子宫切除术和卵巢切除术后患甲状腺癌的风险：一项荟萃分析。
The risk of thyroid cancer after hysterectomy and oophorectomy: a meta-analysis.
作者信息
Fu Shenguang, Lu Yiping, Liu Yibo
机构信息
Beijing University of Chinese Medicine, Beijing, China.
Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China.
出版信息
Front Oncol. 2024 Sep 24;14:1446303. doi: 10.3389/fonc.2024.1446303. eCollection 2024.
OBJECTIVES
The purpose of this meta-analysis is to assess whether there is an association between hysterectomy and oophorectomy and risk of primary thyroid cancer.
METHODS
PubMed, Cochrane Library, Embase, and Web of Science were searched for eligible studies published from database inception to May 13, 2024, using medical subject headings (MeSH) and keywords. All statistical analyses were performed using Stata statistical software (version 14.0). If P > 0.1 and I ≤ 50%, a fixed-effects model was adopted. If I > 50% a random-effects model was adopted. The funnel plot and Egger's test were used to evaluate publication bias.
RESULTS
A total of 11 studies explored the association between a history of hysterectomy, oophorectomy and the risk of thyroid cancer. The pooling analysis shows that a history of hysterectomy, oophorectomy is associated with an increased risk of thyroid cancer (HR = 1.597; 95% CI: 1.467-1.738; I = 57.1%, P = 0.01 < 0.1). In the subgroup analysis, a follow-up duration exceeding 20 years is linked to an elevated risk of thyroid cancer (HR = 1.772; 95% CI: 1.301-2.414; I² = 81.70%, P = 0.004 > 0.001). Hysterectomy combined with salpingo-oophorectomy is associated with a higher risk of thyroid cancer incidence (HR = 1.633; 95% CI: 1.449-1.841; I² = 51.10%, P = 0.069 > 0.001). Studies that balanced smoking, alcohol consumption, and history of thyroid disease demonstrated an association between hysterectomy and increased risk of thyroid disease (HR = 1.734; 95% CI: 1.591-1.891; I² = 31.30%, P = 0.225 > 0.001).
CONCLUSIONS
Our meta-analysis reveals a heightened risk of primary thyroid cancer following hysterectomy and oophorectomy. These findings underscore the importance of considering potential cancer risks when determining surgical approaches and implementing preventive measures prior to these procedures.The meta-analysis was conducted in adherence to the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) (1). The protocol was pre-registered on the International Prospective Register of Systematic Reviews (PROSPERO) platform, with the registration number CRD42024546451.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier CRD42024546451.
目的
本荟萃分析旨在评估子宫切除术和卵巢切除术与原发性甲状腺癌风险之间是否存在关联。
方法
使用医学主题词（MeSH）和关键词，在PubMed、Cochrane图书馆、Embase和Web of Science中检索从数据库建立到2024年5月13日发表的符合条件的研究。所有统计分析均使用Stata统计软件（版本14.0）进行。如果P>0.1且I≤50%，则采用固定效应模型。如果I>50%，则采用随机效应模型。采用漏斗图和Egger检验评估发表偏倚。
结果
共有11项研究探讨了子宫切除术、卵巢切除术病史与甲状腺癌风险之间的关联。汇总分析表明，子宫切除术、卵巢切除术病史与甲状腺癌风险增加相关（HR = 1.597；95%CI：1.467 - 1.738；I = 57.1%，P = 0.01<0.1）。在亚组分析中，随访时间超过20年与甲状腺癌风险升高相关（HR = 1.772；95%CI：1.301 - 2.414；I² = 81.70%，P = 0.004>0.001）。子宫切除术联合输卵管卵巢切除术与甲状腺癌发病率较高相关（HR = 1.633；95%CI：1.449 - 1.841；I² = 51.10%，P = 0.069>0.001）。对吸烟、饮酒和甲状腺疾病史进行均衡处理的研究表明，子宫切除术与甲状腺疾病风险增加之间存在关联（HR = 1.734；95%CI：1.591 - 1.891；I² = 31.30%，P = 0.225>0.001）。
结论
我们的荟萃分析显示，子宫切除术和卵巢切除术后原发性甲状腺癌风险增加。这些发现强调了在确定手术方法和在这些手术前实施预防措施时考虑潜在癌症风险的重要性。本荟萃分析是按照系统评价和荟萃分析的首选报告项目（PRISMA）中概述的指南进行的（参考1）。该方案已在国际前瞻性系统评价注册库（PROSPERO）平台上预先注册，注册号为CRD42024546451。
系统评价注册
https://www.crd.york.ac.uk/PROSPERO/#recordDetails，标识符CRD42024546451 。
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