Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.
Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Gynecology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Gynecol Oncol. 2020 May;157(2):549-554. doi: 10.1016/j.ygyno.2020.02.032. Epub 2020 Mar 2.
The few studies on the association between benign ovarian tumors and endometrial cancer have been inconclusive. Using data from a large Danish register-based cohort study, we assessed the overall and type-specific risk of endometrial cancer among women with a benign ovarian tumor.
We identified all Danish women diagnosed with a benign ovarian tumor during 1978-2016 in the Danish National Patient Register (n = 149,807). The study population was followed for subsequent development of endometrial cancer by linkage to the Danish Cancer Register and standardized incidence ratios (SIRs) with corresponding 95% confidence intervals (CIs) were calculated after correction for hysterectomy.
After a one-year delayed study entry, women with benign ovarian tumors had a decreased incidence of endometrial cancer (SIR = 0.74, 95% CI: 0.68-0.81) compared with women in the general Danish population. Both solid benign ovarian tumors (SIR = 0.79, 95% CI 0.70-0.88) and cystic benign ovarian tumors (SIR = 0.68, 95% CI 0.58-0.78) were associated with decreased incidences of endometrial cancer. Likewise, women with benign ovarian tumors had decreased incidences of both type I and type II endometrial cancer. The incidence of endometrial cancer was decreased to virtually the same magnitude irrespective of the age at diagnosis of a benign ovarian tumor and the reduction persisted throughout the follow-up period.
The risk of endometrial cancer was decreased beyond the first year after a benign ovarian tumor and the decrease persisted for 20 or more years. The possible underlying mechanisms are not known and should be investigated further.
少数关于良性卵巢肿瘤与子宫内膜癌之间关联的研究尚无定论。利用来自丹麦大型基于注册库的队列研究数据，我们评估了患有良性卵巢肿瘤的女性罹患子宫内膜癌的总体风险和特定类型风险。
我们在丹麦国家患者登记处（Danish National Patient Register）中确定了 1978 年至 2016 年间所有被诊断患有良性卵巢肿瘤的丹麦女性（n=149807）。通过与丹麦癌症登记处链接，对该研究人群进行了随后发展为子宫内膜癌的随访，并计算了标准化发病比（SIR）及其相应的 95%置信区间（CI），校正了子宫切除术的影响。
经过一年的延迟研究入组，与丹麦普通人群相比，患有良性卵巢肿瘤的女性子宫内膜癌的发病率降低（SIR=0.74，95%CI：0.68-0.81）。实性良性卵巢肿瘤（SIR=0.79，95%CI 0.70-0.88）和囊性良性卵巢肿瘤（SIR=0.68，95%CI 0.58-0.78）均与子宫内膜癌发病率降低相关。同样，患有良性卵巢肿瘤的女性罹患 I 型和 II 型子宫内膜癌的发病率也降低。无论良性卵巢肿瘤的诊断年龄如何，子宫内膜癌的发病率都降低到几乎相同的程度，且这种降低在整个随访期间都持续存在。
良性卵巢肿瘤发生后，子宫内膜癌的风险在第一年后降低，并且这种降低持续了 20 年或更长时间。其潜在的机制尚不清楚，应进一步研究。
