Chen Ying, Du Hui, Bao Lewen, Liu Wenxin
Department of Gynecologic Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China.
Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China.
J Cancer. 2018 Jan 1;9(1):141-147. doi: 10.7150/jca.21187. eCollection 2018.
Current evidences indicate that the fallopian tube plays a major role in the pathogenesis of epithelial ovarian cancer (EOC). Salpingectomy represents a novel and potentially effective risk-reducing option. In this study, there were 1822 patients diagnosed and treated for EOC or primary peritoneal cancer (PPC) at Department of Gynecologic Oncology, Tianjin Medical University Cancer Institute and Hospital from January 1, 2007 to April 30, 2017. Among them, 198 patients with a history of gynecological surgery because of benign diseases were enrolled to analyze further. Using 1:2 case-control study, we found that the incidence of EOC was significantly decreased in the population with salpingectomy, compared to women with fallopian tube reserved (). At the same period, there were 4339 patients receiving opportunistic salpingectomy in our centre because of benign gynecological diseases. The results showed the rate of bilateral salpingectomy was annually increased from 2007 to 2017 (22.02% to 60.22%), which showed approximately threefold increase in a decade. In general, factors affecting the rate of salpingectomy included age, child number, menopause or not, marital status, educational status, income status, and with or without family history of tumor. Therefore, based on ten years experiences from our centre, it is recommended that physician should discuss with appropriate patients to perform opportunistic bilateral salpingectomy at the time of receiving benign gynecological surgery for preventing ovarian cancer. Moreover, the prospective, large scale and multi-centre studies to evaluate the safety and efficacy of salpingectomy as a preventive strategy for ovarian cancer warrant to conduct in the future.
目前的证据表明,输卵管在上皮性卵巢癌(EOC)的发病机制中起主要作用。输卵管切除术是一种新的、潜在有效的降低风险的选择。本研究纳入了2007年1月1日至2017年4月30日在天津医科大学肿瘤医院妇科肿瘤科诊断并治疗的1822例EOC或原发性腹膜癌(PPC)患者。其中,198例因良性疾病有妇科手术史的患者被纳入进一步分析。采用1:2病例对照研究,我们发现与保留输卵管的女性相比,接受输卵管切除术的人群中EOC的发病率显著降低。同期,我院有4339例因良性妇科疾病接受择期输卵管切除术的患者。结果显示,2007年至2017年双侧输卵管切除术的比例逐年增加(从22.02%增至60.22%),十年间增长了约三倍。一般来说,影响输卵管切除术比例的因素包括年龄、子女数、是否绝经、婚姻状况、教育程度、收入状况以及有无肿瘤家族史。因此,基于我院十年的经验,建议医生在为合适的患者进行良性妇科手术时,应与患者讨论进行择期双侧输卵管切除术以预防卵巢癌。此外,未来有必要开展前瞻性、大规模、多中心研究来评估输卵管切除术作为卵巢癌预防策略的安全性和有效性。