妊娠并发症与子宫内膜癌或卵巢癌发病风险：病例对照研究。
Complications of Pregnancy and the Risk of Developing Endometrial or Ovarian Cancer: A Case-Control Study.
机构信息
School of Medicine, Nanjing Medical University, Nanjing, China.
Department of Obstetrics & Gynaecology, The University of Auckland, Auckland, New Zealand.
出版信息
Front Endocrinol (Lausanne). 2021 Apr 30;12:642928. doi: 10.3389/fendo.2021.642928. eCollection 2021.
BACKGROUND
The association of complications of pregnancy and the risk of developing gynecological cancer is controversial with the limited study. In this study, we investigated the association of preeclampsia, or gestational diabetes mellitus (GDM), or large for gestational age (LGA), or intrauterine growth restriction (IUGR) and the risk of endometrial or ovarian cancer.
METHODS
In this case-control study, 189 women with endometrial cancer and 119 women with ovarian cancer were included. 342 women without gynecological cancers were randomly selected as a control group. Data on the history of pregnancy and age at diagnosis of gynecological cancer as well as the use of intrauterine devices (IUDs) were collected.
RESULTS
Women with a history of preeclampsia or IUGR did not have an increased risk of developing endometrial or ovarian cancer. While women with a history of GDM or with the delivery of LGA infant increased the risk of developing endometrial cancer but not ovarian cancer. The odds of women with a history of GDM or with the delivery of LGA infant developing endometrial cancer was 2.691 (95% CI: 1.548, 4.3635, p=0.0003), or 6.383 (95% CI: 2.812, 13.68, p<0.0001) respectively, compared to the controls. The odds ratio of women who did not use IUDs developing ovarian cancer was 1.606 (95% CI: 1.057, 2.434), compared to the controls. There was no association of age at first birth and developing endometrial or ovarian cancer.
CONCLUSION
Our observational data suggested that GDM and delivery of an LGA infant are associated with an increased risk of endometrial cancer.
背景
妊娠并发症与妇科癌症风险之间的关联存在争议，相关研究有限。本研究旨在探讨子痫前期、妊娠期糖尿病（GDM）、巨大儿（LGA）或宫内生长受限（IUGR）与子宫内膜癌或卵巢癌风险之间的关联。
方法
本病例对照研究纳入了 189 例子宫内膜癌患者和 119 例卵巢癌患者。随机选择 342 例无妇科癌症的女性作为对照组。收集了患者的妊娠史、妇科癌症诊断年龄以及宫内节育器（IUD）使用情况等数据。
结果
患有子痫前期或 IUGR 的女性发生子宫内膜癌或卵巢癌的风险并未增加。而患有 GDM 或分娩 LGA 婴儿的女性发生子宫内膜癌的风险增加，但不增加卵巢癌风险。患有 GDM 或分娩 LGA 婴儿的女性发生子宫内膜癌的风险比对照组分别增加了 2.691 倍（95%CI：1.548，4.3635，p=0.0003）和 6.383 倍（95%CI：2.812，13.68，p<0.0001）。与对照组相比，未使用 IUD 的女性发生卵巢癌的风险比为 1.606（95%CI：1.057，2.434）。初产年龄与子宫内膜癌或卵巢癌发生风险无关联。
结论
本观察性数据提示 GDM 和 LGA 婴儿分娩与子宫内膜癌风险增加相关。
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