Association between endometriosis and risk of histological subtypes of ovarian cancer: a pooled analysis of case-control studies

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• 作者：Dr Celeste Leigh Pearce ; PhD^a ; ^{cpearce@usc.edu} ; Claire Templeman ; MD^b ; Prof Mary Anne Rossing ; PhD^c ; Alice Lee ; MPH^a ; Aimee M Near ; MPH^d ; Penelope M Webb ; PhD^e ; Christina M Nagle ; PhD^e ; Jennifer A Doherty ; PhD^c ; Kara L Cushing-Haugen ; MS^c ; Kristine G Wicklund ; PhD^c ; Prof Jenny Chang-Claude ; PhD^f ; Rebecca Hein ; PhD^f ; ^g ; Galina Lurie ; PhD^h ; Lynne R Wilkens ; DrPH^h ; Michael E Carney ; MD^h ; Prof Marc T Goodman ; PhD^h ; Prof Kirsten Moysich ; PhDⁱ ; Prof Susanne K Kjaer ; MD^j ; ^k ; Estrid Hogdall ; PhD^j ; Allan Jensen ; PhD^j ; Ellen L Goode ; PhD^l ; Brooke L Fridley ; PhD^l ; Melissa C Larson ; MS^l ; Prof Joellen M Schildkraut ; PhD^m ; Rachel T Palmieri ; MSPH^o ; Prof Daniel W Cramer ; MD^p ; Kathryn L Terry ; ScD^p ; Allison F Vitonis ; SM^p ; Prof Linda J Titus ; PhD^q ; Argyrios Ziogas ; PhD^r ; Wendy Brewster ; PhD^s ; Prof Hoda Anton-Culver ; PhD^r ; Alexandra Gentry-Maharaj ; PhD^t ; Susan J Ramus ; PhD^a ; ^t ; A Rebecca Anderson ; BS^a ; Doerthe Brueggmann ; MD^b ; ^u ; Peter A Fasching ; MD^v ; ^w ; Prof Simon A Gayther ; PhD^a ; ^t ; Prof David G Huntsman ; MD^x ; Prof Usha Menon ; MD^t ; Prof Roberta B Ness ; MD^y ; Prof Malcolm C Pike ; PhD^a ; ^z ; Prof Harvey Risch ; MD^aa ; Prof Anna H Wu ; PhD^a ; Prof Andrew Berchuck ; MDⁿ ; on behalf of the Ovarian Cancer Association Consortium
• 刊名：Lancet Oncology
• 出版年：2012
• 期刊代码：184_14702045
• 类别：med
• 出版时间：April, 2012
• 卷：13
• 期：4
• 页码：385-394
• 文件大小：200 K

摘要

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Summary

Background

Endometriosis is a risk factor for epithelial ovarian cancer; however, whether this risk extends to all invasive histological subtypes or borderline tumours is not clear. We undertook an international collaborative study to assess the association between endometriosis and histological subtypes of ovarian cancer.

Methods

Data from 13 ovarian cancer case-control studies, which were part of the Ovarian Cancer Association Consortium, were pooled and logistic regression analyses were undertaken to assess the association between self-reported endometriosis and risk of ovarian cancer. Analyses of invasive cases were done with respect to histological subtypes, grade, and stage, and analyses of borderline tumours by histological subtype. Age, ethnic origin, study site, parity, and duration of oral contraceptive use were included in all analytical models.

Findings

13鈥?26 controls and 7911 women with invasive ovarian cancer were included in this analysis. 818 and 738, respectively, reported a history of endometriosis. 1907 women with borderline ovarian cancer were also included in the analysis, and 168 of these reported a history of endometriosis. Self-reported endometriosis was associated with a significantly increased risk of clear-cell (136 [20路2%] of 674 cases vs 818 [6路2%] of 13鈥?26 controls, odds ratio 3路05, 95%CI 2路43-3路84, p<0路0001), low-grade serous (31 [9路2%] of 336 cases, 2路11, 1路39-3路20, p<0路0001), and endometrioid invasive ovarian cancers (169 [13路9%] of 1220 cases, 2路04, 1路67-2路48, p<0路0001). No association was noted between endometriosis and risk of mucinous (31 [6路0%] of 516 cases, 1路02, 0路69-1路50, p=0路93) or high-grade serous invasive ovarian cancer (261 [7路1%] of 3659 cases, 1路13, 0路97-1路32, p=0路13), or borderline tumours of either subtype (serous 103 [9路0%] of 1140 cases, 1路20, 0路95-1路52, p=0路12, and mucinous 65 [8路5%] of 767 cases, 1路12, 0路84-1路48, p=0路45).

Interpretation

Clinicians should be aware of the increased risk of specific subtypes of ovarian cancer in women with endometriosis. Future efforts should focus on understanding the mechanisms that might lead to malignant transformation of endometriosis so as to help identify subsets of women at increased risk of ovarian cancer.

Funding

Ovarian Cancer Research Fund, National Institutes of Health, California Cancer Research Program, California Department of Health Services, Lon V Smith Foundation, European Community's Seventh Framework Programme, German Federal Ministry of Education and Research of Germany, Programme of Clinical Biomedical Research, German Cancer Research Centre, Eve Appeal, Oak Foundation, UK National Institute of Health Research, National Health and Medical Research Council of Australia, US Army Medical Research and Materiel Command, Cancer Council Tasmania, Cancer Foundation of Western Australia, Mermaid 1, Danish Cancer Society, and Roswell Park Alliance Foundation.