Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Int J Cancer. 2014 Nov 1;135(9):2183-90. doi: 10.1002/ijc.28869. Epub 2014 Apr 10.
There is an unexplained strong male predominance in the aetiology of oesophageal adenocarcinoma (OAC). The hypothesis that oestrogens are protective, deserves attention. A potential protective influence of exogenous oestrogen exposure, that is, hormone replacement therapy (HRT) and oral contraceptives (OC) has been addressed only in studies of limited statistical power, and the individual studies have not provided conclusive results. We conducted a systematic literature search and meta-analysis on HRT and OC and the risk of OAC. We used the databases PubMed and the Web of Science. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by the Mantel-Haenszel random-effect method. A total of five studies were included. Compared to never users, ever users of HRT had a statistically significantly decreased risk of OAC (pooled OR = 0.75; 95% CI: 0.58-0.98), and ever users of OC had a borderline significantly decreased risk of this cancer (pooled OR = 0.76; 95% CI: 0.57-1.00). In conclusion, HRT and OC use seems to be associated with a decreased risk of OAC. However, further research is warranted.
食管腺癌（OAC）的病因存在无法解释的强烈男性优势。雌激素具有保护作用的假设值得关注。雌激素暴露的潜在保护作用，即激素替代疗法（HRT）和口服避孕药（OC），仅在统计效力有限的研究中进行了探讨，而且个别研究并未得出结论性结果。我们对 HRT 和 OC 与 OAC 风险的关系进行了系统的文献检索和荟萃分析。我们使用了 PubMed 和 Web of Science 数据库。比值比（OR）和 95％置信区间（CI）通过 Mantel-Haenszel 随机效应法进行估计。共纳入了 5 项研究。与从未使用者相比，HRT 的曾使用者 OAC 的风险显著降低（汇总 OR=0.75；95％CI：0.58-0.98），OC 的曾使用者发生这种癌症的风险也有降低的趋势（汇总 OR=0.76；95％CI：0.57-1.00）。总之，HRT 和 OC 的使用似乎与 OAC 风险降低有关。但是，还需要进一步的研究。
