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J Clin Endocrinol Metab:绝经后女性行子宫切除术可增加甲状腺癌的发病风险

2016-07-31 MedSci MedSci原创

已知雌激素是甲状腺癌发病的一个危险因素。本研究旨在子宫切除术、双侧输卵管卵巢切除术(BSO)与甲状腺癌发病率之间的关联。 采用前瞻性队列研究,纳入美国40个临床中心的127566名参与女性健康计划(1993-1998年)的研究对象,年龄在50-79岁。 主要研究结果为子宫切除术和BSO,使用医疗记录审查证实甲状腺癌病例。 结果,平均随访14.4年后,共发生了344例甲状腺癌病例。

已知雌激素是甲状腺癌发病的一个危险因素。本研究旨在子宫切除术、双侧输卵管卵巢切除术(BSO)与甲状腺癌发病率之间的关联。

采用前瞻性队列研究,纳入美国40个临床中心的127566名参与女性健康计划(1993-1998年)的研究对象,年龄在50-79岁。

主要研究结果为子宫切除术和BSO,使用医疗记录审查证实甲状腺癌病例。

结果,平均随访14.4年后,共发生了344例甲状腺癌病例。与未行子宫切除术的女性相比,行子宫切除术的女性,无论卵巢状态如何,其甲状腺癌的发病风险显著升高(HR = 95% [ 1.46 CI:1.16 - 1.85))。与仅行子宫切除术的女性相比,同时行子宫切除术和BSO并不会降低甲状腺癌的发病风险。仅行子宫切除术的女性中,使用激素治疗与较低的甲状腺癌的发病风险相关(HR = 0.47 [ 95% CI:0.28 - 0.78))。然而,在未行子宫切除术的女性或同时行子宫切除术和BSO的女性中,研究并未发现使用激素治疗与甲状腺癌发病风险之间存在显著关联。

总而言之,此大型前瞻性队列研究发现,绝经后女性无论卵巢状况如何,行子宫切除术与甲状腺癌的发病风险增加相关。此外,该研究结果并不支持这一假设——外源性雌激素是甲状腺癌发生的危险因素,或雌激素剥夺是预防甲状腺癌发生的因素。仍需进一步的研究以明确这些明显的关联是否是由于子宫切除术适应症和甲状腺癌之间享有相同的危险因素。

原始出处:


Luo J, et al. Hysterectomy, oophorectomy and risk of thyroid cancer - See more at: http://press.endocrine.org/doi/abs/10.1210/jc.2016-2011#sthash.LQkvHJpe.dpuf. J Clin Endocrinol Metab. 2016;doi:10.1210/jc.2016-2011.

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    2016-08-31 guojianrong
  4. 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createdBy=9d8a96, createdName=doctorzheng, createdTime=Mon Dec 19 07:52:00 CST 2016, time=2016-12-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1887549, encodeId=323b188e54911, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Wed Aug 31 14:52:00 CST 2016, time=2016-08-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1895934, encodeId=0c3618959344e, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Sun Nov 06 08:52:00 CST 2016, time=2016-11-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=131766, encodeId=eb71131e660b, content=文章很好,非常有益, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Sep 20 22:33:00 CST 2016, time=2016-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=125588, encodeId=cc4412558833, content=搞清楚机制更有意义,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160907/IMG57D00CF1965701770.jpg, createdBy=565c1948251, createdName=舒心和人, createdTime=Tue Sep 13 18:02:00 CST 2016, time=2016-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1257062, encodeId=c175125e062c1, content=<a href='/topic/show?id=cdfce8879b1' target=_blank style='color:#2F92EE;'>#绝经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78879, encryptionId=cdfce8879b1, topicName=绝经)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=yeye5224612, createdTime=Tue Aug 02 04:52:00 CST 2016, time=2016-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1344449, encodeId=f9991344449e8, content=<a href='/topic/show?id=3ea645166c7' target=_blank style='color:#2F92EE;'>#子宫切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45166, encryptionId=3ea645166c7, topicName=子宫切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=05202500204, createdName=minhuang75_72521584, createdTime=Tue Aug 02 04:52:00 CST 2016, time=2016-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1526622, encodeId=8847152662236, content=<a href='/topic/show?id=2fe6e88863a' target=_blank style='color:#2F92EE;'>#绝经后女性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78886, encryptionId=2fe6e88863a, topicName=绝经后女性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Tue Aug 02 04:52:00 CST 2016, time=2016-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1631520, encodeId=4bc816315203b, content=<a href='/topic/show?id=6395e888343' target=_blank style='color:#2F92EE;'>#绝经后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78883, encryptionId=6395e888343, topicName=绝经后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=32b921798518, createdName=zxxiang, createdTime=Tue Aug 02 04:52:00 CST 2016, time=2016-08-02, status=1, ipAttribution=)]
    2016-11-06 一闲
  5. 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style='color:#2F92EE;'>#子宫切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45166, encryptionId=3ea645166c7, topicName=子宫切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=05202500204, createdName=minhuang75_72521584, createdTime=Tue Aug 02 04:52:00 CST 2016, time=2016-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1526622, encodeId=8847152662236, content=<a href='/topic/show?id=2fe6e88863a' target=_blank style='color:#2F92EE;'>#绝经后女性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78886, encryptionId=2fe6e88863a, topicName=绝经后女性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Tue Aug 02 04:52:00 CST 2016, time=2016-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1631520, encodeId=4bc816315203b, content=<a href='/topic/show?id=6395e888343' target=_blank style='color:#2F92EE;'>#绝经后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78883, encryptionId=6395e888343, topicName=绝经后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=32b921798518, createdName=zxxiang, createdTime=Tue Aug 02 04:52:00 CST 2016, time=2016-08-02, status=1, ipAttribution=)]
    2016-09-20 1e10c84am36(暂无匿称)

    文章很好,非常有益

    0

  6. 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style='color:#2F92EE;'>#子宫切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45166, encryptionId=3ea645166c7, topicName=子宫切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=05202500204, createdName=minhuang75_72521584, createdTime=Tue Aug 02 04:52:00 CST 2016, time=2016-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1526622, encodeId=8847152662236, content=<a href='/topic/show?id=2fe6e88863a' target=_blank style='color:#2F92EE;'>#绝经后女性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78886, encryptionId=2fe6e88863a, topicName=绝经后女性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Tue Aug 02 04:52:00 CST 2016, time=2016-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1631520, encodeId=4bc816315203b, content=<a href='/topic/show?id=6395e888343' target=_blank style='color:#2F92EE;'>#绝经后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78883, encryptionId=6395e888343, topicName=绝经后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=32b921798518, createdName=zxxiang, createdTime=Tue Aug 02 04:52:00 CST 2016, time=2016-08-02, status=1, ipAttribution=)]
    2016-09-13 舒心和人

    搞清楚机制更有意义,学习了

    0

  7. 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    2016-08-02 zxxiang

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