双膦酸盐使用后子宫内膜癌和卵巢癌风险降低：一项荟萃分析。

Risk reduction of endometrial and ovarian cancer after bisphosphonates use: A meta-analysis.

机构信息

Department of Internal Medicine, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan 450008, China.

Department of Internal Medicine, Luoshan County Traditional Chinese Medicine Hospital, Luoshan County, Xinyang, Henan 464200, China.

出版信息

Gynecol Oncol. 2018 Sep;150(3):509-514. doi: 10.1016/j.ygyno.2018.06.012. Epub 2018 Jun 28.

DOI:10.1016/j.ygyno.2018.06.012

PMID:29960711

Abstract

OBJECTIVE

Recent epidemiological studies have investigated the associations between the use of bisphosphonates and the development of endometrial cancer and ovarian cancer; these studies have shown controversial results. Hence, this meta-analysis was conducted to evaluate the changes in the risks of developing endometrial and ovarian cancers after using bisphosphonates based on current evidence.

METHODS

A comprehensive search was performed in the MEDLINE, EMBASE, and Web of Science databases through January 2017. The summary relative risk (RR) estimates for the effects of the use of bisphosphonates on the risks of developing endometrial and ovarian cancers were calculated using a random-effects model.

RESULTS

Seven studies were included with a total of 6471 endometrial cancer cases (7 studies with 213,920 participants) and 6783 ovarian cancer cases (4 studies with 105,507 participants). This meta-analysis suggested that any use of bisphosphonates was associated with a significant 27% reduction in the risk of endometrial cancer (RR = 0.73, 95% CI: 0.58-0.93, P = 0.012), but the reduction in the risk of ovarian cancer (RR = 0.81, 95% CI: 0.58-1.14, P = 0.227) was not significant. The protective effects of the use of bisphosphonates against endometrial cancer are mainly found in postmenopausal women (RR = 0.53, 95% CI: 0.34-0.93, P = 0.012) or in those who have taken bisphosphonates for longer than 1 year (RR = 0.57, 95% CI: 0.35-0.93, P = 0.024).

CONCLUSION

This meta-analysis suggests that the use of bisphosphonates is associated with a reduction in the risk of endometrial cancer but not ovarian cancer.

摘要

目的

最近的一些流行病学研究调查了使用双膦酸盐与子宫内膜癌和卵巢癌发展之间的关联；这些研究结果存在争议。因此，本荟萃分析旨在根据现有证据评估使用双膦酸盐后子宫内膜和卵巢癌风险的变化。

方法

通过 2017 年 1 月在 MEDLINE、EMBASE 和 Web of Science 数据库中进行全面检索。使用随机效应模型计算使用双膦酸盐对子宫内膜和卵巢癌风险的影响的汇总相对风险（RR）估计值。

结果

共纳入 7 项研究，共纳入 6471 例子宫内膜癌病例（7 项研究共纳入 213920 名参与者）和 6783 例卵巢癌病例（4 项研究共纳入 105507 名参与者）。本荟萃分析表明，任何使用双膦酸盐与子宫内膜癌风险降低 27%相关（RR=0.73，95%CI：0.58-0.93，P=0.012），但卵巢癌风险降低（RR=0.81，95%CI：0.58-1.14，P=0.227）无统计学意义。使用双膦酸盐对子宫内膜癌的保护作用主要见于绝经后妇女（RR=0.53，95%CI：0.34-0.93，P=0.012）或使用双膦酸盐超过 1 年的妇女（RR=0.57，95%CI：0.35-0.93，P=0.024）。