Department of Oncology, Affiliated Hospital of Qinghai University, Xining, China.
Department of Obstetrics, Maternity and Child Health Care of Zaozhuang, Zaozhuang, China.
World Neurosurg. 2021 Mar;147:e148-e162. doi: 10.1016/j.wneu.2020.11.175. Epub 2020 Dec 9.
Glioma and meningioma are the most common primary brain tumors in adults. Epidemiologic studies of the relationship between female hormone exposure and exogenous hormone use and the risk of meningioma and glioma in females have yielded inconsistent results.
Two investigators comprehensively searched 3 electronic databases, including PubMed, Embase, and Cochrane Library. A total of 11 case-control studies were enrolled for meta-analysis. Dose-response meta-analyses were conducted.
Compared with the non-oral contraceptives (OCs) female users, the female OC users might have reduced risk of glioma (risk ratio [RR], 0.87; 95% confidence interval [CI], 0.77-0.97; I = 42.6%). However, there was no obvious evidence of an association between OC use and the risk of meningioma in females (RR, 0.99; 95% CI, 0.87-1.13; I = 42.7%). Using OCs for >10 years in females may significantly decrease the risk of glioma to 30% (RR, 0.7; 95% CI, 0.6-0.81; I = 0%). The dose-response meta-analyses indicated that the risk of glioma in females significantly decreased when the duration of oral OC use was >7.5 years.
OC use may not increase the risks of glioma and meningioma in females. Instead, the long-term use of OCs may significantly decrease the risk of glioma, and the benefits are even more pronounced when the time window is >7.5 years. Nonetheless, the pooled results in this study suggest that OC use may not increase the risk of meningioma. Therefore, our conclusion should be validated and supplemented in future larger studies.
脑胶质瘤和脑膜瘤是成人中最常见的原发性脑肿瘤。女性激素暴露和外源性激素使用与女性脑膜瘤和脑胶质瘤风险之间关系的流行病学研究结果不一致。
两位研究者全面检索了 3 个电子数据库，包括 PubMed、Embase 和 Cochrane Library。共纳入了 11 项病例对照研究进行荟萃分析。进行了剂量-反应荟萃分析。
与非口服避孕药（OC）女性使用者相比，OC 女性使用者患脑胶质瘤的风险可能降低（风险比 [RR]，0.87；95%置信区间 [CI]，0.77-0.97；I²=42.6%）。然而，OC 使用与女性脑膜瘤风险之间没有明显的关联（RR，0.99；95% CI，0.87-1.13；I²=42.7%）。女性使用 OC 超过 10 年可能会显著将患脑胶质瘤的风险降低到 30%（RR，0.7；95% CI，0.6-0.81；I²=0%）。剂量-反应荟萃分析表明，当口服 OC 使用时间超过 7.5 年时，女性患脑胶质瘤的风险显著降低。
OC 使用可能不会增加女性患脑胶质瘤和脑膜瘤的风险。相反，长期使用 OC 可能会显著降低女性患脑胶质瘤的风险，且当时间窗口超过 7.5 年时，益处更为明显。尽管如此，本研究的汇总结果表明，OC 使用可能不会增加脑膜瘤的风险。因此，我们的结论需要在未来更大的研究中得到验证和补充。
