山东省上皮性卵巢癌发病因素分析——病例配对研究

A Case-control Study on Etiology of Epithelial Ovarian Cancer in Shandong Province

背景与目的:卵巢癌在妇科恶性肿瘤中列第二位,其死亡率列第一位,尽管研究发现某些因素与卵巢癌发病有关系,但卵巢癌发病病因尚未定论,本课题的目的是研究卵巢癌发病的危险因素,探讨卵巢癌的发病原因。方法:将山东省19所地市以上综合医院住院经病理确诊的307例上皮性卵巢癌患者做为病例组,同时将同期住院的非恶性肿瘤患者307例1∶1配对作为对照组,调查105个因素,资料用条件logistic回归单因素和多因素分析方法进行统计学处理。结果:单因素分析结果筛选出25个因素:接受过学校教育、经济状况好、排卵年延长、长时间放置宫内节育器(intrauterinedevice,IUD)、多食肉类、甜食、脂肪、大便不规律、便秘、接触有害物质、精神抑郁、焦虑、精神紧张、性格急噪、精神创伤、一级亲属卵巢癌家族史阳性是卵巢癌发病危险因素。然而,未接受过学校教育、月经周期延长、婚后至首次妊娠间隔时间长、孕次增加、哺乳时间延长、产后停经时间延长、子宫或/和一侧卵巢切除、多食蔬菜水果、性格温和是降低卵巢癌发病危险的因素。多因素logistic回归分析显示月经周期延长、孕次多、多食蔬菜水果、和性格温和是保护因素,而使用IUD时间长、多食肉类和精神创伤是卵巢癌发病的危险因素。结论:卵巢癌的发病并非由单一因素所致,而是多因素参与卵巢癌的发生发展过程。

BACKGROUND ＆ OBJECTIVE： Among gynecologic malignant tumors, Ovarian cancer has the second highest incidence and is the leading cause of death. Some factors are related to the genesis of ovarian cancer, but the etiology is still unclear, This study was to explore the risk factors and pathogenesis of ovarian cancer. METHODS： A total of 307 women with epithelial ovarian cancer and 307 matched women with other benign diseases, treated simultaneously in 19 hospitals in Shandong Province, were enrolled. Conditional univariate and multivariate logistic regression models were used to analyze 105 factors. RESULTS： Univariate logistic regression analysis revealed the risk factors for developing ovarian cancer included higher education, higher income, increased years of ovulation, prolonged period of intrauterine device （IUD） placement, high fat, sweet and meat diet, irregular defecation, constipation, occupation contacting harmful substance, depressed, anxious, impatient, or stressed mood, spirit stimulation, and family history of ovarian cancer in first-degree relatives; the protective factors for preventing ovarian cancer included lower education, prolonged menstrual cycle, prolonged interval between marriage and pregnancy, multiple pregnancies, prolonged lactation, prolonged interval between delivery and recovery of menstruation, hysterectomy, high vegetable and fruits diet, and mild temper. Multivariate logistic regression analysis showed that prolonged menstrual cycle, multiple pregnancies, high vegetable and fruits diet, and mild temper were protective factors, while prolonged period of IUD placement, high meat diet, and spirit stimulation were high-risk factors. CONCLUSION： The etiology of ovarian cancer involves interaction of many factors rather than any single factor.