促排卵治療與卵巢癌發生風險關系的系統評價_《中國循證醫學雜志》

作者：

何帆 , 甘曉玲 ,  胡麗娜

重慶醫科大學附屬第二醫院婦產科（重慶 400010）;

關鍵詞：

促排卵卵巢癌隊列研究病例-對照研究系統評價 Meta分析

DOI：

10.7507/1672-2531.20120176

視頻：

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摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　系統評價促排卵治療與卵巢癌發生的關系。
方法　采用Cochrane系統評價方法，計算機檢索MEDLINE、EMbase、Cochrane Library、CBM和CNKI，檢索時限均從建庫至2012年2月，納入關于促排卵治療與卵巢癌發生風險的隊列研究和病例-對照研究。由2名評價者獨立選擇文獻、提取資料、評價質量并交叉核對后，用RevMan 5.0軟件進行統計分析，分別計算納入隊列研究的合并相對危險度（RR）及其95%CI以及病例-對照研究的合并優勢比（OR）及其95%CI。
結果　共納入4個隊列研究（暴露組23 162例，非暴露組11 472例）和4個病例-對照研究（病例組1 666例，對照組5 889例）。隊列研究的Meta分析結果顯示，在不孕癥患者中運用促排卵治療不增加卵巢癌的發生風險［RR=1.07，95%CI（0.81，1.42），P=0.63］；病例-對照研究的Meta分析結果顯示，促排卵治療與卵巢癌的發生無關［OR=1.28，95%CI（0.78，2.08），P=0.33］，但當對照組為正常人群時，促排卵治療導致卵巢交界性腫瘤的發生風險增加［OR=1.71，95%CI（1.05，2.79），P=0.03］。
結論　促排卵治療不增加卵巢癌的發生風險，但與正常人群相比，可能增加卵巢交界性腫瘤的發生風險。由于納入研究數量較少，上述結論尚需開展更多高質量研究，尤其是前瞻性隊列研究以進一步驗證。

引用本文： 何帆,甘曉玲,胡麗娜. 促排卵治療與卵巢癌發生風險關系的系統評價. 中國循證醫學雜志, 2012, 12(9): 1129-1134. doi: 10.7507/1672-2531.20120176 復制

1.	Hanna L, Adams M. Prevention of ovarian cancer. Best Pract Res Clin Obstet Gynaecol, 2006, 20(2): 339-362.
2.	Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2009. CA Cancer J Clin, 2009, 59(4): 225-249.
3.	何健榮, 高曦, 任澤舫, 等. 全球女性乳腺癌和卵巢癌最新發病分布特征. 中國腫瘤, 2009,18(3): 169-172.
4.	Mok SC, Kwong J, Welch WR, et al. Etiology and pathogenesis of epithelial ovarian cancer. Dis Markers, 2007, 23(5-6): 367-376.
5.	Fathalla MF. Incessant ovulation: a factor in ovarian neoplasia? [Letter]. Lancet, 1971, 298(7716): 163.
6.	Bamford PN, Steele SJ. Uterine and ovarian carcinoma in a patient receiving gonadotrophin therapy: a case report. Br J Obstet Gynecol, 1982, 89(11): 962-964.
7.	Mosher WD, Pratt WF. Fecundity and infertility in the United States: incidence and trends. Fertil Steril, 1991, 56(2): 192-198.
8.	Cetin I, Cozzi V, Antonazzo P. Infertility as a cancer risk factor-a review. Placenta, 2008, 29(Suppl BN): 169-177.
9.	Jensen A, Sharif H, Frederiksen K, et al. Use of fertility drugs and risk of ovarian cancer: Danish population based cohort study. BMJ, 2009, 338: b249.
10.	Venn A, Watson L, Bruinsma F, et al. Risk of cancer after use of fertility drugs with in-vitro fertilisation. Lancet, 1999, 354(9190): 1586-1590.
11.	Potashnik G, Lerner-Geva L, Genkin L, et al. Fertility drugs and the risk of breast and ovarian cancers: results of a long-term follow-up study. Fertil Steril, 1999, 71(5): 853-859.
12.	Modan B, Ron E, Lerner-Geva L, et al. Cancer incidence in a cohort of infertile Women. Am J Epidemiol, 1998, 147(11): 1038-1042.
13.	Cusidó M, Fábregas R, Barris SP, et al. Ovulation induction treatment and risk of borderline ovarian tumors. Gynecol Endocrinol, 2007, 23(7): 373-376.
14.	Rossing MA, Tang MC, Flagg EW, et al. A case-control study of ovarian cancer in relation to infertility and the use of ovulation-inducing drugs. Am J Epidemiol, 2004, 160(11): 1070-1078.
15.	Parazzini F, Pelucchi C, Negri E, et al. Use of fertility drugs and risk of ovarian cancer. Hum Reprod, 2001, 16(7): 1372-1375.
16.	Mosgaard BJ, Lidegaard ?, Kjær SK, et al. Ovarian stimulation and borderline ovarian tumors: a case-control study. Fertil Steril, 1998, 70(6): 1049-1055.
17.	Wells G, Shea B, O’Connell D, et al. NEWCASTLE - OTTAWA QUALITY ASSESSMENT SCALE --COHORT STUDIES. 2010. Available from: URL: http: //www.ohri.ca/programs/clinical_epidemiology/oxford.asp.
18.	Wells G, Shea B, O’Connell D, et al. NEWCASTLE - OTTAWA QUALITY ASSESSMENT SCALE --CASE CONTROL STUDIES. 2010. Available from: URL: http: //www.ohri.ca/programs/clinical_epidemiology/oxford.asp.

