盆腔炎与卵巢肿瘤发生风险的Meta分析

Pelvic Inflammatory Disease and Risk of Ovarian Tumor: A Meta-analysis

目的 Meta分析盆腔炎性疾病(pelvic inflammatory disease,PID)与卵巢肿瘤发病风险的相关性。方法采用Cochrane系统评价方法,检索Pub Med、EMbase、Cochrane Library、中国生物医学文献数据库、中国知网和万方数据库的队列研究及病例-对照研究相关文献。采用Rev Man 5.2软件进行统计分析,分别计算纳入队列研究和病例-对照研究的合并优势比(OR)及其95%CI。结果共纳入2个队列研究和8个病例-对照研究。队列研究Meta分析结果显示,PID暴露可增加卵巢肿瘤的发生风险(OR=1.72,95%CI:1.17~2.52,P=0.006);病例-对照研究Meta分析结果显示,PID暴露史并未明显增加卵巢肿瘤的发生风险(OR=1.07,95%CI:0.86~1.33,P=0.55)。但有2个研究发现复发性PID可增加卵巢肿瘤的发病风险。结论队列研究与病例-对照研究的Meta分析结论相矛盾;但有关复发性PID的研究均提示随着PID暴露次数增多卵巢癌的风险也随之增加。鉴于病例-对照研究自身缺陷及队列研究较少,尚需开展更多高质量的前瞻性研究以进一步验证上述结果,尤其是有关复发性或慢性PID与卵巢肿瘤的风险关系。

Objective To systematically assess the relationship between pelvic inflammatory disease(PID) and the risk of ovarian tumor.Methods We searched the cohort or case-control studies in Pub Med, EMbase, The Cochrane Library, CBM, CNKI and WANFANG(from inception to Oct, 2013). Meta-analysis was performed by Rev Man 5.2 software, to assess OR and 95%CI of involved cohort and case-control studies. Results Two cohort studies and eight case-control studies were included. Meta-analysis on cohort studies showed PID could increase the risk of ovarian tumor(OR=1.72, 95%CI:1.17-2.52, P=0.006).Besides, Metaanalysis of case-control studies showed PID was not associated with the incidence of ovarian tumor(OR=1.07, 95%CI :0.86-1.33, P=0.55). However, two studies found that recurrent PID could increase the risk of ovarian cancer. Conclusion Meta-analysis of cohort studies and case-control studies are inconsistent. However, the risk of ovarian tumor is increased with PID exposure. Because of the limited quantity of case-control studies and too few cohort studies, it needs to develop more high-quality prospective studies to further validate these results, especially about the risk relationship between recurrent or chronic PID and ovarian tumor.