Saraswat L, Ayansina D, Cooper K G, Bhattacharya S
Department of Obstetrics and Gynaecology, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, AB25 2ZN, United Kingdom.
Medical Statistics Team, University of Aberdeen, United Kingdom.
Eur J Obstet Gynecol Reprod Biol. 2021 Feb;257:144-148. doi: 10.1016/j.ejogrb.2020.12.033. Epub 2020 Dec 30.
To explore the risk of melanoma in women with endometriosis.
A retrospective cohort study using Scottish national population-based data was conducted. The study comprised 281,937 women with nearly 5 million person years (4,923,628) of follow up from 1981 to 2010. 17,834 women with a new surgical diagnosis of endometriosis were compared with 83,303 women with no evidence of endometriosis at laparoscopy, 162,966 women who underwent laparoscopic sterilisation and 17,834 age-matched women from the general population to determine the risk of melanoma. Cox proportional hazards regression was used to calculate crude and adjusted Hazards ratios with 95 % Confidence Intervals.
Women with endometriosis had a significantly higher risk of melanoma when compared to women with no evidence of endometriosis at laparoscopy (HR 1.59, 95 % CI 1.19-2.13), women who had undergone laparoscopic sterilisation (HR 1.82, 95 % CI 1.39-2.40) and age-matched women from the general population (HR 1.63, 95 % CI 1.08-2.45).
A diagnosis of endometriosis was associated with an increased risk of developing melanoma compared to those without endometriosis. These findings highlight the need for further research to explore shared pathways in the pathogenesis of the two conditions. It is important to acknowledge that the absolute increase in the risk of melanoma in women with endometriosis remains low, which should be considered when counselling women.
探讨子宫内膜异位症女性患黑色素瘤的风险。
采用基于苏格兰全国人口的数据进行回顾性队列研究。该研究纳入了281,937名女性，随访时间从1981年至2010年，累计近500万人年（4,923,628）。将17,834例新诊断为子宫内膜异位症的手术患者与83,303例腹腔镜检查无子宫内膜异位症证据的女性、162,966例行腹腔镜绝育术的女性以及17,834例年龄匹配的普通人群女性进行比较，以确定黑色素瘤的风险。采用Cox比例风险回归分析计算粗风险比和校正风险比以及95%置信区间。
与腹腔镜检查无子宫内膜异位症证据的女性（风险比1.59，95%置信区间1.19 - 2.13）、行腹腔镜绝育术的女性（风险比1.82，95%置信区间1.39 - 2.40）以及年龄匹配的普通人群女性（风险比1.63，95%置信区间1.08 - 2.45）相比，子宫内膜异位症女性患黑色素瘤的风险显著更高。
与无子宫内膜异位症的女性相比，子宫内膜异位症的诊断与黑色素瘤发生风险增加相关。这些发现凸显了进一步研究以探索这两种疾病发病机制中共同途径的必要性。必须认识到，子宫内膜异位症女性患黑色素瘤风险的绝对增加仍然较低，在为女性提供咨询时应考虑到这一点。
