Capmas Perrine, Suarthana Eva, Tulandi Togas
Department of Obstetrics and Gynecology, McGill University, Montreal, QC, Canada; AP-HP, GHU-Sud, Hospital Bicêtre, Department of Gynecology and Obstetrics, Le Kremlin Bicêtre, France; Faculty of Medicine, University Paris-Sud Saclay, Le Kremlin Bicêtre, France; University Paris-Saclay, UVSQ, INSERM, CESP Centre of Research in Epidemiology and Population Health, Villejuif, France.
Department of Obstetrics and Gynecology, McGill University, Montreal, QC, Canada.
Eur J Obstet Gynecol Reprod Biol. 2021 May;260:105-109. doi: 10.1016/j.ejogrb.2021.02.022. Epub 2021 Feb 24.
To evaluate associations between endometriosis and tubal and ovarian cancers in a large population-based study.
The Health Care Cost and Utilization Project - National Inpatient Sample databases from 2005 to 2014 were used in this study. Data on patients with a diagnosis of tubal or ovarian cancer and endometriosis (overall and subtypes including adenomyosis and pelvic endometriosis) using International Classification of Diseases, Ninth Edition, Clinical Modification codes were extracted. Logistic regression analysis was performed to evaluate associations between tubal and ovarian cancers and endometriosis. Adjustment was made for age, race, median income level, payment plan, hospital location and obesity.
Of 38,800,139 women aged >18 years who were hospitalized between 2005 and 2014, 271,444 women with adenomyosis and/or pelvic endometriosis, 4289 women with tubal cancer and 133,253 women with ovarian cancer were identified. The rate of tubal cancer was three-fold higher in women with endometriosis compared with women without endometriosis (0.03 % vs 0.01 %). The odds ratio (OR) adjusted for age, race, obesity, income and insurance type was 4.02 [95 % confidence interval (CI) 3.17-5.11; p < 0.01]. The rate of tubal cancer was higher in women with adenomyosis (0.04 % vs 0.01 %; adjusted OR 4.88, 95 % CI 3.66-6.50; p < 0.01) and women with pelvic endometriosis (0.02 % vs 0.01 %; adjusted OR 2.80, 95 % CI 1.84-4.27; p < 0.01) compared with women without these conditions. Similar associations were found between ovarian cancer and pelvic endometriosis and ovarian cancer and adenomyosis.
Both pelvic endometriosis and adenomyosis are strongly associated with tubal and ovarian cancers.
在一项基于大样本人群的研究中评估子宫内膜异位症与输卵管癌和卵巢癌之间的关联。
本研究使用了2005年至2014年的医疗成本和利用项目-国家住院患者样本数据库。使用国际疾病分类第九版临床修订版代码提取了诊断为输卵管癌或卵巢癌以及子宫内膜异位症（总体及包括子宫腺肌病和盆腔子宫内膜异位症在内的亚型）患者的数据。进行逻辑回归分析以评估输卵管癌和卵巢癌与子宫内膜异位症之间的关联。对年龄、种族、收入中位数水平、支付计划、医院位置和肥胖进行了校正。
在2005年至2014年期间住院的38800139名年龄大于18岁的女性中，识别出271444名患有子宫腺肌病和/或盆腔子宫内膜异位症的女性、4289名患有输卵管癌的女性和133253名患有卵巢癌的女性。患有子宫内膜异位症的女性输卵管癌发病率是未患子宫内膜异位症女性的三倍（0.03%对0.01%）。经年龄、种族、肥胖、收入和保险类型校正后的优势比（OR）为4.02[95%置信区间（CI）3.17-5.11；p<0.01]。与未患这些疾病的女性相比，患有子宫腺肌病的女性输卵管癌发病率更高（0.04%对0.01%；校正后OR为4.88，95%CI为3.66-6.50；p<0.01），患有盆腔子宫内膜异位症的女性输卵管癌发病率也更高（0.02%对0.01%；校正后OR为2.80，95%CI为1.84-4.27；p<0.01）。在卵巢癌与盆腔子宫内膜异位症以及卵巢癌与子宫腺肌病之间发现了类似的关联。
盆腔子宫内膜异位症和子宫腺肌病均与输卵管癌和卵巢癌密切相关。
