association existed between meningioma risk and current smoking (p < 0.01). Among premenopausal women, current use of oral contraceptives was associated with an increased risk of meningiomas (OR 1.8, 95% CI 1.1-2.9), while current use of hormone replacement therapy among postmenopausal women was not associated with a significant elevation in risk (OR 1.1, 95% CI 0.74-1.67). There was no association between use of fertility medications and meningioma risk.
The authors' study confirms associations for body mass index, breastfeeding, and cigarette smoking but provides little evidence for associations of reproductive and menstrual factors with meningioma risk. The relationship between current use of exogenous hormones and meningioma remains unclear, limited by the small numbers of patients currently on oral hormone medications and a lack of hormone receptor data for meningioma tumors.
女性脑膜瘤的发病率比男性高 2 倍,这长期以来表明存在激素介导的风险因素,但具体机制仍难以捉摸。
该研究纳入了 2006 年 5 月 1 日至 2011 年 10 月 6 日期间,在康涅狄格州、马萨诸塞州、北卡罗来纳州、旧金山湾区和得克萨斯州 8 个县居住的年龄在 29-79 岁之间被诊断为颅内脑膜瘤的 1127 名女性患者的数据,以及与脑膜瘤患者年龄组和地理位置相匹配的 1092 名对照个体的数据。
初潮年龄、绝经年龄或产次与脑膜瘤风险之间无关联。报告至少母乳喂养 6 个月的女性脑膜瘤发病风险降低(OR 0.78,95%CI 0.63-0.96)。脑膜瘤风险与体重指数增加呈显著正相关(p<0.01),与当前吸烟呈显著负相关(p<0.01)。在绝经前女性中,当前使用口服避孕药与脑膜瘤风险增加相关(OR 1.8,95%CI 1.1-2.9),而绝经后女性当前使用激素替代疗法与风险升高无显著关联(OR 1.1,95%CI 0.74-1.67)。使用生育药物与脑膜瘤风险之间无关联。
作者的研究证实了体重指数、母乳喂养和吸烟与脑膜瘤之间的关联,但提供的生殖和月经因素与脑膜瘤风险之间关联的证据很少。目前使用外源性激素与脑膜瘤之间的关系仍不清楚,这受到目前口服激素药物患者数量较少以及脑膜瘤肿瘤缺乏激素受体数据的限制。