研究生殖因素与非上皮性卵巢癌风险之间的关系,并将其与浆液性卵巢癌的关系进行比较。
来自丹麦癌症登记处,我们确定了生殖细胞(n=188)的所有卵巢癌病例(诊断时≥20岁),性索基质(n=116),或浆液(n=4854)组织学在1982-2016年。对于每种情况,通过风险集采样选择15个年龄匹配的女性对照。生殖历史是从全国登记册获得的。使用条件逻辑回归以95%置信区间(CI)估计生殖因素与三种卵巢癌类型之间的关联的比值比(OR)。
与无效性相比,分娩后发生生殖细胞肿瘤的几率增加(OR=1.28,95%CI:0.85-1.93),性索-基质(OR=0.74,95%CI:0.44-1.26)和浆液性肿瘤的几率降低(OR=0.70,95%CI:0.64-0.76).生殖细胞肿瘤(OR=0.63,95%CI:0.23-1.76)的不孕几率降低,性索间质肿瘤(OR=2.20,95%CI:0.89-5.43)和浆液性肿瘤(OR=1.97,95%CI:1.69-2.30)的几率增加。最后,口服避孕药的使用降低了所有三种肿瘤类型的几率(生殖细胞:OR=0.50,95%CI:0.29~0.87;性索基质:OR=0.40,95%CI:0.13~1.22;浆液性:OR=0.50,95%CI:0.40~0.62).
生殖因素同样影响性索基质和浆液性卵巢癌的风险,与产次和使用口服避孕药相关的风险降低。口服避孕药似乎也降低了生殖细胞肿瘤的风险,而均等与风险增加相关。
To examine the association between reproductive factors and risk of non-epithelial ovarian cancer and to compare the associations with those in serous ovarian cancer.
From the Danish Cancer Registry, we identified all ovarian cancer cases (≥20 years old at diagnosis) of germ cell (n = 188), sex cord-stromal (n = 116), or serous (n = 4854) histology during 1982-2016. For each case, 15 age-matched female controls were selected with risk set sampling. Reproductive history was obtained from nationwide registries. Conditional logistic regression was used to estimate odds ratios (ORs) with 95% confidence intervals (CIs) for the association between reproductive factors and the three ovarian cancer types.
Compared with nulliparity, ever giving birth was associated with increased odds for germ cell tumors (OR = 1.28, 95% CI: 0.85-1.93) and decreased odds for sex cord-stromal (OR = 0.74, 95% CI: 0.44-1.26) and serous tumors (OR = 0.70, 95% CI: 0.64-0.76). Infertility decreased odds for germ cell tumors (OR = 0.63, 95% CI: 0.23-1.76) but increased odds for sex cord-stromal tumors (OR = 2.20, 95% CI: 0.89-5.43) and serous tumors (OR = 1.97, 95% CI: 1.69-2.30). Finally, use of oral contraceptives decreased the odds for all three tumor types (germ cell: OR = 0.50, 95% CI: 0.29-0.87; sex cord-stromal: OR = 0.40, 95% CI: 0.13-1.22; serous: OR = 0.50, 95% CI: 0.40-0.62).
Reproductive factors affected the risk of sex cord-stromal and serous ovarian cancer similarly with decreased risk associated with parity and use of oral contraceptives. Oral contraceptives also seemed to decrease the risk of germ cell tumors, whereas parity was associated with increased risk.