Wang Ping, Lv Long, Qi Feng, Qiu Feng
Department of Endocrinology, People's Hospital of Gaochun, Gaochun, 211300, Jiangsu Province, China.
Tumour Biol. 2015 Jul;36(7):5127-32. doi: 10.1007/s13277-015-3165-0. Epub 2015 Feb 11.
Strikingly higher rates of papillary thyroid cancer in women compared with men suggest that hormonal factors may be involved in the development of this cancer. A number of independent studies have investigated the association between hormonal factors and papillary thyroid cancer risk in women but yielded conflicting and inconclusive findings. We performed a meta-analysis of all currently published studies to provide better estimates for the risk of papillary thyroid cancer related to menstrual, reproductive, and other hormonal factors in women. Six cohort studies and three case-control ones were included into our study after a comprehensive literature search. The pooled relative risk (RR) with 95 % confidence interval (95 % CI) implicated that late age at menopause was associated with an increased risk of papillary thyroid cancer (RR = 1.39, 95 % CI 1.03-1.89, P = 0.032). No significant association was demonstrated between papillary thyroid cancer risk and other hormone-related factors, including oral contraceptive, hormone replacement therapy, age at menarche, parity, age at first birth, menopausal status, and breast feeding. Subgroup analysis by study design confirmed those associations. Sensitivity analysis did not materially alter the pooled results. The meta-analysis firstly suggests that late age at menopause is a risk factor for papillary thyroid cancer.
与男性相比,女性甲状腺乳头状癌的发病率显著更高,这表明激素因素可能参与了这种癌症的发生发展。许多独立研究调查了激素因素与女性甲状腺乳头状癌风险之间的关联,但结果相互矛盾且尚无定论。我们对目前已发表的所有研究进行了荟萃分析,以更好地评估女性月经、生殖及其他激素因素与甲状腺乳头状癌风险的关系。经过全面的文献检索,我们的研究纳入了六项队列研究和三项病例对照研究。汇总相对风险(RR)及95%置信区间(95%CI)表明,绝经年龄较晚与甲状腺乳头状癌风险增加相关(RR = 1.39,95%CI 1.03 - 1.89,P = 0.032)。甲状腺乳头状癌风险与其他激素相关因素之间未显示出显著关联,这些因素包括口服避孕药、激素替代疗法、初潮年龄、产次、首次生育年龄、绝经状态及母乳喂养。按研究设计进行的亚组分析证实了这些关联。敏感性分析未对汇总结果产生实质性影响。该荟萃分析首次表明,绝经年龄较晚是甲状腺乳头状癌的一个风险因素。