Malignant Tumor TCM "Yi Qi Qing Du" Key Research Office, Jiangxi Academy of Traditional Chinese Medicine, Nangchang, Jiangxi 330046, China.
Outpatient Clinic of Ethnomedicine, Youjiang Medical University for Nationalities, Baise, Guangxi Zhuang Autonomous Region 533000, China.
Pharmacol Res. 2020 Oct;160:105182. doi: 10.1016/j.phrs.2020.105182. Epub 2020 Sep 2.
A favourable option to management symptoms during menopausal transition is menopausal hormone therapy (MHT) but relation among MHT and risk of melanoma is controversial. This study aims to identify, analyse and present the evidence surrounding post-menopausal exogenous hormone therapy and the risk for melanoma in women. A systematic searches of database was conducted in PubMed/MEDLINE, Scopus, and Cochrane without time, region, and language restrictions from inception to April 2020. The DerSimonian and Laird random-effects model was used to estimate combined risk ratio (RR) and 95% confidence intervals (CI). Subgroup analysis and time-response analysis was conducted based on the formulation of used hormone and length of hormone therapy. Combined results from fourteen studies that containing 19 arms with 1,164,077 participants which 4273 of them had melanoma cancer showed increase risk of melanoma in the hormone-treated versus control group 1.14 (95% CI 1.05-1.24, I2: 21%). The stronger and significant relationship between MHT and risk of melanoma was in participants who used oestrogen formulation (RR 1.32, 95% CI 1.17-1.49, I2 = 0%). Moreover, a significant non-linear time-response relation between MHT and melanoma was also in initial three years of MHT (Coef1 = 0.2423, p1 < 0.01). This study reveals a significant direct relationship between the MHT and risk of melanoma in postmenopausal women.
在更年期过渡期间，治疗症状的一个有利选择是激素替代疗法（MHT），但 MHT 与黑色素瘤风险之间的关系存在争议。本研究旨在确定、分析和呈现绝经后外源性激素治疗与女性黑色素瘤风险相关的证据。系统检索了 PubMed/MEDLINE、Scopus 和 Cochrane 数据库，无时间、地区和语言限制，检索时间从建库至 2020 年 4 月。采用 DerSimonian 和 Laird 随机效应模型估计合并风险比（RR）和 95%置信区间（CI）。根据所用激素的配方和激素治疗的长度进行亚组分析和时间反应分析。14 项研究共包含 19 个组，共有 1164077 名参与者，其中 4273 名参与者患有黑色素瘤癌症，合并结果显示，激素治疗组与对照组相比，黑色素瘤发病风险增加 1.14（95%CI 1.05-1.24，I2：21%）。在使用雌激素配方的参与者中，MHT 与黑色素瘤风险之间的关系更强且更显著（RR 1.32，95%CI 1.17-1.49，I2 = 0%）。此外，MHT 与黑色素瘤之间也存在显著的非线性时间反应关系，这种关系出现在 MHT 初始的 3 年内（Coef1 = 0.2423，p1 < 0.01）。本研究揭示了 MHT 与绝经后妇女黑色素瘤风险之间存在显著的直接关系。
