Johnson Jean-Ellen, Daley Diandra, Tarta Cristi, Stanciu Paul I
Gynaecological Oncology Department, Watford General Hospital, West Hertfordshire Teaching Hospitals NHS Trust, Watford, West Hertfordshire, WD18 0HB, UK.
Department X, 2nd Surgical Clinic, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Oncol Lett. 2023 Mar 8;25(4):168. doi: 10.3892/ol.2023.13754. eCollection 2023 Apr.
While existing literature suggests an association between polycystic ovarian syndrome (PCOS) and endometrial cancer, the sparsity and inconsistency of current evidence indicates a lack of clarity regarding the exact strength of this association. It also remains uncertain whether the degree of risk of disease is affected by confounding factors, such as age and body mass index (BMI). The present meta-analysis is aimed to quantify the risk of endometrial cancer in female subjects with PCOS compared to those without PCOS. PubMed, MEDLINE, EMBASE, Scopus and Cochrane were searched from inception to October 31, 2022, to identify peer-reviewed case-control, cohort and cross-sectional studies that assessed the association between endometrial cancer and PCOS and contained original data. Two researchers independently extracted data and performed quality assessment using the Newcastle-Ottawa criteria. Pooled odds ratios (ORs) were calculated using the random-effect model and inverse variance. The degree of heterogeneity was assessed using I statistics. A total of 10 relevant studies were identified and included in the meta-analysis (comprising 12,248 female patients with PCOS and 54,120 controls). Females with PCOS had a significantly increased odds of developing endometrial cancer as compared to those without PCOS [OR, 4.07; 95% confidence interval (CI), 2.13-7.78; P<0.0001]. When postmenopausal subjects (age, >54 years) were excluded from the meta-analysis, the odds increased further (OR, 5.14; 95% CI, 3.22-8.21; P<0.00001). Patients with PCOS are up to 5 times more likely to develop endometrial cancer compared to those without PCOS. Larger, prospective studies that are well-controlled for confounding factors, such as BMI, are required.
虽然现有文献表明多囊卵巢综合征（PCOS）与子宫内膜癌之间存在关联，但目前证据的稀少和不一致表明，对于这种关联的确切强度尚不清楚。疾病风险程度是否受年龄和体重指数（BMI）等混杂因素影响也仍不确定。本荟萃分析旨在量化患有PCOS的女性与未患PCOS的女性相比患子宫内膜癌的风险。检索了PubMed、MEDLINE、EMBASE、Scopus和Cochrane数据库，检索时间从建库至2022年10月31日，以识别评估子宫内膜癌与PCOS之间关联并包含原始数据的经同行评审的病例对照研究、队列研究和横断面研究。两名研究人员独立提取数据，并使用纽卡斯尔-渥太华标准进行质量评估。使用随机效应模型和逆方差计算合并比值比（OR）。使用I统计量评估异质性程度。共识别出10项相关研究并纳入荟萃分析（包括12248例患有PCOS的女性患者和54120例对照）。与未患PCOS的女性相比，患有PCOS的女性患子宫内膜癌的几率显著增加[OR，4.07；95%置信区间（CI），2.13 - 7.78；P<0.0001]。当将绝经后受试者（年龄>54岁）排除在荟萃分析之外时，几率进一步增加（OR，5.14；95%CI，3.22 - 8.21；P<0.00001）。与未患PCOS的患者相比，患有PCOS的患者患子宫内膜癌的可能性高出5倍。需要开展规模更大、对BMI等混杂因素进行良好控制的前瞻性研究。
