University of Pittsburgh Graduate School of Public Health, Department of Epidemiology, Pittsburgh, PA, USA.
Magee-Womens Research Institute and Hillman Cancer Center, Womens Cancer Research Center, Pittsburgh, PA, USA; University of Pittsburgh School of Medicine, Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, Pittsburgh, PA, USA.
Gynecol Oncol. 2022 Jun;165(3):650-663. doi: 10.1016/j.ygyno.2022.04.001. Epub 2022 Apr 23.
To assess the relationship between lifetime ovulatory years (LOY) and Epithelial ovarian cancer (EOC) risk and survival.
A systematic review was performed in accordance with PRISMA guidelines. Relevant studies were identified from PubMed, MEDLINE, and Embase through December 31, 2021 combining the following search: [("ovulation" or "ovulation cycles" or "ovulatory age" or "ovulatory cycles") and ("ovarian cancer" or "ovarian neoplasms") and ("humans" and "female")]. Reference lists of identified articles were searched for additional studies. Studies were excluded from consideration if they were not a published, peer-review article; not in English; lacked data on effect sizes; had data included in another publication; or were a review article, cross-sectional study, or case report. Two independent investigators screened abstracts and full texts for eligibility, extracted study-level data, and assigned study quality. Disagreements between abstractors were discussed and resolved by consensus.
Thirty-one reports were included in the qualitative review of LOY and EOC risk, inclusive of 24 studies with sufficient data to be included in the meta-analysis. Women with the highest level of LOY had 2.26 times higher odds of EOC than women with the lowest level of LOY (95% CI 1.94-2.83). LOY was associated with risk of serous (pooled OR 2.31, 95% CI 1.60-3.33) and endometrioid tumors (pooled OR 3.05, 95% CI 2.08-4.45) but not mucinous disease (pooled OR 1.52, 95% CI 0.87-2.64). There were only four studies examining the LOY-survival association, which precluded a quantitative assessment; however, three of the published studies reported worse outcome with greater LOY.
LOY is a risk factor for specific EOC histotypes and may also influences EOC survival. Standard definitions of LOY, participant-level data, and larger sample size will enable more precise quantitation of the LOY-EOC association, which can inform EOC risk assessment models.
评估一生中排卵年数（LOY）与上皮性卵巢癌（EOC）风险和生存之间的关系。
按照 PRISMA 指南进行系统评价。通过结合以下搜索，从 PubMed、MEDLINE 和 Embase 中检索到相关研究，截止到 2021 年 12 月 31 日：[（“排卵”或“排卵周期”或“排卵年龄”或“排卵周期”）和（“卵巢癌”或“卵巢肿瘤”）和（“人类”和“女性”）]。还对已确定文章的参考文献进行了搜索，以查找其他研究。如果文章不是已发表的同行评审文章；不是英文的；没有关于效应大小的数据；数据包含在另一篇出版物中；或者是评论文章、横断面研究或病例报告，则将其排除在考虑范围之外。两名独立调查员筛选摘要和全文以确定合格性，提取研究级别的数据，并评估研究质量。摘要员之间的分歧通过讨论和达成共识来解决。
在对 LOY 和 EOC 风险的定性综述中，包括 24 项具有足够数据可纳入荟萃分析的研究，共纳入 31 项报告。一生中 LOY 水平最高的女性患 EOC 的可能性是 LOY 水平最低的女性的 2.26 倍（95%CI 1.94-2.83）。LOY 与浆液性（汇总 OR 2.31，95%CI 1.60-3.33）和子宫内膜样肿瘤（汇总 OR 3.05，95%CI 2.08-4.45）的风险相关，但与黏液性疾病无关（汇总 OR 1.52，95%CI 0.87-2.64）。仅有四项研究检查了 LOY-生存关联，因此无法进行定量评估；然而，已发表的三项研究报告称，LOY 较高的患者预后较差。
LOY 是特定 EOC 组织学类型的危险因素，并且可能也会影响 EOC 的生存。标准化的 LOY 定义、参与者水平的数据和更大的样本量将能够更精确地量化 LOY-EOC 关联，这可以为 EOC 风险评估模型提供信息。
