Department of Ophthalmology, Taipei Ren-Ai Branch, and Department of Education and Research, Taipei City Hospital, Taipei, Taiwan.
Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan.
JNCI Cancer Spectr. 2024 Apr 30;8(3). doi: 10.1093/jncics/pkae027.
Recent studies propose fallopian tubes as the tissue origin for many ovarian epithelial cancers. To further support this paradigm, we assessed whether salpingectomy for treating ectopic pregnancy had a protective effect using the Taiwan Longitudinal National Health Research Database. We identified 316 882 women with surgical treatment for ectopic pregnancy and 3 168 820 age- and index-date-matched controls from 2000 to 2016. In a nested cohort, 91.5% of cases underwent unilateral salpingectomy, suggesting that most surgically managed patients have salpingectomy. Over a follow-up period of 17 years, the ovarian carcinoma incidence was 0.0069 (95% confidence interval [CI] = 0.0060 to 0.0079) and 0.0089 (95% CI = 0.0086 to 0.0092) in the ectopic pregnancy and the control groups, respectively (P < .001). After adjusting the events to per 100 person-years, the hazard ratio (HR) in the ectopic pregnancy group was 0.70 (95% CI = 0.61 to 0.80). The risk reduction occurred only in epithelial ovarian cancer (HR = 0.73, 95% CI = 0.63 to 0.86) and not in non-epithelial subtypes. These findings show a decrease in ovarian carcinoma incidence after salpingectomy for treating ectopic pregnancy.
最近的研究提出输卵管是许多卵巢上皮性癌的组织起源。为了进一步支持这一观点，我们利用台湾纵向国家健康研究数据库评估了输卵管切除术治疗异位妊娠是否具有保护作用。我们从 2000 年至 2016 年确定了 316882 名接受异位妊娠手术治疗的女性和 3168820 名年龄和指数日期匹配的对照者。在嵌套队列中，91.5%的病例接受了单侧输卵管切除术，这表明大多数接受手术治疗的患者都进行了输卵管切除术。在 17 年的随访期间，异位妊娠组和对照组的卵巢癌发病率分别为 0.0069（95%置信区间[CI] = 0.0060 至 0.0079）和 0.0089（95%CI = 0.0086 至 0.0092）（P<.001）。调整每 100 人年的事件后，异位妊娠组的风险比（HR）为 0.70（95%CI = 0.61 至 0.80）。风险降低仅发生在上皮性卵巢癌（HR = 0.73，95%CI = 0.63 至 0.86），而非上皮性亚型则没有。这些发现表明，输卵管切除术治疗异位妊娠后卵巢癌的发病率降低。
