乳腺癌术后并发妇科生殖道恶性肿瘤的高危因素分析

doi:10.3969/j.issn.1006-7795.2017.01.019

首都医科大学学报 ›› 2017, Vol. 38 ›› Issue (1): 92-96.doi: 10.3969/j.issn.1006-7795.2017.01.019

乳腺癌术后并发妇科生殖道恶性肿瘤的高危因素分析

刘晨¹, 吴龙¹, 蒋宏传², 李杰², 刘军², 王淑珍¹

1. 首都医科大学附属北京朝阳医院妇产科, 北京 100020;
2. 首都医科大学附属北京朝阳医院乳腺外科, 北京 100020

收稿日期:2016-08-01 出版日期:2017-01-21 发布日期:2017-01-20
通讯作者: 王淑珍 E-mail:shuzhenwangd@163.com
基金资助:
北京市朝阳区科技计划项目（1612）。

Risk factor of second primary gynecological malignancy among women with breast cancer surgery

Liu Chen¹, Wu Long¹, Jiang Hongchuan², Li Jie², Liu Jun², Wang Shuzhen¹

1. Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China;
2. Department of Breast Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China

Received:2016-08-01 Online:2017-01-21 Published:2017-01-20
Supported by:
This study was supported by Social Development Planning of Chaoyang District of Beijing(1612).

摘要/Abstract

摘要： 目的探讨乳腺癌术后并发妇科恶性肿瘤病人的高危因素。方法对首都医科大学附属北京朝阳医院收治的乳腺癌术后并发妇科恶性肿瘤病人进行随访，按照病例组：对照组=1：4的比例选取未并发妇科恶性肿瘤的乳腺癌病人作为对照组，收集病人乳腺癌相关资料、月经生育相关资料、肿瘤家族史等资料，采用SPSS18.0统计软件进行数据统计，单因素分析采用χ²检验，多因素分析采用非条件Logistic回归。结果乳腺癌并发的妇科恶性肿瘤包括子宫内膜癌及卵巢癌。单因素分析显示，初潮年龄（OR=6.5，95%CI：2.37~27.81）、一级亲属肿瘤家族史（OR=3.57，95%CI：1.27~10.06）、乳腺或妇科恶性肿瘤家族史（OR=5.13，95%CI：1.47~17.92）、合并糖尿病（OR=2.12，95%CI：1.32~12.70）是乳腺癌并发妇科恶性肿瘤的高危因素。术后内分泌治疗（OR=0.29，95%CI：0.11~0.78）、术后定期妇科检查（OR=0.33，95%CI：0.12~0.86）降低乳腺癌并发妇科恶性肿瘤的危险。多因素分析显示，乳腺或妇科恶性肿瘤家族史（P=0.003，OR=5.951）、初潮年龄早（P=0.000，OR=9.909）、患有糖尿病（P=0.010，OR=9.842）是乳腺癌并发妇科恶性肿瘤的高危因素，乳腺癌术后定期妇科检查（P=0.037，OR=0.268）是其保护性因素。结论肿瘤家族史尤其是乳腺或妇科恶性肿瘤家族史、初潮年龄早、合并糖尿病是乳腺癌术后发生妇科恶性肿瘤的高危因素，术后定期妇科检查是避免并发妇科恶性肿瘤的保护性因素。

关键词: 乳腺癌, 子宫内膜癌, 卵巢癌, 高危因素

Abstract: Objective To investigate the risk factor of second primary gynecological malignancy among women diagnosed with breast cancer.Methods In order to examine these factors in women with breast cancer who develop subsequentgynecological malignancy, a case-control study was performed. All the patients and control cases were enrolled from Beijing Chaoyang Hospital, Capital Medical University with the case vs control ratio of 1:4. Information concerning possible risk factors were extracted from hospital records and compared with matched controls. χ² and multivariate Logistic regression analysis were performed with SPSS18.0 statistical software for data statistics. Results Among the cases followed, 12 cases of ovarian cancer and 12 cases of endometrial cancer were diagnosed. Univariate analysis suggested that factors such as menarche early than 13 years (OR=6.5,95% CI:2.37-27.81), family history of cancer(OR=3.57,95% CI:1.27-10.06),family history of breast and/or gynecological cancer(OR=5.13,95% CI:1.47-17.92),diabetes mellitus(OR=2.12,95% CI:1.32-12.70) were possibly connected with a significantincreased risk of subsequent gynecological malignancy,while endocrine therapy(OR=0.29,95% CI:0.11-0.78), gynecologic examination termly(OR=0.33,95% CI:0.12-0.86) were significantdecreased risk of subsequent gynecological malignancy. Further multivariate Logistic regression analysis showed that heredity of breast and/or gynecological malignancy (P=0.003, OR=5.951), the early menarche age (P=0.000, OR=9.909), diabetes (P=0.010, OR=9.842) are risk factors of the breast cancer subsequent gynecological malignancy. Gynecological examination termly after breast cancer (P=0.037, OR=0.268) was a protective factor.Conclusion Patients of breast cancer with heredity for breast and/or gynecological cancer, early menarche age, suffered from diabetes have a higher risk of subsequent gynecological malignancy.It was recommended that breast cancer surveillance should including gynecologic examination termly which may be a protective factor from subsequent gynecological malignancy.

Key words: breast cancer, endometrial cancer, ovarian cancer, risk factors

中图分类号:

刘晨, 吴龙, 蒋宏传, 李杰, 刘军, 王淑珍. 乳腺癌术后并发妇科生殖道恶性肿瘤的高危因素分析[J]. 首都医科大学学报, 2017, 38(1): 92-96.

Liu Chen, Wu Long, Jiang Hongchuan, Li Jie, Liu Jun, Wang Shuzhen. Risk factor of second primary gynecological malignancy among women with breast cancer surgery[J]. Journal of Capital Medical University, 2017, 38(1): 92-96.

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乳腺癌术后并发妇科生殖道恶性肿瘤的高危因素分析

Risk factor of second primary gynecological malignancy among women with breast cancer surgery

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