■随着激素替代疗法(HRT)的使用增加,有必要了解其对女性恶性肿瘤发生的影响。本系统评价和荟萃分析旨在评估与HRT相关的卵巢癌风险及其相关危险因素。
■PUBMED,OVID,Embase,科克伦,和WebofScience从1980年到2022年4月进行搜索,以确定有关卵巢癌和激素替代疗法风险的研究。随机效应模型用于估计卵巢癌中HRT的合并风险,在队列研究和病例对照研究中。此外,该分析检查了与不同类型的雌激素+孕激素方案相关的结局.采用Meta回归和敏感性分析评价异质性。
■分析了21项队列研究(涉及15,313例和4,564,785名参与者)和30项病例对照研究(包括18,738例和57,747名对照)。来自队列研究的HRT使用者的卵巢癌合并风险为1.20(95%置信区间[CI]1.01-1.44),来自病例对照研究的1.13(95CI1.04-1.22)。然而,在将研究时间限制在最近几十年之后,在2010年之后进行的队列研究和2006年之后进行的病例对照研究中,表明较高风险的显著结果消失了.此外,持续使用雌激素-孕激素替代治疗(EPRT)的风险与序贯使用的风险相当.亚组分析显示,雌激素替代治疗(ERT)和EPRT均存在较小的风险;随着暴露时间的延长,风险进一步增加。特别是超过10年的持续时间。此外,浆液性卵巢癌似乎比其他病理类型更易感。
■随着时间的推移,与HRT相关的卵巢癌风险一直在降低。然而,ERT可能会增加这种风险,特别是长时间使用时。建议长期用户考虑将连续EPRT作为更安全的替代方案。
■www.crd.约克。AC.英国/普华永道/,标识符CRD42022321279。
UNASSIGNED: With the increasing use of hormone replacement therapy (HRT), there is a need to understand its impact on the occurrence of female malignant tumors. This systematic
review and meta-analysis aimed to assess the risk of ovarian cancer associated with HRT and its related risk factors.
UNASSIGNED: PUBMED, OVID, Embase, Cochrane, and Web of Science were searched from 1980 to April 2022 to identify studies on the risk of ovarian cancer and hormone replacement therapy. The random-effects model was used to estimate the pooled risk of HRT in ovarian cancer, both in cohort studies and case-control studies. Additionally, the analysis examined the outcomes associated with different types of estrogen plus progesterone regimens. Meta-regression and sensitive analysis were performed to evaluate the heterogeneity.
UNASSIGNED: 21 cohort studies (involving 15,313 cases and 4,564,785 participants) and 30 case-control studies (including 18,738 cases and 57,747 controls) were analyzed. The pooled risks of ovarian cancer for HRT users were 1.20 (95% confidence interval [CI] 1.01-1.44) from cohort studies and 1.13 (95%CI 1.04-1.22) from case-control studies. However, after restricting the study period to recent decades, the significant results indicating a higher risk disappeared in cohort studies conducted after 2010 and in case-control studies conducted after 2006. Furthermore, the continuous use of estrogen-progesterone replacement therapy (EPRT) was associated with a risk comparable to that of sequential use. Subgroup analysis showed that both estrogen replacement treatment (ERT) and EPRT had minor risks; The risk further increased with prolonged exposure time, particularly for durations exceeding 10 years. Additionally, serous ovarian cancer appeared to be more susceptible than other pathological types.
UNASSIGNED: The risk of ovarian cancer associated with HRT has been decreasing over time. However, ERT may increase this risk, particularly when used for an extended period. It is recommended that long-time users consider continuous EPRT as a safer alternative.
UNASSIGNED: www.crd.york.ac.uk/prospero/, identifier CRD42022321279.