Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, 2100 Copenhagen, Denmark.
Statistics and Data Analysis, Danish Cancer Society Research Center, 2100 Copenhagen, Denmark.
Gynecol Oncol. 2021 May;161(2):553-558. doi: 10.1016/j.ygyno.2021.02.010. Epub 2021 Feb 17.
To examine risk factors for Type I and Type II endometrial cancer (EC) and to directly compare the influence of risk factors for Type II with Type I tumors. Furthermore, to examine whether risk factors for high-grade Type I and Type II tumors differed from low-grade Type I tumors.
Women with EC diagnosed during 2000-2016 were identified in the Danish Cancer Registry. A case-control analysis was conducted with 1:15 random population controls matched on age and gender. Using conditional logistic regression, odds ratios and 95% confidence intervals on risk factors for Type I and II tumors were estimated. In case-case analyses, risk factors were evaluated in a direct comparison of cases grouped by tumor type and grade.
We identified 6958 women with Type I EC and 1206 women with Type II EC. In the case-control analysis, nulliparity and diabetes were associated with increased risk of both tumor types, whereas hormone replacement therapy only increased the risk of Type I EC. When directly comparing Type I and II tumors, the influence of BMI ≥ 30, current smoking, and parity ≥ 3 was strongest for Type I EC. The associations for the majority of risk factors were similar for Type II and high-grade Type I tumors compared with low-grade Type II tumors.
Risk factors for Type I and II tumors were overlapping suggesting that Type II tumors may be less estrogen-independent than previously anticipated. High-grade Type I tumors seemed to resemble Type II tumors more than low-grade Type I tumors.
探讨Ⅰ型和Ⅱ型子宫内膜癌（EC）的危险因素，并直接比较Ⅱ型肿瘤危险因素的影响。此外，还研究了高级别Ⅰ型和Ⅱ型肿瘤的危险因素是否与低级别Ⅰ型肿瘤的危险因素不同。
在丹麦癌症登记处确定了 2000 年至 2016 年间诊断为 EC 的女性。采用病例对照分析，按年龄和性别 1:15 随机匹配人群对照。采用条件逻辑回归，估计Ⅰ型和Ⅱ型肿瘤危险因素的比值比和 95%置信区间。在病例对照分析中，通过按肿瘤类型和分级分组的病例直接比较来评估危险因素。
我们确定了 6958 名Ⅰ型 EC 女性和 1206 名Ⅱ型 EC 女性。在病例对照分析中，未婚和糖尿病与两种肿瘤类型的风险增加相关，而激素替代疗法仅增加了Ⅰ型 EC 的风险。当直接比较Ⅰ型和Ⅱ型肿瘤时，对于Ⅰ型 EC，BMI≥30、当前吸烟和产次≥3 的影响最大。与低级别Ⅱ型肿瘤相比，大多数危险因素与Ⅱ型和高级别Ⅰ型肿瘤的关联相似。
Ⅰ型和Ⅱ型肿瘤的危险因素重叠，表明Ⅱ型肿瘤可能不像以前预期的那样与雌激素无关。高级别Ⅰ型肿瘤似乎比低级别Ⅰ型肿瘤更类似于Ⅱ型肿瘤。