1. Hanna L, Adams M. Prevention of ovarian cancer. Best Pract Res Clin Obstet Gynaecol, 2006, 20(2): 339-362.
2. Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2009. CA Cancer J Clin, 2009, 59(4): 225-249.
3. 何健榮, 高曦, 任澤舫, 等. 全球女性乳腺癌和卵巢癌最新發病分布特征. 中國腫瘤, 2009,18(3): 169-172.
4. Mok SC, Kwong J, Welch WR, et al. Etiology and pathogenesis of epithelial ovarian cancer. Dis Markers, 2007, 23(5-6): 367-376.
5. Fathalla MF. Incessant ovulation: a factor in ovarian neoplasia? [Letter]. Lancet, 1971, 298(7716): 163.
6. Bamford PN, Steele SJ. Uterine and ovarian carcinoma in a patient receiving gonadotrophin therapy: a case report. Br J Obstet Gynecol, 1982, 89(11): 962-964.
7. Mosher WD, Pratt WF. Fecundity and infertility in the United States: incidence and trends. Fertil Steril, 1991, 56(2): 192-198.
8. Cetin I, Cozzi V, Antonazzo P. Infertility as a cancer risk factor-a review. Placenta, 2008, 29(Suppl BN): 169-177.
9. Jensen A, Sharif H, Frederiksen K, et al. Use of fertility drugs and risk of ovarian cancer: Danish population based cohort study. BMJ, 2009, 338: b249.
10. Venn A, Watson L, Bruinsma F, et al. Risk of cancer after use of fertility drugs with in-vitro fertilisation. Lancet, 1999, 354(9190): 1586-1590.
11. Potashnik G, Lerner-Geva L, Genkin L, et al. Fertility drugs and the risk of breast and ovarian cancers: results of a long-term follow-up study. Fertil Steril, 1999, 71(5): 853-859.
12. Modan B, Ron E, Lerner-Geva L, et al. Cancer incidence in a cohort of infertile Women. Am J Epidemiol, 1998, 147(11): 1038-1042.
13. Cusidó M, Fábregas R, Barris SP, et al. Ovulation induction treatment and risk of borderline ovarian tumors. Gynecol Endocrinol, 2007, 23(7): 373-376.
14. Rossing MA, Tang MC, Flagg EW, et al. A case-control study of ovarian cancer in relation to infertility and the use of ovulation-inducing drugs. Am J Epidemiol, 2004, 160(11): 1070-1078.
15. Parazzini F, Pelucchi C, Negri E, et al. Use of fertility drugs and risk of ovarian cancer. Hum Reprod, 2001, 16(7): 1372-1375.
16. Mosgaard BJ, Lidegaard ?, Kjær SK, et al. Ovarian stimulation and borderline ovarian tumors: a case-control study. Fertil Steril, 1998, 70(6): 1049-1055.
17. Wells G, Shea B, O’Connell D, et al. NEWCASTLE - OTTAWA QUALITY ASSESSMENT SCALE --COHORT STUDIES. 2010. Available from: URL: http: //www.ohri.ca/programs/clinical_epidemiology/oxford.asp.
18. Wells G, Shea B, O’Connell D, et al. NEWCASTLE - OTTAWA QUALITY ASSESSMENT SCALE --CASE CONTROL STUDIES. 2010. Available from: URL: http: //www.ohri.ca/programs/clinical_epidemiology/oxford.asp.

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促排卵治療與卵巢癌發生風險關系的系統評價

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