促排卵治疗与卵巢癌发生风险关系的系统评价_《中国循证医学杂志》

作者：

何帆 , 甘晓玲 ,  胡丽娜

重庆医科大学附属第二医院妇产科（重庆 400010）;

关键词：

促排卵卵巢癌队列研究病例-对照研究系统评价 Meta分析

DOI：

10.7507/1672-2531.20120176

视频：

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摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的　系统评价促排卵治疗与卵巢癌发生的关系。
方法　采用Cochrane系统评价方法，计算机检索MEDLINE、EMbase、Cochrane Library、CBM和CNKI，检索时限均从建库至2012年2月，纳入关于促排卵治疗与卵巢癌发生风险的队列研究和病例-对照研究。由2名评价者独立选择文献、提取资料、评价质量并交叉核对后，用RevMan 5.0软件进行统计分析，分别计算纳入队列研究的合并相对危险度（RR）及其95%CI以及病例-对照研究的合并优势比（OR）及其95%CI。
结果　共纳入4个队列研究（暴露组23 162例，非暴露组11 472例）和4个病例-对照研究（病例组1 666例，对照组5 889例）。队列研究的Meta分析结果显示，在不孕症患者中运用促排卵治疗不增加卵巢癌的发生风险［RR=1.07，95%CI（0.81，1.42），P=0.63］；病例-对照研究的Meta分析结果显示，促排卵治疗与卵巢癌的发生无关［OR=1.28，95%CI（0.78，2.08），P=0.33］，但当对照组为正常人群时，促排卵治疗导致卵巢交界性肿瘤的发生风险增加［OR=1.71，95%CI（1.05，2.79），P=0.03］。
结论　促排卵治疗不增加卵巢癌的发生风险，但与正常人群相比，可能增加卵巢交界性肿瘤的发生风险。由于纳入研究数量较少，上述结论尚需开展更多高质量研究，尤其是前瞻性队列研究以进一步验证。

引用本文： 何帆,甘晓玲,胡丽娜. 促排卵治疗与卵巢癌发生风险关系的系统评价. 中国循证医学杂志, 2012, 12(9): 1129-1134. doi: 10.7507/1672-2531.20120176 复制

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4.	Mok SC, Kwong J, Welch WR, et al. Etiology and pathogenesis of epithelial ovarian cancer. Dis Markers, 2007, 23(5-6): 367-376.
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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 Ø, 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. 何健荣, 高曦, 任泽舫, 等. 全球女性乳腺癌和卵巢癌最新发病分布特征. 中国肿瘤, 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 Ø, 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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《中国循证医学杂志》

促排卵治疗与卵巢癌发生风险关系的系统评价

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《中国循证医学杂志》

促排卵治疗与卵巢癌发生风险关系的系统评价

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