Wang Pei, You Xiuxiu, Zeng Xianjing, Peng Qingmei
Xianyang Central Hospital in Shaanxi Province, Department of Gynecology and Obstetrics, Xianyang, Popular Republic of China.
The Affiliated Hospital of Southwest Medical University, Department of Gynecology, Luzhou, Popular Republic of China.
Rev Inst Med Trop Sao Paulo. 2025 Jun 9;67:e34. doi: 10.1590/S1678-9946202567034. eCollection 2025.
Chlamydia trachomatis infection has been implicated as a potential risk factor for ovarian cancer (OC), but evidence remains inconclusive. This study aims to assess the association between C. trachomatis infection and OC risk using a systematic review and meta-analysis. A comprehensive literature search was conducted in PubMed, Embase, Scopus, Web of Science, and SciELO from their inception to October 2024. Observational studies examining the association between C. trachomatis infection and OC risk were included. Pooled odds ratios (ORs) were calculated using random-effects models. Subgroup and sensitivity analyses were performed based on diagnostic methods and control group types, and publication bias was assessed using Egger's test. Out of 3,288 records, 11 studies involving 4,518 participants were included. The overall meta-analysis revealed a non-significant association between C. trachomatis infection and OC risk (OR = 1.30, 95% CI = 0.99-1.70). However, sensitivity analysis excluding two studies demonstrated a significant association (OR = 1.37, 95% CI = 1.16-1.61). Subgroup analysis showed that PCR-diagnosed C. trachomatis infection was significantly associated with an increased risk (OR = 6.64, 95% CI = 1.62-25.71), while serology-based studies yielded non-significant results. Heterogeneity was high (I² = 70.83%), and publication bias was detected (Egger's test p = 0.015). These findings highlight the role of infection chronicity in OC pathogenesis and suggest that diagnostic methodology significantly impacts observed associations. Future research should employ longitudinal designs with serial molecular testing to establish temporality and evaluate whether targeted Chlamydia screening or treatment interventions could mitigate OC risk in high-prevalence populations.
沙眼衣原体感染被认为是卵巢癌（OC）的一个潜在风险因素，但证据仍不确凿。本研究旨在通过系统评价和荟萃分析评估沙眼衣原体感染与OC风险之间的关联。从创刊至2024年10月，在PubMed、Embase、Scopus、Web of Science和SciELO中进行了全面的文献检索。纳入了检验沙眼衣原体感染与OC风险之间关联的观察性研究。使用随机效应模型计算合并比值比（OR）。根据诊断方法和对照组类型进行亚组分析和敏感性分析，并使用Egger检验评估发表偏倚。在3288条记录中，纳入了11项研究，涉及4518名参与者。总体荟萃分析显示，沙眼衣原体感染与OC风险之间无显著关联（OR = 1.30，95%CI = 0.99 - 1.70）。然而，排除两项研究的敏感性分析显示存在显著关联（OR = 1.37，95%CI = 1.16 - 1.61）。亚组分析表明，PCR诊断出的沙眼衣原体感染与风险增加显著相关（OR = 6.64，95%CI = 1.62 - 25.71），而基于血清学的研究结果不显著。异质性较高（I² = 70.83%），且检测到发表偏倚（Egger检验p = 0.015）。这些发现突出了感染慢性在OC发病机制中的作用，并表明诊断方法显著影响观察到的关联。未来的研究应采用具有系列分子检测的纵向设计来确定时间顺序，并评估针对性的衣原体筛查或治疗干预措施是否可以降低高流行人群中的OC风险。
