Lessard-Anderson Collette R, Handlogten Kathryn S, Molitor Rochelle J, Dowdy Sean C, Cliby William A, Weaver Amy L, Sauver Jennifer St, Bakkum-Gamez Jamie N
Division of Gynecologic Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, United States.
Mayo Medical School, Mayo Clinic College of Medicine, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, United States.
Gynecol Oncol. 2014 Dec;135(3):423-7. doi: 10.1016/j.ygyno.2014.10.005. Epub 2014 Oct 12.
To determine the effect of excisional tubal sterilization on subsequent development of serous epithelial ovarian cancer (EOC) or primary peritoneal cancer (PPC).
We performed a population-based, nested case-control study using the Rochester Epidemiology Project. We identified all patients with a diagnosis of serous EOC or PPC from 1966 through 2009. Each case was age-matched to 2 controls without either diagnosis. Odds ratios (ORs) and corresponding 95% CIs were estimated from conditional logistic regression models. Models were adjusted for prior hysterectomy, prior salpingo-oophorectomy, oral contraceptive use, endometriosis, infertility, gravidity, and parity.
In total, we identified 194 cases of serous EOC and PPC during the study period and matched them with 388 controls (mean [SD] age, 61.4 [15.2] years). Fourteen cases (7.2%) and 46 controls (11.9%) had undergone tubal sterilization. Adjusted risk of serous EOC or PPC was slightly lower after any tubal sterilization (OR, 0.59 [95% CI, 0.29-1.17]; P=.13). The rate of excisional tubal sterilization was lower in cases than controls (2.6% vs 6.4%). Adjusted risk of serous EOC and PPC was decreased by 64% after excisional tubal sterilization (OR, 0.36 [95% CI, 0.13-1.02]; P=.054) compared with those without sterilization or with nonexcisional tubal sterilization.
We present a population-based investigation of the effects of excisional tubal sterilization on the risk of serous EOC and PPC. Excisional methods may confer greater risk reduction than other sterilization methods.
确定输卵管切除绝育术对随后浆液性上皮性卵巢癌（EOC）或原发性腹膜癌（PPC）发生发展的影响。
我们利用罗切斯特流行病学项目开展了一项基于人群的巢式病例对照研究。我们确定了1966年至2009年间所有诊断为浆液性EOC或PPC的患者。每例病例按年龄匹配2名未患这两种疾病的对照。通过条件逻辑回归模型估计比值比（OR）及相应的95%置信区间（CI）。模型对既往子宫切除术、既往输卵管卵巢切除术、口服避孕药使用情况、子宫内膜异位症、不孕、妊娠次数和产次进行了校正。
在研究期间，我们共确定了194例浆液性EOC和PPC病例，并将其与388名对照匹配（平均[标准差]年龄为61.4[15.2]岁）。14例病例（7.2%）和46名对照（11.9%）接受过输卵管绝育术。任何输卵管绝育术后，浆液性EOC或PPC的校正风险略低（OR，0.59[95%CI，0.29 - 1.17]；P = 0.13）。病例组的输卵管切除绝育率低于对照组（2.6%对6.4%）。与未绝育或未行输卵管切除绝育术的患者相比，输卵管切除绝育术后浆液性EOC和PPC的校正风险降低了64%（OR，0.36[95%CI，0.13 - 1.02]；P = 0.054）。
我们开展了一项基于人群的研究，探讨输卵管切除绝育术对浆液性EOC和PPC风险的影响。与其他绝育方法相比，切除方法可能能更大程度地降低风险。
