Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institute of Health, Department of Health and Human Services, Bethesda, Maryland.
Int J Cancer. 2014 Jan 15;134(2):405-10. doi: 10.1002/ijc.28352. Epub 2013 Jul 30.
Recent cohort findings suggest that women who underwent a hysterectomy have an elevated relative risk of kidney cancer, although evidence from past studies has been inconsistent. We conducted a systematic review and meta-analysis of published cohort and case-control studies to summarize the epidemiologic evidence investigating hysterectomy and kidney cancer. Studies published from 1950 through 2012 were identified through a search of PubMed and of references from relevant publications. Meta-analyses were conducted using random-effects models to estimate summary relative risks (SRRs) and 95% confidence intervals (CIs) for hysterectomy, age at hysterectomy (<45, 45+ years) and time since hysterectomy (<10, 10+ years). The SRR for hysterectomy and kidney cancer for all published studies (seven cohort, six case-control) was 1.29 (95% CI, 1.16-1.43), with no evidence of between-study heterogeneity or publication bias. The summary effect was slightly weaker, although still significant, for cohorts (SRR, 1.26; 95% CI, 1.11-1.42) compared with case-control findings (1.37; 95% CI, 1.09-1.73) and was observed irrespective of age at hysterectomy, time since the procedure and model adjustment for body mass index, smoking status and hypertension. Women undergoing a hysterectomy have an approximate 30% increased relative risk of subsequent kidney cancer. Additional research is needed to elucidate the biological mechanisms underlying this association.
最近的队列研究结果表明，接受子宫切除术的女性患肾癌的相对风险升高，尽管过去的研究证据并不一致。我们对已发表的队列研究和病例对照研究进行了系统评价和荟萃分析，以总结调查子宫切除术与肾癌关系的流行病学证据。通过在 PubMed 中搜索以及从相关文献中检索参考文献，确定了 1950 年至 2012 年发表的研究。使用随机效应模型进行荟萃分析，以估计子宫切除术、子宫切除术年龄（<45 岁、45 岁以上）和子宫切除术时间（<10 年、10 年以上）的汇总相对风险（SRR）和 95%置信区间（CI）。所有已发表研究（七项队列研究，六项病例对照研究）的子宫切除术与肾癌的 SRR 为 1.29（95%CI，1.16-1.43），无研究间异质性或发表偏倚的证据。尽管队列研究的汇总效应（1.26；95%CI，1.11-1.42）比病例对照研究（1.37；95%CI，1.09-1.73）稍弱，但仍然具有统计学意义，且与子宫切除术年龄、手术时间以及体重指数、吸烟状况和高血压的模型调整无关。接受子宫切除术的女性随后患肾癌的相对风险增加约 30%。需要进一步的研究来阐明这种关联的生物学机制。
