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盆腔炎女性患子宫内膜癌的风险:一项基于全国人口的回顾性队列研究。

Risk of Endometrial Cancer in Women With Pelvic Inflammatory Disease: A Nationwide Population-Based Retrospective Cohort Study.

作者信息

Yang Teng-Kai, Chung Chi-Jung, Chung Shiu-Dong, Muo Chih-Hsin, Chang Chao-Hsiang, Huang Chao-Yuan

机构信息

From the Surgery Department (T-KY), Yonghe Cardinal Hospital; School of Medicine, College of Medicine (T-KY, S-DC), Fu Jen Catholic University, New Taipei City; Department of Health Risk Management (C-JC), College of Public Health, China Medical University; Department of Medical Research (C-JC), China Medical University Hospital, Taichung; Division of Urology Department of Surgery (S-DC), Far Eastern Memorial Hospital, New Taipei; College of Medicine (C-HM, C-HC), China Medical University; Management Office for Health Data (C-HM), China Medical University and Hospital; Department of Urology (C-HC), China Medical University and Hospital, Taichung; and Department of Urology (C-YH), National Taiwan University Hospital, Taipei, Taiwan.

出版信息

Medicine (Baltimore). 2015 Aug;94(34):e1278. doi: 10.1097/MD.0000000000001278.

Abstract

To investigate the association between pelvic inflammatory disease (PID) and endometrial cancer (EC).We conducted a nationwide population-based retrospective cohort study, and data were obtained from the National Health Insurance Research Database. We defined 41,065 patients with PID as the PID cohort and 82,130 randomly selected patients as the control cohort through frequency matching by age and index year. PID and EC were diagnosed in accordance with the International Classification of Diseases, Ninth Revision, and Clinical Modification. Cox proportional hazards regression and Kaplan-Meier method were used in the analysis.Incidence rates of 16.1 and 9.6 per 100,000 person-years and mean follow-up durations of 4.84 and 6.63 years were observed in the PID and non-PID cohorts, respectively. After adjusting for potential risk factors, the PID cohort had a 1.79-fold higher risk of developing EC than the non-PID cohort. The incidence of EC increased with age, particularly for those aged >50 years (HR=2.45, 95% CI=1.29-4.65). Higher EC risk was also observed in the PID cohort with hypertension than in the non-PID cohort.The results of this large-scale population-based study showed an increased risk of EC in PID patients, particularly in older patients or those with hypertension. Future large-scale clinical trials are warranted to clarify the function of medication in PID-related EC progression.

摘要

为了研究盆腔炎(PID)与子宫内膜癌(EC)之间的关联。我们开展了一项基于全国人口的回顾性队列研究,数据取自国民健康保险研究数据库。通过年龄和索引年份进行频数匹配,我们将41,065例PID患者定义为PID队列,将82,130例随机选取的患者定义为对照队列。PID和EC依据《国际疾病分类第九版临床修订本》进行诊断。分析中采用了Cox比例风险回归和Kaplan-Meier方法。在PID队列和非PID队列中,观察到的发病率分别为每10万人年16.1例和9.6例,平均随访时间分别为4.84年和6.63年。在调整潜在风险因素后,PID队列发生EC的风险比非PID队列高1.79倍。EC的发病率随年龄增加,尤其是对于年龄>50岁的人群(风险比=2.45,95%置信区间=1.29 - 4.65)。在患有高血压的PID队列中也观察到比非PID队列更高的EC风险。这项基于大规模人群的研究结果显示,PID患者发生EC的风险增加,尤其是老年患者或患有高血压的患者。未来有必要开展大规模临床试验以阐明药物在PID相关EC进展中的作用。

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