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母乳喂养对 BRCA1 和 BRCA2 基因突变携带者卵巢癌的预防作用:系统评价和荟萃分析。

The preventive effect of breastfeeding against ovarian cancer in BRCA1 and BRCA2 mutation carriers: A systematic review and meta-analysis.

机构信息

Department of Obstetrics and Gynecology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea.

Biostatistics Collaboration Team, Research Core Center, National Cancer Center, Goyang, Republic of Korea; Department of Statistics and Data Science, College of Commerce and Economics, Yonsei University, Seoul, Republic of Korea.

出版信息

Gynecol Oncol. 2021 Oct;163(1):142-147. doi: 10.1016/j.ygyno.2021.07.028. Epub 2021 Jul 23.

Abstract

OBJECTIVE

A recent study showed that even a few months of breastfeeding is associated with a significant decrease in the risk of ovarian cancer in the general population. This study aimed to perform a systematic review and meta-analysis to determine the significance of the length of the breastfeeding period on ovarian cancer risk in BRCA1/2 mutation carriers.

METHODS

PubMed, EMBASE, and Cochrane databases were searched up to June 1, 2021. We included case-control and cohort studies that contained information on breastfeeding and the risk of ovarian cancer in BRCA1/2 mutation carriers. Odds ratios (OR) were meta-analytically pooled using a fixed-effects model.dd RESULTS: Five studies, including one cohort study and four case-control studies, were included in this meta-analysis. Of the 14,601 BRCA1/2 mutation carriers, the overall pooled OR of ever having performed breastfeeding in patients who had ovarian cancer was 0.767 (95% confidence interval [CI], 0.688-0.856) and 0.817 (95% CI, 0.650-1.028) for patients with BRCA1 and BRCA2 mutation, respectively. Breastfeeding for >1 year acted as a protective factor in both BRCA1 [OR: 0.787 (95% CI, 0.682-0.907)] and BRCA2 [OR: 0.567 (95% CI, 0.400-0.802)] mutation carriers. No significant heterogeneity was present (I2 = 0%), and the funnel plot was also properly distributed, showing no publication bias.

CONCLUSIONS

Breastfeeding is a preventive, modifiable factor for ovarian cancer in BRCA1/2 mutation carriers. Ever having performed breastfeeding was significantly preventive for ovarian cancer in the BRCA1 mutation carriers, however a period of 1 year or more of breastfeeding is required for a reduced ovarian cancer risk in BRCA2 mutation carriers.

摘要

目的

最近的一项研究表明,即使母乳喂养几个月,也与普通人群卵巢癌风险的显著降低有关。本研究旨在进行系统评价和荟萃分析,以确定母乳喂养时间长度对 BRCA1/2 突变携带者卵巢癌风险的意义。

方法

检索了 PubMed、EMBASE 和 Cochrane 数据库,截至 2021 年 6 月 1 日。我们纳入了包含 BRCA1/2 突变携带者母乳喂养与卵巢癌风险信息的病例对照研究和队列研究。使用固定效应模型进行荟萃分析汇总比值比(OR)。

结果

本荟萃分析纳入了 5 项研究,包括 1 项队列研究和 4 项病例对照研究。在 14601 名 BRCA1/2 突变携带者中,患有卵巢癌的患者中曾进行过母乳喂养的总体汇总 OR 为 0.767(95%置信区间 [CI],0.688-0.856)和 0.817(95% CI,0.650-1.028),分别为 BRCA1 和 BRCA2 突变患者。对于 BRCA1 [OR:0.787(95% CI,0.682-0.907)]和 BRCA2 [OR:0.567(95% CI,0.400-0.802)]突变携带者,母乳喂养 >1 年均为保护因素。无显著异质性(I2=0%),漏斗图也分布合理,表明无发表偏倚。

结论

母乳喂养是 BRCA1/2 突变携带者卵巢癌的一种预防、可改变的因素。曾进行过母乳喂养与 BRCA1 突变携带者的卵巢癌显著预防相关,然而,BRCA2 突变携带者需要 1 年或更长时间的母乳喂养才能降低卵巢癌风险。

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