Department of Experimental Oncology, European Institute of Oncology IRCCS, Milan, Italy.
Division of Cancer Prevention and Genetics, European Institute of Oncology IRCCS, Milan, Italy.
Crit Rev Oncol Hematol. 2019 Feb;134:72-81. doi: 10.1016/j.critrevonc.2018.12.009. Epub 2019 Jan 9.
We conducted a meta-analysis of studies reporting on the risk of extra-ovarian malignancies among women with endometriosis. Summary relative risk (SRR) and 95% confidence intervals (CI) were calculated through random effect models. We explored causes of between-studies heterogeneity and assessed the presence of publication bias. We included 32 studies published between 1989 and 2018. We found an increased risk of endometrial (SRR 1.38, 95%CI 1.10-1.74) and thyroid cancer (SRR 1.38, 95%CI 1.17-1.63), and inverse association with cervical cancer (SRR 0.78, 95%CI 0.60-0.95). No association emerged for breast cancer (SRR 1.04, 95%CI 0.99-1.09) and melanoma (SRR 1.31, 95%CI 0.86-1.96). Between-study heterogeneity was large for breast and endometrial cancer and melanoma. Associations were generally stronger in case-control, cross-sectional, and cohort studies with internal control group, compared to cohort studies with external control group. No indication for publication bias was found. Our conclusions need to be confirmed in properly designed cohort studies with clinical confirmation of endometriosis.
我们对报告子宫内膜异位症女性卵巢外恶性肿瘤风险的研究进行了荟萃分析。通过随机效应模型计算汇总相对风险（SRR）和 95%置信区间（CI）。我们探讨了研究间异质性的原因，并评估了发表偏倚的存在。我们纳入了 1989 年至 2018 年期间发表的 32 项研究。我们发现子宫内膜癌（SRR 1.38，95%CI 1.10-1.74）和甲状腺癌（SRR 1.38，95%CI 1.17-1.63）的风险增加，而宫颈癌（SRR 0.78，95%CI 0.60-0.95）的风险降低。乳腺癌（SRR 1.04，95%CI 0.99-1.09）和黑色素瘤（SRR 1.31，95%CI 0.86-1.96）之间没有关联。对于乳腺癌和子宫内膜癌以及黑色素瘤，研究间异质性较大。与外部对照组的队列研究相比，内部对照组的病例对照、横断面和队列研究通常与更强的关联。未发现发表偏倚的迹象。我们的结论需要在经过适当设计的队列研究中得到证实，这些研究应通过临床确认子宫内膜异位症。
