Ouldamer L, Body G, Daraï E, Bendifallah S
Département de gynécologie, centre hospitalier régional universitaire de Tours, hôpital Bretonneau, 37044 Tours, France; Unité Inserm 1069, 10, boulevard Tonnellé, 37044 Tours, France.
Département de gynécologie et d'obstétrique et médecine de la reproduction, Sorbonne université, hôpital universitaire Tenon, Assistance publique-hôpitaux de Paris (AP-HP), 4, rue de la Chine, 75020 Paris, France; UMR_S938, centre de recherche de Saint-Antoine, université Sorbonne, 75006 Paris, France.
Gynecol Obstet Fertil Senol. 2020 Mar;48(3):239-247. doi: 10.1016/j.gofs.2020.01.012. Epub 2020 Jan 28.
The incidence (rate/100,000) of BOT gradually increases with age from 15-19 years of age and peaks at nearly 4.5 cases/100,000 for the 55-59 year age group (NP3). In the presence of a benign ovarian mass, the standardized risk ratio of serous and mucinous BOT is 1.69, (95% CI 1.39-2.03) and 1.75, (95% CI 1.45-2.10), respectively (NP2). At diagnosis, a median age of diagnosis of OFA is 46 years, unilateral forms (79.7% of cases) are predominant compared to cancers (45.3%) (<0.001) and FIGO I stages represent nearly 63.7% of cases (NP3). The 5-year survival rates for FIGO I, II, III, IV stages are: 99.7% (95% CI: 96.2-100%), 99.6% (95% CI: 92.6-100%), 95.3% (95% CI: 91.8-97.4%), 77.1% (95% CI: 58.0-88.3%), respectively (NP3). Survivors at 5 years for serous and mucinous tumours are 99.7% (95% CI: 99.2-99.9%), 98.5% (95% CI: 96.9-99.3%), respectively (NP3). An epidemiological association exists between personal BOT risk and: (1) a familial history of BOT/certain cancers (pancreas, lung, bone, leukemia) (NP3), (2) a personal history of benign ovarian cyst (NP2), (3) a personal history of pelvic inflammatory disease (IGH), (4) the use of intrauterine device levonorgestrel (NP3), (5) the use of oral contraceptive pills (NP3), (6) multiparity (NP3), (7) hormone replacement therapy (NP3), (8) high consumption of coumestrol (NP4), (9) medical treatment of infertility with progesterone (NP3), (10) non-steroidal anti-inflammatory drug (NSAID). An epidemiological association exists between previous/actual tabacco consumption and the risk of mucinous ovarian BOT (NP2). Relative risk (RR) varies between 2.2 and 2.7, however the relationship is not necessarily a causal one. An epidemiological association exists between overweight/obesity and the risk of serous BOT (NP2). RR varies between 1.2 to 1.8. The high Vitamin D was inversely associated to the risk of serous BOT (NP4). The risk of mucinous BOT was lowered with paracetamol use (OR=0.77; 95% CI: 0.60-0.98) (NP3). However, the relationship between these factors and BOT is not necessarily a causal one and no screening modality can be proposed in the general population (gradeC).
交界性卵巢肿瘤（BOT）的发病率（每10万人中的病例数）从15 - 19岁开始随年龄逐渐上升，在55 - 59岁年龄组达到峰值，接近4.5例/10万（NP3）。存在良性卵巢肿块时，浆液性和黏液性BOT的标准化风险比分别为1.69（95%置信区间1.39 - 2.03）和1.75（95%置信区间1.45 - 2.10）（NP2）。诊断时，卵巢纤维瘤病（OFA）的中位诊断年龄为46岁，与癌症（45.3%）相比，单侧形式（占病例的79.7%）更为常见（<0.001），国际妇产科联盟（FIGO）I期占病例的近63.7%（NP3）。FIGO I、II、III、IV期的5年生存率分别为：99.7%（95%置信区间：96.2 - 100%）、99.6%（95%置信区间：92.6 - 100%）、95.3%（95%置信区间：91.8 - 97.4%）、77.1%（95%置信区间：58.0 - 88.3%）（NP3）。浆液性和黏液性肿瘤的5年生存率分别为99.7%（95%置信区间：99.2 - 99.9%）、98.5%（95%置信区间：96.9 - 99.3%）（NP3）。个人患BOT的风险与以下因素存在流行病学关联：（1）BOT/某些癌症（胰腺、肺癌、骨癌、白血病）的家族史（NP3），（2）个人良性卵巢囊肿病史（NP2），（3）个人盆腔炎病史（IGH），（4）使用左炔诺孕酮宫内节育器（NP3），（5）使用口服避孕药（NP3），（6）多产（NP3），（7）激素替代疗法（NP3），（8）高剂量香豆雌酚摄入（NP4），（9）用黄体酮治疗不孕症（NP3），（10）非甾体抗炎药（NSAID）。既往/当前吸烟与黏液性卵巢BOT的风险存在流行病学关联（NP2）。相对风险（RR）在2.2至2.7之间变化，然而这种关系不一定是因果关系。超重/肥胖与浆液性BOT的风险存在流行病学关联（NP2）。RR在1.2至1.8之间变化。高维生素D水平与浆液性BOT的风险呈负相关（NP4）。使用对乙酰氨基酚可降低黏液性BOT的风险（比值比=0.77；95%置信区间：0.60 - 0.98）（NP3）。然而，这些因素与BOT之间的关系不一定是因果关系，且无法在普通人群中推荐任何筛查方式（C级）。
